Are children with low vision adapted to the visual environment in classrooms of mainstream schools?

Purpose: The study aimed to evaluate the classroom environment of children with low vision and provide recommendations to reduce visual stress, with focus on mainstream schooling. Methods: The medical records of 110 children (5–17 years) seen in low vision clinic during 1 year period (2015) at a tertiary care center in south India were extracted. The visual function levels of children were compared to the details of their classroom environment. The study evaluated and recommended the chalkboard visual task size and viewing distance required for children with mild, moderate, and severe visual impairment (VI). Results: The major causes of low vision based on the site of abnormality and etiology were retinal (80%) and hereditary (67%) conditions, respectively, in children with mild (n = 18), moderate (n = 72), and severe (n = 20) VI. Many of the children (72%) had difficulty in viewing chalkboard and common strategies used for better visibility included copying from friends (47%) and going closer to chalkboard (42%). To view the chalkboard with reduced visual stress, a child with mild VI can be seated at a maximum distance of 4.3 m from the chalkboard, with the minimum size of visual task (height of lowercase letter writing on chalkboard) recommended to be 3 cm. For 3/60–6/60 range, the maximum viewing distance with the visual task size of 4 cm is recommended to be 85 cm to 1.7 m. Conclusion: Simple modifications of the visual task size and seating arrangements can aid children with low vision with better visibility of chalkboard and reduced visual stress to manage in mainstream schools

Fig 2 -

Receiver-operating characteristic curves for a) 30-day mortality and b) 30-day unplanned readmission models.</p

Variables used for model development.

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Flow chart illustrating the phases of model development.

Flow chart illustrating the phases of model development.</p

Gini impurity and SHAP scores for mortality.

a) Gini impurity scores for features included in the 30-day mortality model. Higher values indicate increased effectiveness of features at separating those at risk of 30-day mortality from those not at risk of 30-day mortality. b) A Shapley summary plot. Color indicates feature value (red: High, blue: Low) and position.</p

Performance metrics of all readmission models on the testing set.

Performance metrics of all readmission models on the testing set.</p

Survival curves for subgroups stratified by top predictive features.

(30-day mortality: Physiologic high-risk factors, elective surgery, functional status, HCT, and creatinine, 30-day unplanned readmission: Open wound/wound infection, major reintervention of treated arterial segment, elective surgery, claudication, and diabetes). (TIF)</p

Model performance on demographic subgroups of the test set, demonstrating equivalent performance on race (white and non-white), sex (male and female), and age (under age 65 and 65 and older) groups.

Model performance on demographic subgroups of the test set, demonstrating equivalent performance on race (white and non-white), sex (male and female), and age (under age 65 and 65 and older) groups.</p

CPT codes of cases extracted from the ACS-NSQIP database.

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Performance metrics of all models on the testing set.

Performance metrics of all models on the testing set.</p