Final Exam Flashcards
Name a quick screening tool for gross visual field defects?
Confrontation Field
What is an advantage of confrontation visual field testing?
No equipment needed
Which visual field test uses manual kinetic perimetry with movable targets?
Goldmann Perimetry
What is the primary use of Humphrey Visual Field testing?
Long-term glaucoma monitoring
Which of the following is a disadvantage of Goldmann perimetry?
No digital storage
What type of visual field loss is commonly associated with stroke?
Hemianopia
Which rehabilitation method uses high-powered prism segments for hemianopia patients?
Peli Prisms
What is the main purpose of microperimetry?
Measure retinal sensitivity and fixation
What does the Visual Field Index (VFI) represent in Humphrey testing?
Represents the rate of visual field change;
100% = normal vision; 0% = blind
less affected by cataracts than MD
Which device is useful for enhancing vision in patients with tunnel vision?
Reverse Telescopes
What is required for effective low vision care and rehabilitation?
A collaborative effort from various healthcare professionals
This addresses the ‘whole’ patient.
Why is an interdisciplinary approach important in low vision care?
It addresses the holistic needs of each patient.
What role do referrals and consultations play in low vision care?
They are essential to address the complex needs of the visually impaired.
What does the whole patient approach recognize?
The interconnectedness of physical, mental, and social aspects of a person’s well-being.
How can organizations maximize outcomes in low vision care?
By drawing upon a network of resources to provide a holistic approach to care.
What is essential for identifying appropriate resources for low vision patients?
A thorough conversation between the patient and practitioner.
What is the role of ophthalmologists in low vision care?
They recognize patients with low vision and make referrals to low vision rehabilitation.
What are the primary mental health concerns for individuals with visual impairments?
Depression and anxiety.
What do mental health specialists provide for visually impaired patients?
Support, guidance, and coping mechanisms.
What is cognitive restructuring?
Identifying and replacing self-defeating thoughts with healthier thoughts.
What unique skills do occupational therapists provide for visually impaired patients?
Compensatory methods and strategies to regain function in daily activities.
What challenges do many vision disorders create for patients?
ADL challenges such as cooking, cleaning, and independent mobility.
What is the purpose of orientation and mobility (O&M) training?
To empower patients and foster their independence in navigating environments.
What is systematic scanning?
A technique taught during orientation and mobility training; teaches patients to detect obstacles using a grid-like pattern.
What is the significance of the white cane for visually impaired individuals?
It serves as a recognizable symbol and aids in independent mobility.
What are the requirements for patients to apply for guide dog services?
Must be at least 18 years old, legally blind, and have had O&M instruction.
What are some features of GPS technology designed for visually impaired users?
Voice guidance, braille displays, and personalized navigation.
What is the role of a sighted guide?
To assist visually impaired individuals in navigating unfamiliar environments.
What do assistive technology specialists do?
Evaluate devices, perform assessments, and train clients on accessibility features.
What is the focus of driver rehabilitation specialists?
Assessing driving history and needs, conducting on-road testing.
What educational benefits do students with visual impairments have?
Eligibility for services under federal legislation and individualized learning plans.
What is the purpose of IEP and 504 Plans?
To outline specific services and accommodations for students.
What types of resources are available for individuals with vision loss?
National organizations, state and local groups, and various social resources.
What is the mission of the Department of Veterans Affairs?
To care for injured war veterans, including those disabled during wartime.
What does the VICTORS outpatient program focus on?
Restoring functional vision and improving quality of life for veterans.
What does Medicare currently cover for cataract surgery?
Intraocular lenses, post-surgical glasses, and implantable miniature telescopes.
What are the limitations of Medicare coverage for low vision devices?
Does not reimburse for optical aids, glasses, or low vision devices.
What is the significance of the H.R. 6848 bill, the Medicare Demonstration of Coverage for Low vision Devices act of 2022?
It requires CMS to evaluate fiscal coverage for low vision devices.
specifically the fiscal impact of covering devices in the same manner as durable medical equipment; does not include ordinary eyeglasses or contact lenses
What year was Medicare established?
1965
What items were excluded from Medicare coverage due to budget constraints?
Low-cost items like hearing aids and visual aids
What is the key concern regarding Medicare coverage for visual aids today?
Financial feasibility
What does H.R. 6848 aim to evaluate?
The fiscal impact of covering low-vision devices under Medicare
Define ‘low-vision device’ as per H.R. 6848.
A physician-prescribed device that magnifies, enhances, or augments visual images; excludes ordinary eyeglasses or contact lenses
What percentage of working-age adults with vision loss were unemployed in 2023?
