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Clinical Skills > Helping people with Visual Impairment > Flashcards

Helping people with Visual Impairment Flashcards

1
Q

What to say when seeing a px

A
  • What is causing the sight loss
  • Which eye disease ?
  • How long have they had it ?
  • What difficulties do they have?
  • What do they want help with?
  • What help have they received to date?
  • History taking - how long condition
  • Any struggles/difficulties - how to help them
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2
Q

What else to ask px

A

What can px see - SVD/SVI/SVN - objective measurement of what they can see
- Measure each eye individually then both eyes together
-

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3
Q

What’s the problem with SVD chart

A

Its all 100% contrast - black on white

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4
Q

What chart is used to measure contrast sensitivity

A

Penny Robson chart

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5
Q

What is contrast sensitivity

A

How well they can see at different contrasts - top = dark, bottom = light i.e. letters are faded out
- Letter sizes are constant

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6
Q

Eyecare journey

A 
Each person with a visual impairment goes on their own “Eyecare journey”
Journey is never ending
There are journeys within the journey
“Eyecare” implies focusing on health
Journey is often very difficult
What can be done to make it easier?
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7
Q

What are the 3 B’s to help px’s

A

Bigger
Brighter
Bolder

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8
Q

How do the 3 B’s help

A 
Bigger = read print more easily - bring closer
Brighter = dark room - see things
-Bolder = easier to read
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9
Q

How to make things bigger

A

Doubling the size of an object gives X2 magnification
Move closer
Half the distance will make things twice the size
Use magnifiers
Use large print
Try adapted equipment e.g. large faced clocks and watches
Try larger TV screens
Try large labels and notes

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10
Q

How to make things bolder

A 
Use colour and tone contrast
Try a bold font when using a PC
Try white crockery on a dark tablecloth
Try white cups for tea and coffee
Try white edges on dark steps and dark edges on white steps
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11
Q

How to make things brighter

A

Use increased light

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12
Q

What is purpose of magnifiers

A

Make things bigger

Optical low vision aids

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13
Q

What are the types of magnifiers

A

-Spectacle Magnifiers
-Hand-held magnifiers
Illuminated
Non-Illuminated
Stand magnifiers
Illuminated
Non-Illuminated
Other Magnifiers
Bar Magnifier
Flat Field Magnifier
Telescopes

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14
Q

What’s the formula for magnification and example

A

Magnification= F/4

e.g. If F=12DS, Magnification=12/4=3x ( how much bigger it would make it )

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15
Q

Whats the magnification for 4DS

A

1X

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16
Q

What does magnification assume

A

Working distance of 25 cm

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17
Q

Spectacle Magnifiers: Advantages

A

Hands free
Cosmetically and psychologically acceptable
Different types possible-e.g. bifocals
Large Field of view
May flip up/out of line of sight - can wear them on nose and read
May be able to use both eyes

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18
Q

Spectacle Magnifiers: Disadvantages

A 
Short working distance
Conspicuous if clip on/head band mounted
May be heavy - due to higher power of lens
Lens errors
May be difficult to use both 
  eyes together
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19
Q

What happens when high power

A

More errors in lens due to optical properties

Cant use both eyes together

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20
Q

Hand-Held Magnifiers

A

Available up to about 6x non-illuminated and about 15x illuminated ( light )
Cosmetically/Socially acceptable
Cheap
Portable
Easy to use
Can be used at any distance from the eye - adjust working distance to suit your needs
Lower powers available in larger diameters

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21
Q

Hand-Held Magnifiers: Disadvantages

A

Not good if hand tremor present or arthritic especially at higher powers
Best suited for short duration tasks e.g. reading off medicine to see how many times to use
Can be used inappropriately
Internal illumination can make magnifier heavy

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22
Q

Stand- Magnifiers: Advantages

A 
Up to 20x available 
Both hands are available to use and working distance easily maintained - dont have to adjust working distance 
Lower powers may allow use of pen 
Stable 
Hold them flat in page
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23
Q

Stand Magnifiers: Disadvantages

A

May block light although illuminated varieties available
Can be bulky and heavy especially lower powers - cant put in pocket
Might be difficult to read a book because of the hump caused by the binding
Difficult to perform tasks underneath at high powers - stand is v.small

