10- Peds LV Flashcards
What is the who definition of legal blindness?
Uncorrected acuity of 20/400 or worse
- not 20/200 b/c it’s based on the UNDERPRIVELEGED world (hence, the fact that they’re uncorrected)
- you’re thinking 20/200 or worse in the better seeing eye…not the same.
What is the leading cause of pediatric vision impairment worldwide (including developed and under developed countries)?
-due to what reasons?
Corneal blindness (350,000/yr)-most die w/i a yr of blindness onset
-Vit A deficiency (peak b/w 3-5Y/O), post-infectious, trauma, congenital dz, traditional med/home remedies
Leading cause of pediatric visual impairment in developed world?
Cerebral/cortical impairment
As it relates to vision educator services which of the following is true?
Services are available from early intervention and beyond
early intervention: birth-3
preschool: 3-5
grade school/beyond: end age depends - Maine is 20Y/O
T/F: reporting print size is not a sufficient recommendation
TRUE - should recommend it, not determine (as in, require,) it
T/F: ODs determine print size?
FALSE - we recommend it, NOT mandate it
T/F: Devices are all that’s needed for proper learning of a LV pt
FALSE
-Do children w/ visual impairment usually have other impairments/disabilities? About what percentage?
yes; typically…about 2/3rds
T/F: readiness for braille needs to be evaluated in a pediatric LV evaluation
FALSE - but ODs should look for: the impact of crowding, contrast, and numerous aspects of visual based communication system
T/F: individuals w/ CVI rarely improve on their own
FALSE - they CAN improve on their own (or w/ medical intervention)
Once found, are null points (in strabismus) typically stable?
NO, not usually. They CAN change overtime, and can even differ b/w dist. and near.
What is the no. 1 OVERALL leading cause of blindness/vis. impairment worldwide?
cataracts
leading cause of congenital glaucoma in peds population (I’m assuming worldwide)?
rubella!
list some forms assistive technology - and some things they do:
1) assistive devices: lessens functional limitations
2) adaptive technology: substitutes/makes up for the loss of fxning from a disability
3) augmentative devices: augments a specific fxn (ie. aid speech understanding w/ a microchip voice output device)
Bardet-Biedl is an example of a __-__ dystrophy.
- Associated with…
- Night blindess by…
- Legal blindess by ~___…Y/O
rod-cone dystrophy –> 90% AR
assn: truncal obesity, polydactyly, genitouinary & renal malformations
- night blind by 7, legally blind by ~15
- other eye findings: nystagmus, strab, high myopia, cataracts, glaucoma
greater than a ___ line difference on contrast cards such as the double happy, lea, and colenbrander cards indicates a potential problem
two
Stargardt’s disease
- inheritance pattern?
- first causes visual loss in what area of the VF? In what decade of life?
AR; first-second decade of life
- CENTRAL acuity loss - initially 20/60 but will end up 20/200 or worse
- loss of RPE support - leads to retinal PR death
What size text do we initially consider as a STARTING POINTi for text size adjusted for working distance?
2-3 times the threshold acuity
four classifications of vision loss (OOCC)
Ocular: eye structures to chiasm
Oculomotor: brainstem, cerebellum
Cortical: primary pathway (post-chiasm to occipital/V1)
Cerebral: post-occipital, complex processing/temporal & parietal & frontal
What type of nystagmus is typically seen in albinism?
pendular - specifically, oculo-cutaneous albinism
what is the SINGLE MOST POWERFUL therapeutic intervention for improving vision and visual fxn in many LV/VI pts?
correction of significant REFRACTIVE ERROR
Kestenbaum method of surgical intervention has been proposed for when the null point needs to be shifted how?
Vertically OR horizontally
If you’re going to Rx yoked prisms to a pt whose eyes are UP, what prism base direction will you select?
base DOWN - shifts image up to where the eyes are already pointing- (weiss & brown suggest 6PD each eye to start)
ONH hyperplasia is considered an ____ cause (one of those four groups) of vision loss
- Can you predict what the vision is based on how much of the nerve has been lost/its size?
- T/F: this person’s color vision will likely be abnormal.
ocular (recall: eye structures to chiasm)
NO, you can’t predict based on nerve size
-FALSE - somehow, these pts (specifically w/ ONH hyperplasia) have NORMAL CV.
What are the three phases of brain development? [ICS]. Part of WHICH group of vision loss?
cortical: post-chiasm to V1
- I: induction - days 1-60
- C: cellular proliferation - days 61-24wks
- S: synapse formation - 25wks-4yrs
Name some characteristics based on the Roman-Lantzy scale of cortical visual impairment (CVI)
color preference, need for mvmt, visual latency, VF preference, difficulties w/ vix. complexity, light gazing/nonpurposeful gaze, difficulty w/ dist. viewing, atypical visual reflexes, difficulty w/ visual novelty, absence of visually-guided REACH
- each item scored on scale of 0-1, 1 meaning the factor is no longer an issue affecting their visual function - score up to 10
- intervention is based on the score
What are the three stages of intervention in the Roman-Lanzky scale of CVI?
1) building visual behavior
2) integrating vision w/ fxn
3) “resolution” of CVI characteristics
ventral stream: the ___ stream
-in which two main lobes?
dorsal stream: the __ stream
–in which two main lobes?
-in cerebral and ocular visual impairment, WHICH stream’s dysfunction is more common?
ventral - what (pumping chest) - temporal, occipital lobes
dorsal - where - posterior parietal, middle temporal
-DORSAL more common - difficulty w/ VF/visual attn when moving, visually guided movement, crowded env, etc.
Three characteristics of cerebral visual impairment (CVI)?
1) variably reduced central acuity
2) dorsal/ventral stream dysfxn
3) possibly reduced VF