43.1%
How many visually impaired individuals aged 21 to 64 are receiving SSI benefits?
> 630K
Which organization initiated the national effort for Medicare coverage of low vision devices?
American Council of the Blind (ACB)
What is the purpose of Social Security and Supplemental Security Income (SSI)?
To provide financial assistance to individuals with disabilities, including visual impairments
What was added to the Social Security Act in 1954?
Disability insurance
What defines statutory blindness under Social Security Administration (SSA) rules?
definition of legal blindness
Central visual acuity of 20/200 or worse with corrective lenses or visual field constriction of 20 degrees or less
True or False: Individuals with statutory blindness are eligible for free mailing services.
True
What are visual efficiency classifications used for?
They use visual acuity and visual fields to determine eligibility for social security benefits
What services do State Rehabilitation Agencies provide?
- Vocational rehabilitation counseling
- Assistive technology
- Transportation and travel training
Name two types of assistance available for visually impaired elders.
- Caregiver assistance
- Respite care
What do early intervention programs for small children provide?
- Counseling
- Parent training
- Information about ocular conditions
What transportation options are available for individuals with low vision?
- Public transportation discounts
- Private agencies
- Ride sharing services
Fill in the blank: Ride-sharing services offer various ______ features to support visually impaired users.
accessibility
What is one goal of the National Federation of the Blind (NFB) regarding ride-sharing?
Enhance accessibility features
What is the status of automated vehicle laws in California?
Full testing and deployment regulations, mandatory database tracking
Which state does not require special permits for automated vehicle testing?
Florida
What does Illinois law require for testing automated vehicles on public roads?
Manufacturers must coordinate with the Department of Transportation
True or False: Fully autonomous vehicles in Illinois can operate without a human operator present.
True
What approach should doctors take to support patient success?
Whole person approach
What is important for setting realistic expectations in patient care?
Communication
What is the purpose of Confrontation Field Testing?
Quick screening tool for gross defects
It is used in most eye care settings as a quick assessment.
What does the Goldmann Perimetry test involve?
Kinetic perimetry with movable targets
It allows effective use of both static and kinetic techniques.
What is Automated Perimetry?
Computerized static testing (e.g. Humphrey)
This method analyzes visual fields automatically.
What does the Confrontation Visual Field Testing utilize?
Comparison Method
The examiner compares patient’s field to their own.
How is the result recorded in Confrontation Field Testing?
Recorded as Full To Finger Counting (FTFC)
This is done if no gross defects are detected.
What is the positioning of the examiner in Confrontation Field Technique?
Examiner stands a few feet in front of patient
This allows for effective comparison of visual fields.
True or False: Confrontation Fields are a precise method for detecting subtle defects.
False
They are not as accurate as automated perimetry.
What is the key feature of the Tangent Screen Test?
Manual mapping of visual field
It involves a patient indicating when an object appears or disappears.
What does the Goldmann Visual Field test utilize?
Projected stimulus on illuminated bowl
This method has remained a clinical standard until automated perimetry.
What is the purpose of Humphrey Visual Field?
One of the most widely used automated visual field tests
It uses computer-controlled stimulus presentation and result analysis.
What are common testing strategies in Humphrey Visual Field?
- SITA
- SWAP
- FAST-PAC
- Kinetic
These strategies help in different aspects of visual field testing.
What is the Visual Field Index (VFI)?
The rate of visual field change; given as a percentage score, 100% normal; 0% blind
It is less affected by cataracts than Mean Deviation (MD).
When should Goldmann Visual Field be used?
- Poor Automated Performance
- Full Field Testing
- Defect Confirmation
It is helpful for patients with history of poor performance on automated tests.
What are the advantages of Humphrey Visual Fields?
- Reproducibility
- Digital Storage
- Normative Comparison
- Progression Analysis
These features enhance the testing process and result analysis.
What is a common error in Humphrey Visual Field testing?
Trial Lens Placement Error
This can result in artificial ring scotoma appearance.
What does Microperimetry combine?
Structural and functional aspects of the retina
This allows for more comprehensive analysis.
How do central scotomas affect visual function?
Affect reading, recognizing details, and perceiving facial expressions
They significantly impact daily activities.
What does the term ‘Ring Scotomas’ refer to?
Central scotoma surrounding a small area of preserved central vision
This condition can present functional challenges despite good visual acuity.
What is the main advantage of MAIA Microperimetry?
Real-time Imaging
It allows simultaneous measurement of retinal sensitivity while imaging.
