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THE VI SUAL COMMUNI CATI ON I N THE OPTONOMETRI C SCALES
1Rosane Ar r uda Dant as2 Lor it a Mar lena Fr eit ag Pagliuca3
Dant as RA, Pagliuca LMF. The v isual com m unicat ion in t he opt onom et r ic scales. Rev Lat ino- am Enfer m agem 2 0 0 6 n ov em br o- dezem br o; 1 4 ( 6 ) : 9 6 8 - 7 1 .
Com m u n icat ion t h r ou gh v ision in v olv es v isu al appr en t icesh ip t h at dem an ds ocu lar in t egr it y , w h ich r esult s in t he im por t ance of t he ev aluat ion of v isual acuit y . The scale of im ages, for m ed by opt ot y pes, is a m et hod for t he verificat ion of visual acuit y in kindergart en children. To ident ify t he opt ot ype t he child needs t o know t he im age in analy sis. Giv en t he im por t ance of v isual com m unicat ion dur ing t he pr ocess of const r uct ion of t he scale of im ages, one present s a bibliographic, analyt ical st udy aim ing at t hinking about t he principles for t he const r uct ion of t hose t ables. One consider s t he dr aw inser t ed as an opt ot y pe as a non- v er bal sy m bolic ex pr ession of t h e body an d/ or of t h e en v ir on m en t con st r u ct ed based on t h e capt ion of ex per ien ces by t h e indiv idual. One cont est s t he indiscr im inat e use of im ages, for one under st ands t hat t her e m ust be pr ev ious knowledge. Despit e t he subj ect ivit y of t he opt ot ypes, t he scales cont inue valid if one adapt s im ages t o t hose of t he univer se of t he childr en t o be ex am ined.
DESCRI PTORS: com m unicat ion; ocular healt h; v ision t est s - m et hods
LA COMUNI CACI ÓN VI SUAL EN LAS ESCALAS OPTOMÉTRI CAS
La com u n icación qu e ocu r r e a t r av és de la v isión abar ca el apr en dizaj e v isu al qu e depen de de la int egridad ocular, por eso es relevant e la evaluación de su acuidad. La escala de figuras, form ada por opt ot ipos, es u n m ét odo u sado par a v er if icar la acu idad v isu al en pr eescolar es. Par a iden t if icar el opt o- t ipo, el n iñ o necesit a conocer la figura en análisis. Debido a la im port ancia de la com unicación visual durant e el proceso de const r ucción de las escalas de figur as, se pr esent a un est udio bibliogr áfico analít ico, cuy o obj et iv o es el de r eflexionar sobr e los pr incipios de const r ucción de est as t ablas. El dibuj o inser ido com o opt o- t ipo se consider a una ex pr esión no v er bal del cuer po y / o del am bient e, const r uido m ediant e capt ación de ex per iencias por el in d iv id u o. Se cu est ion a el u so in d iscr im in ad o d e las f ig u r as, p u es con f or m e se en t ien d e d eb e ex ist ir u n con ocim ien t o pr ev io de las m ism as. A pesar de la su bj et iv idad de los opt ot ipos, las escalas sigu en sien do v álidas, siem pr e que se adecuen las figur as o sea aquellas del univ er so de los niños que ser án ex am inados.
DESCRI PTORES: com unicación; salud ocular ; pr uebas de v isión - m et odos
A COMUNI CAÇÃO VI SUAL NAS ESCALAS OPTOMÉTRI CAS
A com unicação que ocorre por m eio da visão envolve o aprendizado visual, que depende da int egridade ocular ; daí a r elevância da avaliação da sua acuidade. Um dos m ét odos par a a ver ificação da acuidade visual em pr é- escolar es é a escala de figur as, for m ada por opt ót ipos. Par a ident ificar o opt ót ipo, a cr iança pr ecisa conhecer a figur a em análise. Dada a im por t ância da com unicação v isual, dur ant e o pr ocesso de const r ução das escalas de figur as, apr esent a- se um est udo bibliogr áfico analít ico, obj et iv ando r eflet ir sobr e os pr incípios de const r ução dessas t abelas. Consider a- se o desenho inser ido com o opt ót ipo um a ex pr essão sim bólica não-v er bal do cor po e/ ou do am bient e, const r uído m ediant e capt ação de ex per iências pelo indinão-v íduo. Cont est a- se o uso indiscr im inado das figur as, pois, confor m e se ent ende, dev e hav er um conhecim ent o pr év io. Apesar da su b j et iv id ad e d os op t ót ip os, as escalas con t in u am v álid as, d esd e q u e se ad eq u em as f ig u r as àq u elas d o u n iv er so das cr ian ças a ser em ex am in adas.
