Mannerisms

Visually impaired infants and children may develop repetitive activities to stimulatethemselves. The most common of them are eye pressing, eye poking, waving with hands,rocking, sometimes jumping and even head banging.


101. Eye poking is a social problem because it causesnegative feelings even in individuals who are accustomed to see it. Eye pokingis also dangerous. The child may detach the retina, as did this child who becametotally blind because of the detachment.



102. Eye poking and eye pressing occur in all culturesand is most common in children who have Leber's Amaurosis or retinopathy of prematurity(ROP).



103. Eye poking usually starts as gentle eye pressingwhich may be difficult to diagnose. The parents and other care takers may thinkthat the child is just tired when laying down on the floor pressing on the eyes.(This picture is from Vision in Children.)



104. When children grow up, we may get them understandthat eye poking is an unwanted activity. The child may agree to press on the foreheadwhen having the urge to eye poke. However, eye poking very often happens withoutthe child having any plan to do it and therefore the little fingers get to the eyeeven when protective goggles are used. Keeping the hands very active with differenttasks is the only way of reducing eye poking.



105. Eye pressing causes pressure toward the bony surfacesaround the eye. This leads to atrophy, disappearance, of some of the bone of theorbital rim. The orbits become larger than normal and the rim flatter than normalorbital rims. At the same time fat tissue in the orbit decreases and the eyes becomesunken. These cosmetic problems cannot be corrected and therefore they should beprevented whenever possible.



106. In the side view of the face the changes causedby eye pressure are more clearly visible. The girl to the left had learned to presson her eyes at the age of six months but has not develop changes in the bony structuresof her face because her hands were kept very busy during the first year.


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