2 - Causes And Consequences

Question 1

Cloudy media

-problems (4)

Answer 1

General blur
Glare
Contrast
Severe K problems = diplopia (e.g. keratoconus)

Question 2

Cloudy media
-causes
—corneal (3)

Answer 2

Dry eye
Keratoconus
Scarring

Question 3

Cloudy media
-causes
—cataracts (3)

Answer 3

Nuclear - generally just need magnification
Cortical - glare control
PSC - glare control, difficult to provide magnification

Question 4

Cloudy media
-causes
—vitreous (3)

Answer 4

Hemorrhages and inflammation - depends on severity, can completely block light

Floaters

Question 5

Cloudy media

-management (4)

Answer 5

Best refraction
Filters - glare, contrast
Good lighting
Magnification

Question 6

Cloudy media
-management
—filters and uses (2)

Answer 6

Yellow/orange = contrast when reading

Brown/gray = reduce glare

Question 7

Central VF defect

• what they have
• if one eye is unaffected
• often have

Answer 7

Relative/absolute scotoma in/near central vision

Reduced depth perception

Reduced contrast sensitivity

Question 8

Central VF defect
-causes
—most common

Answer 8

AMD

Question 9

Central VF defect
-causes: dry AMD
—onset
—early
—may develop
—GA

Answer 9

Slow, progressive

Begin as relative scotoma

Ring scotoma - fovea is temporarily preserved while surrounding areas develop atrophy
-typically do well with acuity charts, struggle with reading quickly

GA - almost always absolute scotoma

Question 10

Central VF defect
-causes: wet AMD
—onset
—issues

Answer 10

Sudden, severe

More difficulty reading than expected from their VA

Question 11

Central VF defect
-cauesses: AMD
—treatment/intervention for both types (3 things)

Answer 11

Illuminated magnifiers and improving contrast are important

Begin ASAP

May develop eccentric viewing

Question 12

Central VF defect
-causes
—toxoplasmosis
—myopic degeneration

Answer 12

Both: similar field deficits to mac degen

T: healthy tissue surrounding scars, may have acuities up to 20/20

M: may be able to take off their glasses instead of use magnifiers, be careful to not overminus

Question 13

Central VF defect
-causes
—optic nerve disorders

Answer 13

Central or cecocentral defects

Perform baseline VF

Question 14

Central VF defect
-causes: diabetic ret
—complications causing loss (3)

Answer 14

Vitreous hem
Mac edema
PRP

Question 15

Central VF defect

-management (4)

Answer 15

Careful refraction
Perimetry/Amsler
Filters - esp yellow for reading contrast
Magnification - D and N

Question 16

Peripheral VF defect
-causes: retinitis pigmentosa
—onset
—first complaint, second
—helpful for spot reading
—helpful to reduce glare
—recommend (2)

Answer 16

Gradual, eventually total blindness

Night blindness -> bumping into things

Mini flashlight

Filters - red

Reading assessment, O and M

Question 17

Peripheral VF defect
-causes: glaucoma
—onset
—often have __, management (2 each)

Answer 17

Gradual, eventually total blindness

Poor contrast - filters
Field loss - O and M

Question 18

Peripheral VF defect
-causes: neurologic disorders
—R vs L hemianopia
—aid to maintain same line when reading
—other training (2)

Answer 18

R - usually good VA, but trouble reading
L - trouble finding next line

Typoscope

O and M, scanning training

Question 19

Peripheral VF defect

-management (5)

Answer 19

Refract
Glare control
Least magnification (maintain FOV)
Field expansion - only with good VAs, generally use scanning techniques as first option, prisms/etc. next
O and M (orientation and mobility)