Optic Nerve Hypoplasia is interesting in that it doesn’t work the same way as most vision loss that people think of. ONH is when the optic nerve does not develop fully before birth. This means that the eye may be fully capable of collecting images, but the nerve can’t transmit them to the brain. This could result in a blind spot in a person’s vision, all the way up to having no vision at all.

https://simulator.seenow.org

This website has a vision simulator for the most common causes of vision loss in the US. Check it out. It uses your phone’s camera and changes the picture based on the eye disorder you choose. You can increase or decrease the severity of the condition. Because I don’t have a map of your nephew’s retina and I don’t know what extra complications he has, I can’t tell you which simulation his vision will look like. It might be a combination of a few.

There's a big ONH group on Facebook too that you may find helpful!

My vision is dependant on a variety of factors like lighting, if I’m hungry, tired, if someone close to me is wear stripes and many other things. It’s a kid the spec Ed department did this thing where they brought in these goggles for my classmates to try but they weren’t really accurate. Heck sometimes I don’t know what I can and cannot see. The best reference I have is that is I can’t see sheet music if it’s farther away from my face than what it is when I’m sitting at a piano no matter how big it is, it’s past the distance I can read from rather than just recognizing symbols. Another thing is that I have no depth perception so i can only judge distances from (sometimes painful) experiences. Say if a ball whizzes past my face 2 feet away, it feels like it’s going to hit my face. For near vision with my glasses, I probably see 20/80 but my distance vision is worse than 20/200. I literally sit like a meter away from the board in one of my classes and I cannot see the board so people who can take notes from the back of the class seem superhuman. Also, even reading the menu boards at cafes seems like a superhuman feat so I try to see if they have their prices online and get the cash together. I’ve had to rely on my memory and my residual vision a lot so I don’t think of my vision as being bad I just think of everything else being superhuman to the point where I’m bad at judging my limits. Sometimes when I just wake up I stair at my popcorn ceiling and depending on if my eyes are shaking a foot I can go from being able to see that it’s textured to it looking flat all while my brain tries to decide what eye to pay attention.

Edit: I did some research on ONH and it turns out that it often presents with nystagmus and strabismus which I have due to albinism, Also chances are, your nephew’s sight will improve as he gets older. My parents went from being able to hide things in plain sight to actually having to hide stuff but jokes on them because I know all their hiding spots now so it doesn’t require as much vision to find stuff. Another thing you can do is try setting the text size to watermelon as that’s just a bit too small for me to read without strain.

Everyone is not the same. Blindness is not uniform. The most I could see was the larger picture and never details, I could only see a feet in front of me, but I went blind very quickly. I became totally blind when I was 8 years old. You can’t make a diagram like that. It doesn’t work like that. It depends person to person.

ONH is an interesting vision impairment. It is one of the three most common causes of vision impairment in kids in the US, actually. I’d be curious to know if glasses help your nephew- often they are prescribed due to other eye conditions that are occuring alongside the ONH - like amblyopia/strabismus (the eyes turning inward or outward). I did one of my grad school papers on ONH, and if you’re interested in knowing some other things you may want to be aware of, PM me.

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This is actually really interesting, my daughter has septo optic dysplasia (very similar to what your nephew has) and I keep hearing from her doctors and therapists that glasses would not benefit her since it’s not her eyes that are bad, it’s the optic nerves in her brain. I’m so frustrated because I want to at least try them! And I’m hearing more and more people say that they are using glasses with this condition and am not sure how to go around what they’re saying to get them