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Clinical Skills > An Introduction to Visual Impairment > Flashcards

An Introduction to Visual Impairment Flashcards

1
Q

What is the definition of visual impairment

A

One who has an impairment of visual function for whom full remediation is not possible by conventional spectacles, contact lenses or medical intervention and which causes restriction in that person’s everyday life.

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2
Q

What is visual impairment

A
  • Low vision

- Can’t see very well and cannot correct eye sight fully with glasses/contact lenses

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3
Q

Why is visual impairment important

A

As an optometrist we will be seeing people people with visual impairment, helping them in many ways

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4
Q

Who mainly have low vision and why

A

Older people

due to age related eye conditions

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5
Q

What % of registered people are over 60

A

80

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6
Q

Why is the population of older people in the UK increasing

A

People are living loner

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7
Q

By 2031 what % of the population will be over 60

A

40

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8
Q

What % of people with visual impairment are over 60 years age

A

90

Most of these live alone

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9
Q

Why is it bad that people with visual impairment live alone

A

Difficulty doing things alone, no one to help them
This group often have restricted daily living potential due to other difficulties e.g.
Hearing problems
Mobility problems

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10
Q

What are the types of impact for visual impairment

A 
Employment
Independence
Psychological
Wellbeing
Social impact
Economic
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11
Q

How is employment an impact for visual impairment

A

34% of individuals who have VI are in employment in comparison to 75% overall
- Harder to get employed as theres more struggle, unable to do some tasks

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12
Q

How is Independence an impact for visual impairment

A

No longer able to drive, mobility problems ( as you cant see - bumping into things ) problems while cooking and managing money (Sloan et al., 2005)
- Difficult to get around

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13
Q

How is Psychological Impact

an impact for visual impairment

A

VIP are prone to depressive symptoms (e.g. Burmedis et al., 2003)
- Approx 50% people who go to low vision clinic get positive for depression

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14
Q

How is Wellbeing

an impact for visual impairment

A

Visual impairment can increase the number of injuries resulting from falls (Vu et al., 2005) = more likely to go doctor

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15
Q

How is Social Impact

an impact for visual impairment

A

Reduced participation in social activities (Dickinson 1998)

Loss of vision is one of the most feared results of ageing - they said sight is the most important to them

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16
Q

Economic impacts of visual impairment

A

Cost of visual impairment in 2008 £6.5 billion.
£2.2 billion direct costs, such as hospital and social care
£4.3 billion indirect costs, such as costs associated with lower employment, informal carers
Costs associated with loss of healthy life and loss of life due to premature death associated with visual impairment is estimated at a further £15.51 billion.

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17
Q

How is the carer impacted by visual impairment

A

Depressive symptoms
Economic impact - might not be able to work full time as you’re looking after someone with VI
Psychological impact

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18
Q

Common Causes of Visual Impairment UK

A

Age Related Macular Degeneration (40%)
Glaucoma (30%)
Diabetic Retinopathy (8%)

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19
Q

What is the main cause of blindness in the UK and developed nations

A

Age Related Macular Degeneration

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20
Q

What is the 3rd cause of blindness globally

A

Age Related Macular Degeneration

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21
Q

Risk Factors of Age Related Macular Degeneration

A

Age
Genetics
Tobacco consumption = smoking increases risk
High Blood Pressure
UV - sunny country
Diet
Other possible factors: Race, Eye Colour, Hyperopia, High blood Cholesterol

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22
Q

Which eye colour is more prone to Age Related Macular Degeneration

A

Lighter iris colour

23
Q

Which rx is more prone to Age Related Macular Degeneration

A

Hyperopia - plus - long sightedness

24
Q

Types of AMD

A

Atrophic or non-neovascular AMD (Dry AMD)
Exudative or neovascular AMD(Wet AMD)
Sometimes you start with one and end up with the other

