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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
Q

Effect of AMD

A

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
Q

Symptom of AMD

A

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
Q

Current Treatments of Dry AMD

A

Nutritional supplements - diet - stop disease progressing

28
Q

Current Treatments of Wet AMD

A

Anti-vascular endothelial growth factor (VEGF) agents - INJECTION - need to get it every moth
Macugen
Lucentis
Eyelea

29
Q

What is the difference between Dry AMD and Wet AMD

A

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
Q

What can help AMD

A

Low vision aids

31
Q

What do the treatments of AMD do

A

Doesnt make you see like you used to, stabilises the vision lost and prevent from losing further sight - wont regain better sight

32
Q

What is the 2nd most common cause of visual impairment in UK

A

Glaucoma

33
Q

What percentage of UK blind registrations due to glaucoma

A

10

34
Q

What % of people over 40 are affected in the UK

A

2

35
Q

How is glaucoma described as

A

Silent disease - unnoticed until sight test of it gets very bad

36
Q

What might’ve caused glaucoma

A
  • Infected eye disease
  • Born blind
  • Acid attack
37
Q

Risk Factors of Glaucoma

A 
Age
Race
Family History of Glaucoma
Ocular Risk Factors: E.g. Myopia
Systemic Vascular Disease: E.g. Diabetes, Untreated Hypertension
38
Q

Which race is most at risk of Glaucoma

A

Afro - Caribbean

39
Q

Symptoms of Glaucoma

A

Usually asymptomatic until late stages

Tunnel Vision - end stages - its like looking through a tunnel - cant see everything on side

40
Q

Treatment of Glaucoma

A

Drug Treatment - drops - could forget to put in
Laser Treatment
Surgery - more permanent but expensive, not suited to everyone

41
Q

Why is treatment of glaucoma not that good

A

Cant really get rid of it

Doesnt always produce results you want

42
Q

Diabetic Retinopathy statistics

A

‘’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
Q

What does Diabetic Retinopathy cause

A

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
Q

Diabetic Retinopathy Risk Factors

A 
Type of Diabetes and its Duration
Control of Diabetes Mellitus 
Hypertension 
Pregnancy
Hyperlipidaemia 
Age
Ethnicity
45
Q

Diabetic Retinopathy Current Treatment

A

Diabetic control
Laser photocoagulation
Vitrectomy
Main is diet control

46
Q

What does Laser photocoagulation do

A

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
Q

What is swelling behind eye known as

A

Oedema

48
Q

What is cataract

A

Surgery to remove opaque lens so you can see well

Major Cause of global Blindness-33% of all blindness is due to cataract

49
Q

Types of cataract

A

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
Q

Risk Factors of cataract

A

Age
Nutrition - diet
Family History - congenital cataract only - genetics
Others such as Diabetes

51
Q

Charles Bonnet Syndrome

A

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
Q

Content of hallucinations

A

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
Q

Exploding some more myths about the eyes

A

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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