What to Expect in a Functional Vision Assessment
- 4 days ago
- 5 min read
Tests, What They Tell Us & How Therapy is Tailored to Your Needs
At In-Sight Vision Therapy, we believe true clarity of vision goes far beyond seeing 20/20 on a chart. Many people may have “normal” acuity yet still struggle with reading, tracking, coordination, or learning tasks because their visual system isn’t working as a coordinated whole. That’s where a Functional Vision Assessment comes in.
This in-depth assessment looks at how your eyes and brain work together in real-world situations: not just how clearly you see, but how efficiently and comfortably your visual system performs the tasks you need every day.
What Is a Functional Vision Assessment?
A Functional Vision Assessment goes beyond a routine eye exam. Rather than focusing only on how clearly someone can see, it looks at how the visual system is working in everyday tasks, such as learning, reading, moving through environments, and interacting with the world.
This type of assessment is particularly important for children with disabilities or developmental differences, as vision difficulties commonly occur alongside many conditions and are often overlooked. A child may pass a standard eye test yet still struggle with visual attention, processing, eye coordination, or visual fatigue.
Functional Vision Assessments are frequently recommended for children with conditions such as:
Cerebral Visual Impairment (CVI)
Neurodivergent conditions like ASD & ADHD
Down syndrome
Developmental delay & Learning difficulties
Genetic disorders or neurological conditions
Ocular disease
In these cases, vision challenges may affect learning, behaviour, mobility, and independence — even when eyesight appears “normal.”
By assessing how a child uses their vision, a Functional Vision Assessment helps identify visual strengths and barriers, and guides appropriate therapy, supports, and strategies tailored to the individual.
The Tests We Conduct — and What They Tell Us
A Functional Vision Assessment involves a combination of structured tests and observational tasks. These are adapted to suit the age, abilities, and communication style of each individual. The aim is not just to gather numbers, but to understand how vision is being used in real-world situations.
Below are some of the key areas we assess, and what each tells us about how vision is functioning.
Visual Acuity (Clarity of Vision)
Visual acuity testing measures how clearly a person can see details at a specific distance. For children or individuals who are unable to name letters or symbols, we use developmentally appropriate methods such as preferential looking tests (e.g. black-and-white striped gratings) and observation of visual responses.
What it tells us: Visual acuity gives us an understanding of the level of visual detail a person can access. Importantly, it does not tell us how well vision is processed or used, which is why it forms only one part of the overall assessment
Eye Alignment & Eye Teaming (Binocular Vision)
We assess how well the eyes are aligned and whether they are working together as a team. This includes observation of eye position, corneal reflections, and cover testing.
What it tells us: These tests help identify misalignment (such as inward or outward turning of an eye), suppression, or reduced use of one eye. Difficulties in this area can affect depth perception, comfort, and visual efficiency during tasks like reading or navigating environments
Eye Movements (Ocular Motility, Tracking & Saccades)
Eye movement testing looks at how smoothly the eyes follow moving objects (tracking) and how accurately they shift from one target to another (saccades).
What it tells us: Reduced eye movement control can impact reading, copying, scanning the environment, and coordination. Many individuals rely on head movements to compensate when eye movements are limited, which can increase fatigue and effort
Visual Response Time (Visual Latency)
Visual latency refers to how long it takes for someone to visually notice and respond to a target after it is presented.
What it tells us: Delayed visual responses are common in individuals with neurological or developmental conditions, including CVI. This helps explain why some children appear to “see sometimes but not others” and why extra processing time is often needed
Contrast Sensitivity
Contrast sensitivity measures how well a person can see objects that do not clearly stand out from their background. This is commonly assessed using graded contrast images.
What it tells us: Reduced contrast sensitivity means a person may struggle to see everyday objects unless they are high-contrast, well-lit, or visually simplified. This directly informs environmental and learning recommendations
Visual Fields (Peripheral Vision)
Visual field testing looks at how much of the surrounding environment can be seen without moving the eyes, including upper, lower, and side vision.
What it tells us: Restricted visual fields can affect mobility, safety, and awareness of people or objects outside central vision. Eye alignment and neurological factors can influence the usable visual field
Visual Attention, Recognition & Visual-Motor Skills
We observe how long visual attention can be maintained, whether objects or people are visually recognised, and how vision supports reaching, movement, and interaction.
What it tells us: These observations provide insight into how vision supports learning, play, communication, and daily function, often explaining challenges that are not captured by standard eye tests
From Assessment to a Tailored Therapy Plan
Once the Functional Vision Assessment is complete, we bring together the results from all areas of testing to create a clear picture of how vision is functioning in everyday life, not just what can be seen, but how vision is being used.
By looking at visual acuity, eye alignment and movements, visual response time, contrast sensitivity, visual fields, and visual attention, we can identify both visual strengths and areas of difficulty. This helps us understand how vision may be impacting learning, play, communication, mobility, and independence.
From here, your Orthoptist develops an individualised therapy plan that is tailored to the person’s age, abilities, goals, and daily visual demands. Therapy activities and strategies are selected to specifically target the visual skills that need support, which may include:
Improving eye coordination and teaming
Developing smoother tracking and more accurate eye movements
Reducing visual response time and fatigue
Strengthening visual attention and processing
Supporting visual-motor coordination and functional use of vision
Assessment findings also guide practical recommendations for the home, learning, or care environment, such as lighting, contrast, positioning, task presentation, and visual pacing, to help reduce visual overload and support success.
Rather than applying a one-size-fits-all approach, this process ensures therapy is meaningful, achievable, and relevant. The goal is to help individuals use their vision more effectively and comfortably in the activities that matter most to them.
Functional vision is about more than seeing clearly, it’s about how vision supports learning, movement, communication, and independence. A Functional Vision Assessment allows us to understand each person’s unique visual profile and provide therapy and strategies that genuinely support their everyday life.
If you’d like to learn more about how our assessments work or book an appointment for your child or yourself, contact us at In-Sight Vision Therapy. We’re here to help you understand not just how you see, but how your vision supports your life.