DESCRI TORES: com unicação; saúde ocular ; t est es v isuais - m ét odos
1
Paper ext ract ed from t he Mast er ’s Thesis, Proj ect funded by CNPq/ CAPES; 2 RN, Doct oral St udent , Subst it ut e Professor, e- m ail: rosane_dant [email protected] ;
3
RN, Full Professor, Coordinat or of t he Ocular Healt h Proj ect / CNPq, e- m ail: [email protected]. Ceará Federal Universit y.
Rev Lat ino- am Enferm agem 2006 novem bro- dezem bro; 14( 6) : 968- 71 w w w .eer p.usp.br / r lae
Com unicações Breves/ Relat o de Casos
969
I NTRODUCTI ON
A
t pr eschool age, one of t he m et hods used t o ch eck v isu al acu it y is t h e scale of im ag es. I t ischaract erized by a whit e board on which black im ages
of d if f er en t d iam et er s ar e d isp lay ed , d if f er en t iat ed
according t o t he scale. These are called opt ot ypes and
are m ost ly grouped in t en horizont al lines, equivalent
t o t he coefficient s t hat det erm ine visual acuit y.
This acuit y is verified by t he ( decim al) num ber
corresponding t o t he last line on which t he child ident ified
all indicat ed opt ot ypes. I n t his process, first ly, t he child
needs t o know t he im age under analysis.
I n t h e co n st r u ct i o n o f o p t o m e t r i c sca l e s,
o p t i cal p r i n ci p l es r ecei v e t h e st r o n g est em p h asi s,
g e n e r a l l y w i t h o u t i n q u i r i n g a b o u t h o w t h e ch i l d
perceives t he im ages in t his inst rum ent . This can m ake
an ex am iner w ho is inex per ienced or not t r ained t o
d eal w it h t h ese clien t s ob t ain f alse r esu lt s, d u e t o
in t er fer en ces in com m u n icat ion .
Som e st u dies pr esen t dif f icu lt ies m et w h en
apply ing a t est w it h a scale of im ages, such as t he
i n s t r u m e n t a d a p t e d f o r t h e r e g i o n o f Ca b u r y /
Am azon as, w h ich f aced dif f er en t obst acles, r an gin g
from com m unicat ion wit h t he children ( som e of t hem
cr ied or ev en r an hom e w hen t he t im e of t heir t est
got near) t o t he ident ificat ion of opt ot ype im ages, as
m any childr en m ixed up t he m oon w it h a canoe and
o t h e r d i d n o t k n o w t h e B r a z i l i a n f l a g ( 1 ). Th i s
dem on st r at es an ot h er aspect in t h e con st r u ct ion of
t hese t ables, t hat is, t he opt ot ypes should not only be
cu lt u r ally adequ at e, bu t ch ildr en sh ou ld be able t o
per ceiv e t heir out lines. Nex t , t hey should define t he
best out lines for ident ify ing t hese opt ot y pes.
Cult ural diversit y and it s aspect s should also
b e t ak en in t o accou n t . Hen ce, p r esch ool ch ild r en ’s
r ecognit ion of im ages w ill pr obably be r elat ed t o t he
env ir on m en t t h ey liv e in . Mor eov er, v isu al lear n in g
changes over t im e. The form at of drawings can differ
i n l i n e w i t h t e ch n o l o g i ca l a d v a n ce s a n d ch a n g e s
r elat ed t o t he obj ect under analy sis( 2).
I n a p r e v i o u s st u d y, t h e r e su l t s a n d t h e
l i t e r a t u r e r e v i e w d e m o n s t r a t e t h a t , b e s i d e s a l l
t ech n i cal car e t ak en w h en el ab o r at i n g o p t o m et r i c
scales, in accordance wit h opt ic principles, associat ed
w i t h t h e ex a m i n er ’ s co m p et en ce a n d ex p er i en ce,
difficult ies cont inued t o use t he scales( 3,4,5) . There are
s t r o n g s i g n s t h a t t h e s e d i f f i c u l t i e s d e r i v e f r o m
com m unicat ion barriers in preschool children, who are
in t he sy m bolic im age const r uct ion phase.