What are the common causes of Central Field Defects?
- Macular Degeneration
- Diabetic Eye Disease
- Other Retinal Conditions
- Inherited Diseases
Conditions like AMD and diabetic macular edema are notable examples.
What is the impact of Central Field Loss on reading?
Impaired reading performance and speed
Central field defects strongly correlate with reduced quality of life.
What is the goal of rehabilitation for Peripheral Field Defects?
Bring information from non-seeing field into seeing field
This is crucial for improving navigation and mobility.
What does ‘Eccentric Viewing’ refer to?
Use of a Preferred Retinal Locus; Strategy to compensate for scotomas
Patients may need to adjust their eye movements to see around blind spots.
What types of visual field loss does the term ‘Hemianopic Visual Field Loss’ include?
- Homonymous
- Bi-temporal
- Bi-nasal
- Altitudinal
These types are often caused by neurological disorders like stroke, brain injuries, tumors, AION and retinal detachment.
What is a common characteristic of patients with hemianopic visual field loss?
Patients may be unaware of field loss
Hemianopic visual field loss can significantly affect daily activities.
What types of hemianopic visual field loss exist?
- Homonymous
- Bi-temporal
- Bi-nasal
- Altitudinal
Each type has different implications for visual function.
What are some causes of hemianopic visual field loss?
- Neurological disorders (stroke, brain injuries, tumors)
- AION
- Retinal detachment
Identifying the cause is crucial for effective management.
What are common patient complaints associated with hemianopic visual field loss?
- Not seeing things on one side
- Bumping into objects
- Losing place while reading
These complaints can lead to significant functional impairments.
What is the goal of rehabilitation for peripheral field defects?
Bring information from non-seeing field into the seeing field
This rehabilitation aims to improve patients’ quality of life.
What types of devices may be required for comprehensive rehabilitation of peripheral field defects?
Various devices including field enhancement devices and non-optical strategies
Different devices address unique aspects of visual impairment.
What are compensatory optics in the context of visual field enhancement?
- Field enhancement devices
- Non-optical strategies
These strategies help maximize the use of available vision.
What is minification in visual field enhancement?
Use of reverse telescopes or minus lenses for overall constriction
Minification helps patients with tunnel vision or severe peripheral field loss.
How do reverse telescopes assist patients?
Reduces image size to fit within remaining visual field
This allows patients to see more information at once.
What are the clinical applications of minus lenses?
Provides overall field constriction while maintaining reasonable working distance
Useful for patients with limited peripheral vision.
What is the function of prisms in visual field enhancement?
Redirect images from blind areas into functional visual field
Prisms help expand the patient’s awareness of their environment.
What role do mirrors play in visual field enhancement?
Help detect objects in non-seeing areas
Mirrors can be mounted on regular spectacles for daily use.
What is a caution when using minification techniques?
May have poor image resolution and decreased visual acuity proportionally
Patients should be informed about potential downsides.
What are Fresnel prisms?
Press-on prisms, thinner and lighter than traditional prisms
They are less expensive and can be applied without grinding into glasses.
What is the design of Peli prisms?
High-powered prism segments placed above or below the line of sight
They expand awareness of the visual field for hemianopia patients.
What is the importance of visual field testing?
- Critical for low vision exams
- Monitors ocular conditions
- Impacts daily activities
Essential for understanding patient function and categorizing visual impairment.
What are two considerations when thinking about children with low vision?
Children have unique needs due to their developing visual systems and cognitive abilities.
What are some age-related changes in vision that geriatric patients experience?
Geriatric patients may experience age-related changes in vision, requiring different examination approaches.
What is essential for patients with multiple disabilities?
Patients with multiple disabilities require careful consideration and customized rehabilitation plans.
What are the main components of a rehabilitation plan?
- Refractive correction
- Magnification devices
- Assistive technology
- Recommendations for training
- Referral to other services and specialists
What is the goal of rehabilitation for patients with visual impairments?
Maximize the patient’s residual vision while taking into consideration their unique set of needs and challenges.
What should be considered when examining infants, toddlers, and children?
Individual abilities and behaviors; use age as a guideline.
Why is building rapport with the child important during examinations?
Building rapport helps adapt strategies to reflect the capabilities of the child and based on past exam experiences.
What strategies can be used for child examinations?
- Patience & Creativity
- Repeat & Modify
- Reward Systems
- Parent Collaboration
What is the purpose of a reward system during child examinations?
The goal of a reward is to reinforce the importance of visual attention and cooperation.
What information should a pre-exam information packet contain?