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24
Q

Flat-field Magnifiers

A

1.7-5X magnification
Popular with children
Dome shaped

25
Bar Magnifiers
``` Plano-cylindrical lenses Magnify the height of letters only Can cover whole page Usually on 1-2X magnification Can read long distances as its long Low magnification ```
26
Telescopes: Advantages
Wide range of focusing distances: distance/intermediate/near Incorporate patient’s prescription Greater working distance than other equivalent LVAs Spectacle-mounted design allows hands free Auto focus available - dont have to manually focus - but more expensive
27
Telescopes: Disadvantages
``` Expensive Difficult to use Poor field of view Can be heavy Reduces image brightness ```
28
Where can you get optical Low vision aids
Usually through the Hospital Eye service | Optical aids tend to be free on the NHS
29
What is a non-optical low vision aid?
A device which doesn’t use any optical lenses, but that helps people with low vision to function more effectively and comfortably during visual tasks
30
What is function of low vision aid
- increase a persons functioning by improving the localised environment and supporting the person - Specialist lighting equipment that improves visual performance and supports the use of vision and LVAs - Devices that provide posture and ergonomic support -
31
Non- Optical Devices
- Large number and extensive range of non-optical devices including electronic devices Large print books-Speech synthesisers Cost can vary considerably from little as a pound to several thousand pounds
32
What is the most important non - optical aid
Lights
33
How does performance increase
With improvements in task illuminance
34
Difference between amount of light received by 20 year old and 60 year old
60-year-old retina receives one-third the amount of light that reaches the 20-year old retina (Weale,1961)
35
How to Increase general ambient level of illuminance
E.g.- Draw curtains well back, clean curtains regularly and avoid use of net curtains Paint house walls with light colours Use fluorescent fittings
36
Optimising Lighting for VI patients
Providing enhanced illumination for detailed tasks in a localised area (task lighting) Localised lighting not only while reading but also for other tasks such as over telephone, under wall mounted kitchen cabinets etc. Carry torch when ambient lighting is poor
37
Glare
Visually Impaired people may suffer from glare Use sunglasses Visors or Caps
38
What can be used to make reading/writing easier for visually impaired
- Reading stands - Writing guide - Typoscopes - Signature guide
39
What are some large print items used
``` Large button phones Large print books, address books, diaries, crosswords etc. Large playing cards Big Print Newspaper Large number clocks/watches ```
40
What are some talking items used
``` Talking Watches, Talking Clocks Talking Microwave Talking Newspaper Talking Calculators Talking Blood Glucose meter ```
41
What are some managing money items used
Note Detector | Coin Holder
42
What are some other useful gadgets/aids
``` Audio described Videos Pen Friend Voice labeller Pill Organisers Bump-ons Liquid Level indicators ```
43
Electronic Visual Enhancement Systems
CCTVs- Correct terminology | Not available on NHS
44
Advantages of
Large Range of Magnification: Variable Magnification: Deterioration of vision Good Contrast, Different Contrast Options, Contrast Reversal Good working distance Good Field of View Can use both eyes Minimal peripheral Aberration, less critical focus and reduced light loss Various option such as underlining text, splitting screen, cutting out unwanted text, scrolling of text Longer reading duration than optical aids
45
Disadvantages of
More practice Can be bulky Expensive Can cause poor posture if bad position is adopted
46
CCTV's
``` Mouse Style Devices Need an ordinary TV or a computer Cheapest Option Portable devices Also cheap ```
47
Advantage of CCTV desktop varieties
More options than mouse style devices or portable devices
48
Disadvantage of CCTV desktop varieties
Expensive
49
Head Mounted Devices examples
Give Vision glasses ESight glasses Oxford Smart Specs
50
Examples of apps for visually impaired
Be my eyes Seeing AI/Envision AI/KNFB reader Tap Tap See See Soundscape/Seeing Eye GPS/Nearby Explorer
51
Digital Assistants examples
Alexa | Google home assist
52
How do computers help visually impaired
``` Most computers have accessibility settings to Magnifiers, narrators, reverse colours Settings > Ease of Access->Magnifier Magnification software for Windows Supernova Zoomtext MAGic Screen readers Supernova Reader System Access Window-Eyes Combined speech and magnification software iZoom Screen Magnifier/Reader SuperNova Access Suite ```
53
What is Braille and Moon
Tactile reading code that enables VI people to access information by touch
54
What are examples of Braille gadgets
Braille Note Braille Displays Braille Embossers and writers Tactile graphic maker
55
The Voluntary Sector – the eye world
``` National RNIB Guide Dogs for the Blind (GDBA) Macular Local Local societies About 100 ```
56
The Voluntary Sector – how to find out more
``` Internet Publications Charities Digest Voluntary Agencies Directory (NCVO) Directory of Specialist Conditions ```
57
Personnel Involved in Low Vision Services
``` Carers Dispensing Opticians General Practitioners Occupational Therapists Ophthalmic Nurses Ophthalmologists ```
58
Personnel Involved in Low Vision
``` Optometrists Orthoptists Rehabilitation Workers/Officers Social Workers Voluntary Workers Eye Care Liaison Officers (ECLOs) Specialist Teachers ```
59
The Voluntary Sector – other related groups
``` Age Concern Help the Aged Arthritis Care RNID Sense ```

Clinical Skills (6 decks)

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