25
Effect of AMD
It affects central part of eye - causes central scotoma which is central visual field loss so you can see people off to the side not straight ahead.
26
Symptom of AMD
Blurred vision  - cant see as well as they used to Straight lines appear wavy/crooked - not straight Things look faded - due to colour vision loss Problems recognising people Problems seeing colours
27
Current Treatments of Dry AMD
Nutritional supplements - diet - stop disease progressing
28
Current Treatments of Wet AMD
Anti-vascular endothelial growth factor (VEGF) agents - INJECTION - need to get it every moth Macugen Lucentis Eyelea
29
What is the difference between Dry AMD and Wet AMD
Wet AMD is more sudden and quick, faster progression, however dry AMD is not as quick, adapt better, progression is slower, slow loss in visual acuity, it takes years or decades
30
What can help AMD
Low vision aids
31
What do the treatments of AMD do
Doesnt make you see like you used to, stabilises the vision lost and prevent from losing further sight - wont regain better sight
32
What is the 2nd most common cause of visual impairment in UK
Glaucoma
33
What percentage of UK blind registrations due to glaucoma
10
34
What % of people over 40 are affected in the UK
2
35
How is glaucoma described as
Silent disease - unnoticed until sight test of it gets very bad
36
What might've caused glaucoma
- Infected eye disease - Born blind - Acid attack
37
Risk Factors of Glaucoma
``` Age Race Family History of Glaucoma Ocular Risk Factors: E.g. Myopia Systemic Vascular Disease: E.g. Diabetes, Untreated Hypertension ```
38
Which race is most at risk of Glaucoma
Afro - Caribbean
39
Symptoms of Glaucoma
Usually asymptomatic until late stages | Tunnel Vision - end stages - its like looking through a tunnel - cant see everything on side
40
Treatment of Glaucoma
Drug Treatment - drops - could forget to put in Laser Treatment Surgery - more permanent but expensive, not suited to everyone
41
Why is treatment of glaucoma not that good
Cant really get rid of it | Doesnt always produce results you want
42
Diabetic Retinopathy statistics
‘’In 2030, the number of people with diabetes is expected to increase to 440 million, 54% more than in 2010. This means that, for every two people with diabetes today, there would be three in 2030 ‘’ 1 in 133 people with Diabetes become blind Major cause of visual impairment in the working population in the UK
43
What does Diabetic Retinopathy cause
Can get new blood vessels at back of eye and these can pull on the retina and detach it, bleeding back of eye - prevents you from seeing well and causes swelling behind eye.
44
Diabetic Retinopathy Risk Factors
``` Type of Diabetes and its Duration Control of Diabetes Mellitus Hypertension Pregnancy Hyperlipidaemia Age Ethnicity ```
45
Diabetic Retinopathy Current Treatment
Diabetic control Laser photocoagulation Vitrectomy Main is diet control
46
What does Laser photocoagulation do
Kill off all new blood vessels cause if theres too many it causes a mesh and it pulls retina away which causes visual loss
47
What is swelling behind eye known as
Oedema
48
What is cataract
Surgery to remove opaque lens so you can see well | Major Cause of global Blindness-33% of all blindness is due to cataract
49
Types of cataract
Senile - old age Traumatic- E.g. Penetrating injury - impacts on lens on eye Metabolic- E.g. Diabetes Toxic -E.g. Steroids Secondary- E.g. eye infection/disease e.g. uveitis = chronic inflammation of eye Maternal infections-E.g. Rubella to child Congenital
50
Risk Factors of cataract
Age Nutrition - diet Family History - congenital cataract only - genetics Others such as Diabetes
51
Charles Bonnet Syndrome
Visual hallucinations in elderly individuals with normal intellectual and psychological functioning Associated with bilateral visual impairment Commonly associated with AMD, DR, Glaucoma & cataract Prevalence ranges from 11%-63% More common in women and elderly population although it can be found in children Association with living alone
52
Content of hallucinations
Wide range of content Consistent themes include people- adults, faces (often grotesque) Less common- animals and plants Geometric shapes, spots and flashes Occur mostly in vivid colour Hallucinations appear with greater clarity and detail in comparison to reality and the persons normal vision
53
Exploding some more myths about the eyes
Using sight will not damage the eyes Reading in dim light will not damage eyes But it is not helpful You cannot strain your eyes It is physically impossible, although they can get tired

Clinical Skills (6 decks)

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