Information Packet should have questionnaires for teachers, parents and caregivers to be completed before the examination; should help to understand the child’s needs and goals as well as provide background information on eye care history, exam data and educator insights
What considerations should be made for children with medical conditions?
- Neurological Monitoring: seizure disorders, medication effects
- Medical Alert Systems: diabetes, allergies, swallowing issues, cardiopulmonary conditions
- Activities & Engagement: choose activities carefully
What should be reviewed when assessing medications and ocular health in children?
- Developmental History
- Educational Information
- Medication Side-Effects
- Comprehensive Evaluation
What should be observed in children’s visual exploration?
- Object Size
- Reaching for Objects
- Visual vs Oral Exploration
What is the significance of IEP/504 plans in children’s visual assessments?
Individualized Education Programs (IEP) and 504 plans help to meet a child’s educational needs through goal setting.
What are two strategies for determining visual acuity in children with visual impairment?
- Resolution acuity
- Recognition acuity
What factors should be considered in visual acuity testing in children?
- Visual Status
- Cognitive Abilities
- Acuity Strategies
When should resolution acuity testing be performed?
Resolution acuity testing is typically performed on a child whose cognitive age is below 3 years old.
When is recognition acuity testing typically performed?
Recognition acuity is typically performed on a child whose cognitive age is above 3.
LEA symbols, letters, or numbers
What should be maintained during visual acuity testing?
Try to maintain the same working distance.
What is the purpose of using an OKN drum?
An OKN drum can be used to test acuity in younger children and measures involuntary visual response.
provides a rough estimate of visual acuity based on strip width; OKN reflex develops around 6 months of age
What testing methods can be used to determine refractive error in children?
- Mohindra Retinoscopy
- Cycloplegic Refraction
- Autorefractors
What are common chronic conditions affecting the geriatric population?
- Cardiovascular Disease
- Strokes
- Diabetes
What is crucial when developing a low vision rehabilitation plan for geriatrics?
Consider all diagnoses and impairments.
What should be included in the documentation review for geriatric examinations?
Request all available documentation regarding the patient’s visual status, including past examinations and medical history.
What essential items should be gathered for geriatric examinations?
- Medication List
- Current and Previous Eyeglasses
- Previous Low Vision Devices
What should be assessed during near vision testing in geriatrics?
Assessing near vision is crucial for identifying challenges with everyday tasks, like reading.
True or False: The geriatric population is expected to decrease in prevalence until 2050.
False
What are essential considerations for testing children with visual impairments?
- Visual Processing Evaluation
- Figure-Ground Issues
- Contrast Sensitivity
What is eccentric viewing?
A technique used by patients to optimize their vision by adjusting their preferred viewing position
Consider providing additional training if necessary.
What is the purpose of determining visual acuity with isolated vs. single letters?
To identify if visual acuity is better with isolated letters or single letters, indicating an island of vision centrally.
What could it indicate if a patient omits letters during testing?
Visual field loss or peripheral scotomas.
Why is near vision assessment important in geriatrics?
To identify challenges with everyday tasks, like reading.
What is the initial step in near vision testing for geriatric patients?
Begin with single letter acuity to gauge initial success and build confidence.
What does continuous text testing assess in geriatric patients?
Reading fluency and comprehension using standardized continuous text charts.
What is a key consideration for lighting during near vision testing?
Introduce proper lighting to ensure minimal glare or reflections.
What common refractive error increases with age?
Increased hyperopia.
What type of astigmatism becomes more prevalent in older adults?
Increased against-the-rule astigmatism.
What is the purpose of accurate refraction in geriatrics?
To determine the best corrective lenses and assess best-corrected visual acuity (BCVA).
What challenges may arise during refraction in geriatric patients?
Age-related changes such as miosis, high refractive error, and media opacities.
What is the goal of refraction for geriatric patients?
To provide the best-possible spectacle prescription for optimal BCVA.
What activities do many geriatric patients value maintaining?
- Reading
- Writing
- Activities of daily living
- Distance vision
Why is patient education important in geriatric rehabilitation?
It allows for more effective goal setting and device selection.
How can improved reading skills impact medication management for seniors?
Enables seniors to read labels and administer medication correctly.
What is the significance of visual field testing in geriatrics?
Identifies potential issues due to higher risk of developing peripheral vision impairments.
What should be evaluated in patients with Age-Related Macular Degeneration (AMD)?
The central 10 degrees of visual field.
What testing tool is used for standard contrast sensitivity measurement?
Pelli-Robson Chart.
What common complaints related to vision may geriatrics experience?
