FND Education Project

REFERENCE · RECOVERY TECHNIQUE

Graded Visual Tasks Linked to Daily Life

Most likely fit: An assessed, low-risk visual task is possible and can be adjusted toward a specific reading, locating or everyday goal. [Clinical rehabilitation adaptation; no established universal exercise dose]

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For the Person With FND

What this approach is for

Begin with what the task needs, not the hardest visual test. Reading a short message might be easier with larger text, less surrounding clutter, a comfortable screen setting or audio alongside it. Locating a cup can start at a stable table while seated.

A graded task changes one demand at a time. It does not require pushing through worsening symptoms or giving up adaptations before you can manage without them.

Terms in everyday language

Contrast is the difference between a target and its background. Crowding means surrounding details can make a target harder to identify. Fixation means directing the eyes toward a target; tracking follows a moving target. These place different demands on vision, so moving-target practice is not a necessary first step.

Practical discussion and flare adaptations

With the therapist, choose one plain, stationary target and an activity that matters. Find a manageable size, distance, contrast and duration. Complete a short attempt, then check comfort and whether the task was useful. Later, change only one demand if appropriate.

For example, identifying a large symbol can lead toward locating that symbol on a useful label. This is an educational example, not a validated programme. During a flare, stop the task, use the accessible alternative and return at an easier level if and when ready. Do not practise on stairs, near traffic or while cooking.

These examples require selection for your assessed presentation. The clinical rationale and its limits are described in the sources below. (Sources: 1, 2)

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Prepare the agreed layout and let the person control the attempt. Offer the alternative method without describing it as giving in: audio, assistance or larger text may remain necessary.

Avoid increasing brightness, target speed or task length without agreement. Check the later response as well as what happened during practice; a task completed at a high cost may need changing.

For the Person With FND
For Family, Friends, and Other Supporters
For Clinicians and the Care Team
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For Clinicians and the Care Team

Selection and assessment

Select tasks according to acuity, field, binocular status, visual processing, motor access and sensory tolerance. Assess whether a coexisting reading, vestibular or ocular-motor problem requires another pathway. A generic tracking exercise is not a substitute for this formulation.

Explicit procedure

  1. Define one meaningful task and a safe supported starting position.
  2. Set baseline target size, distance, contrast, clutter and duration, retaining necessary correction and aids.
  3. Use a stationary task first when movement is unnecessary or poorly tolerated.
  4. Compare task completion, assistance and symptom cost rather than acuity alone.
  5. Progress one relevant variable only when the response is repeatable and acceptable, including later effects.
  6. Agree an easier version and an accessible non-training way to complete essential activities.

Review, progression and stopping

Measure the task achieved, help needed, discomfort and recovery time. More exposure is not automatically a better dose. Sustained worsening warrants reducing or stopping the trial and reviewing its rationale. Do not use success in a seated task as clearance for driving or unsupported navigation.

This is an educational implementation example, not a validated standalone treatment protocol. (Sources: 1, 2)

For the Person With FND
For Family, Friends, and Other Supporters
For Clinicians and the Care Team
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Research and Sources

This page translates the original graded-task entry into practical examples. The specialist literature supplies a rationale for selected visual practice but does not validate this progression, dose or transfer to every visual presentation.

Citation Full citation
[1] Ramsay N, McKee J, Al-Ani G, Stone J. How do I manage functional visual loss. Eye. 2024;38:2257–2266. FND-CIT-0024. Source
[2] Ramsay N, Tessmann H, McKee J, Ercoli T, Stone J. Functional visual loss: a systematic review and meta-analysis of epidemiology, prognosis and treatment. Eye. 2026;40:1784–1793. Published online June 26, 2026. FND-CIT-0103. Source

Source check: September 16, 2026 · Ophthalmology, neuro-ophthalmology, orthoptics, migraine, psychological, lived-experience, supporter and accessibility review pending.

For the Person With FND
For Family, Friends, and Other Supporters
For Clinicians and the Care Team
Research and Sources —