We pr esent t his analy t ic and bibliographical
st udy, w hich addr esses t he under st anding of im ages,
i n o r d e r t o h i g h l i g h t t h e i m p o r t a n c e o f v i s u a l
com m u n icat ion d u r in g t h e con st r u ct ion p r ocess of
opt om et r ic scales.
THE UNDERSTANDI NG OF THE I MAGE
Th e s u b j e c t ’ s l e a r n i n g a b o u t t h e o b j e c t
depends on r ecor ding inst r um ent s, m ent al st r uct ur es
and specific or ganic st r uct ur es for t he act of get t ing
t o know, available at t hat t im e. There exist s a visual
knowledge const ruct ion. Each person’s look is involved
w i t h ea r l i er ex p er i en ces, a sso ci a t i o n s, m em o r i es.
What we see is not t he real fact , but what we m anage
t o capt ur e and int er pr et about w hat w e see, w hat is
significant t o us( 6).
I n t h i s s e n s e , i n p r i n c i p l e , i n d i v i d u a l s
underst and t he fam ily cont ext , t he relat ion wit h people
fr om t he neighbor hood t hey com e fr om , t he school.
A s a g e a d v a n c e s , t h i s k n o w l e d g e g r o w s a n d i s
st rongly m arked by t he social aspect . Learning is said
t o inv olv e per cept ions by t he fiv e hum an senses.
Se e i n g ch i l d r e n ’ s f i r st e x p e r i e n ce i n t h e
lear n in g p r ocess occu r s t h r ou g h t act ile aw ar en ess.
Besides t his knowledge obt ained t hrough t heir hands,
ot her st im uli include sm ell, hear ing and t ast e. These
sen ses ar e r apidly in t en sif ied an d ov er com e by t h e
i c o n i c l e v e l – t h e a b i l i t y t o s e e , r e c o g n i z e a n d
u n d e r st a n d , i n v i su a l t e r m s, e n v i r o n m e n t a l a n d
em ot ional for ces( 7 ).
I t is a fact t h at sy m bolic lear n in g pr ecedes
t h e l ea r n i n g o f w r i t i n g a n d ev en w o r d s. Ch i l d r en
r ecog n i ze t h ei r m ot h er ev en w i t h ou t k n ow i n g h er
nam e. Considering t hat t he sym bolic is sim ult aneously
m a n i f e st e d t h r o u g h i m a g e s a n d w o r d s, w i t h a n
i n h er en t o r g an i zi n g p l ast i ci t y, p o ssi b l e k n o w l ed g e
f o r m s a r e o b j e c t s o f v e r b a l a s w e l l a s v i s u a l
com m u n icat ion( 6 ).
W h e n t r a n s f e r r i n g t h e s e c o n c e p t s t o
oph t h alm ology, specifically in t h e u se of opt om et r ic
scales t o ident ify visual acuit y in preschool children, it
is per ceiv ed t hat , in or der t o be able t o ident ify t he
im age shown in t he scale, t he child first needs t o know
it . “ I t is not difficult t o det ect t he t endency t ow ar ds
visual inform at ion in hum an behavior. We look for visual
reinforcem ent of our knowledge due t o m any reasons;
t h e m o s t i m p o r t a n t o n e i s t h e d i r e c t n a t u r e o f
inform at ion, t he proxim it y of t he act ual experience”( 7). The visual com m unicat ion...
Dant as RA, Pagliuca LMF.
970
We could talk about sensitization before applying
the visual acuity test in children, through the exhibition
of im ages inherent to the scale. The im portance of this
m om ent is beyond doubt. However, alone, it is insufficient
for t he easy ident ificat ion of sym bols.
The use of universal figures could be added,
which all children have in com m on, excluding diversit y
f r om t h is r elat ion . I n it ially, t h is belief goes again st
t he prem ises of visual learning and t he cult ural aspect .
“ Th e h u m a n v i su a l e x p e r i e n ce i s f u n d a m e n t a l i n
lear n in g f or u s t o u n der st an d t h e en v ir on m en t an d
react t o it ; visual inform at ion is t he oldest regist er of
hum an hist or y ”( 7).