- Glare
- Photophobia
What is essential to consider when selecting low vision devices for geriatrics?
An individualized approach tailored to each patient’s needs.
What may make it difficult for patients with arthritis to use telescopic devices?
Difficulty adjusting or grasping the device.
How can handheld magnifiers be challenging for certain geriatric patients?
Patients with tremors or grip problems may find them difficult to use.
What are some examples of non-optical devices for geriatrics?
- Large syringes
- Pill boxes with large print
- Liquid level indicators
What social changes may occur during late adulthood?
- Passing away of peers
- Retirement adjustments
- Income changes
- Living arrangements
What is a common personal care challenge for geriatrics?
Decreased vision making routine tasks difficult.
What is the impact of dual sensory impairment in older adults?
Reduces functional independence and quality of life.
What types of visual deficits can result from traumatic brain injury (TBI)?
- Poor concentration
- Fatigue
- Headaches
- Reading problems
- Visual field defects
- Spatial perception difficulties
What are common recommendations for low vision rehabilitation after TBI?
- Magnification
- Electronic magnification
- Optical character readers
- Contrast adjustments
- Tinted glasses
What percentage of adults aged 75 and older experience some degree of hearing loss?
Over 33%.
What are auditory aids?
Talking devices and alarms that provide verbal cues. Improves safety and awareness.
How does adjustable lighting benefit individuals with visual impairments?
Enhances contrast and reduces glare, promoting visual comfort.
What are tactile aids and give examples?
Bump dots and Braille labels that offer tactile identification. Increases ease of use.
True or False: Non-optical aids can only be used without magnification devices.
False
What is the purpose of extra long oven mittens?
Decrease the risk of burns.
What do high contrast measuring cups enhance?
Visibility for accurate measuring.
What does a liquid level indicator do?
Alerts when liquid nears the top of the cup.
What is the function of a talking microwave and timer?
Provide auditory alerts and feedback.
List some non-optical aids used in the kitchen.
- Extra Long Oven Mittens
- High Contrast Measuring Cups
- Liquid Level Indicator
- Talking Microwave and Timer
- High Contrast Cutting Boards
What is the benefit of using barrel magnifiers?
Make markings easier to see.
What does a safe shot assist with?
Set up pre-measured insulin dosages.
Fill in the blank: Large print ____ provide spiritual support and readability.
[texts]
What are some examples of large print materials?
- Religious Texts
- Magazines and Crosswords
- Board Games and Playing Cards
- Large Button Phones
What are bump dots used for?
Raised stickers placed on appliances to aid in identifying controls.
What is the purpose of Braille?
Offers a tactile reading system that enhances literacy and independence.
What is the function of screen readers?
Reads on-screen content aloud.
What does optical character recognition do?
Converts printed text to digital format.
What are some key accessibility features of phones and tablets?
- Voice Activated Dialing
- Adjustable Font Size
- Text to Speech
- Contrast settings
- Screen magnification
What benefits do mobile technologies provide for accessibility?
Growing accessibility, voice control, adjustable settings, and text-to-speech.
What is the purpose of GPS apps?
Navigation assistance.
What does the KNFB Reader app do?
Text recognition.
Fill in the blank: iPhone features like ____ assist users with visual impairments.
[Zoom and VoiceOver]
What is the function of the OrCam MyEye?
A discreet wearable device that reads text, recognizes faces, and provides audio feedback.
What are the key accessibility features of Google Home?
- Voice-activated commands
- Audio feedback
- Reads books and news aloud
- Controls smart home devices
What is optogenetics?
A technique that uses light to control cells and events in living organisms.
What role do nutraceuticals play in eye health?
Support eye health through vitamins and minerals like lutein and zeaxanthin.
What does the AREDS2 formulation include?
- Copper (2 mg)
- Lutein (10 mg)
- Zeaxanthin (2 mg)
- Zinc (80 mg)
- Vitamins A, E, C
True or False: High-dose statins have shown potential benefits in vision gain.
True
What is the Argus II?
A retinal implant device intended for patients with retinitis pigmentosa.
What does the BrainPort V100 do?
Stimulates the tongue to provide tactile feedback for perceiving objects.
What is Charles Bonnet Syndrome?
A condition involving visual hallucinations in individuals with vision loss.
How does echolocation benefit visually impaired individuals?
Helps with direction detection and enhances brain activity.
What is non-24 sleep disorder?
A circadian rhythm disorder affecting totally blind individuals, causing misalignment with the 24-hour cycle.
List some management options for low vision patients.
- Comprehensive Assessment
- Optical Aids
- Non-Optical Aids
