Katie is ten, and like everyone in her class is loving the Wimpy Kid books.
At home Katie likes to lie on her bed, and holds the book up in front of her, so she is reading it facing the ceiling.
At school however, for some reason Katie's reading is not so good. She's ok reading for a bit, but then it seems to get more difficult and she doesn't enjoy it as much. When the teacher is with her, Katie is often told she is missing stuff, which doesn't make much sense to her, but it's the teacher, who is kind and knows best, and Katie just apologises and tries harder, not really sure what she is doing wrong, and inevitably makes the same mistakes again.
The teacher wonders if Katie has a mild form of dyslexia, because her reading is very inconsistent, but sometimes excellent.
Maybe she has problems with distractions in class, as sometimes she is fine and works hard, and other times it's like she's been swapped with a different child who is almost illiterate. It just doesn't add up.
If the book in class is one she likes, Katie just re-reads it at home, not sure why, but knowing home is so much easier.
At school, in her class, when reading most of the children place their book on their desk in front of themselves, like this (below):
What no one knows, including Katie, her parents and her teacher, is that Katie has a lower visual field impairment.
Lower visual field impairments vary in severity from person to person, but commonly they entail an absence of vision in the lower visual field, with a reduction in clarity of vision from around the midline down.
So this is what Katie sees (below):
The bottom of the book has gone, it is not less clear, it is not there. And the words towards the bottom of Katie's visual field are less clear - but because she can read the words at the top clearly and well, no one thinks it could be a visual impairment, it must be something else, maybe tiredness, or could it be dyslexia?
In her bedroom, reading facing upwards, Katie has accommodated for her unknown lower visual field impairment by reading facing upwards, and moving the book into her upper visual field, where she sees most clearly. Another way to achieve this is by elevating the book on a desk, for example if like this (below):
Katie would see this (below):
And all the text is nice and clear, in her upper visual field, where Katie sees best.
Occasionally Katie likes to read with the book upside down, so rather than reading down the page (where her vision reduces the further down she goes) she actually is reading up the page, and the next paragraph can be clearly seen.
There are specialist devices to elevate books and papers with multiple settings, called book stands for reading, and many inexpensive products that may also be helpful, including:
Preferring to read upside down is one little clue that Katie has a lower visual field impairment, others, which may be present in other people might include:
For more information see our section: Lower Visual Field Impairments.
Katie is a made-up character, but the challenges described are from real accounts.
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At CVI Scotland we are devoted to helping people understand cerebral visual impairments, and together working towards developing the understanding of this complex condition.