The visual st im ulat ion levels cont ribut e t o t he
process of conceiving, creat ing and refining any visual
w o r k . Ea ch o f t h ese l ev el s, i . e. r ep r esen t a t i o n a l ,
a b s t r a c t a n d s y m b o l i c , p o s s e s s e s s p e c i f i c
ch a r a ct e r i st i cs t h a t ca n b e i so l a t e d a n d d e f i n e d ,
alt hough t hey ar e not st r ict ly ant agonist ic. The final
v isual infor m at ion lev el is t he sy m bolic. The sy m bol
can be any t hing, r anging fr om a sim plified im age t o
an ext rem ely com plex syst em of at t ribut ed m eanings,
such as language or figur es for ex am ple( 7).
Dr aw in g is con sid er ed as a sy m b olic n on
-verbal expression of t he body and/ or t he environm ent ,
c o n s t r u c t e d b y t h e i n d i v i d u a l ’ s a c q u i s i t i o n o f
ex per iences. “ Our ow n aw ar eness t ot ally depends on
our view of t he ext erior world in such cat egories. And
aw ar en ess pr oblem s em er ge w h en r econ st it u t ion is
placed at t he side of int ernalizat ion; t hey also em erge
because w e ar e capable of seeing our selves as if w e
were obj ect s in t he ext ernal world. This is part of t he
nat ur e of language it self; it is im possible t o hav e a
sy m bolic sy st em w it hout t his”( 8).
I n v i e w o f t h e s e a r g u m e n t s , t h e
indiscrim inat e use of im ages is cont est ed, wit hout t he
ad ap t at i o n o f o p t o t y p es t o t h ei r act i v i t y ar ea. As
hum an beings, w e r eceive st im uli ever y day, but w e
need a code t o underst and t hem . The lat t er is linked
u p w i t h e a c h p e r s o n ’ s r e f e r e n c e f r a m e w o r k ,
elabor at ed on t h e basis of h is/ h er ex per ien ces an d
values. For t he m essage t o have a m eaning, it needs
t o be coded in our know ledge.
Our ex per ience in t he Ocular Healt h Pr oj ect
allow ed us t o per ceiv e t hat t he av ailable scales and
t h o se sh o w n i n b o o k s w er e n o t a l w a y s ef f ect i v e,
because t hey cont ained im ages of unk now n for m at s
i n t h e r e g i o n , su ch a s t h e ca se o f t h e b i r d i n a
Co l o m b i an scal e, w h i ch i s o f t en m i x ed u p w i t h a
but t er fly( 9). Visual associat ions ar e com m on in t hese
scal es. Fo r ex am p l e, t h e b asi c v i su al i n f o r m at i o n
a b o u t a b i r d f o r m , w h en co m b i n ed w i t h a n o l i v e
br an ch , t u r n s in t o t h e easily iden t if iable sy m bol of
peace. I n t his case, t he public needs som e educat ion
w it h a v iew t o a clear m essage. How ever, t he m or e
ab st r act t h e sy m b ol, t h e clear er it s r ep r esen t at ion
sh o u l d b e i n o r d er t o p en et r a t e i n t o t h e p u b l i c’ s
m ind( 7).
FI NAL CONSI DERATI ONS
V i s u a l c o m m u n i c a t i o n o c c u r s b e f o r e
alphabet izat ion, consider ing t hat , w hen look ing at a
f ig u r e or a h u m an g est u r e, ch ild r en in t er p r et . Th e
capacit y t o underst and and express t hem selves about
t heir w orld precedes t eaching of reading and w rit ing.
I t should be highlight ed t hat , despit e t he subj ect ivit y
of op t ot y p es, t h e scal es of i m ag es ar e st i l l v al i d ,
p r o v i d ed t h a t t h e i m a g es a r e a d a p t ed t o i m a g es
present in t he universe of t he children under analysis.
This avoids t he m assificat ion of visual com m unicat ion
in childr en’s ex pr ession. When t hey t alk about t heir
r ealit y and ident ify obj ect s in t he env ir onm ent , t hey
appr ehend and com pr ehend t he w or ld it self, ranging
f r o m t h e cl o sest t o t h e f ar t h est o b j ect s, t h r o u g h
com m unicat ion, k now ledge acquisit ion and ex change
w it h t he env ir onm ent .
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Recebido em : 16.12.2004 Aprovado em : 13.9.2006
The visual com m unicat ion...
Dant as RA, Pagliuca LMF.
