Low Vision Conditions In Adults

Question 1

Mild vision loss, or near-normal vision: 20/30 to 20/_______.

Answer 1

20/30 to 20/60

Question 2

Moderate visual impairment, or moderate low vision: 20/70 to 20/___________.

Answer 2

20/70 to 20/160

Question 3

Severe visual impairment, or severe low vision: 20/_____ or __________

Answer 3

20/200 or worse

Question 4

Profound visual impairment or profound low vision 20/500 to 20/________.

Answer 4

20/500 to 20/1000

Question 5

Near-total visual impairment or near-total low vision: <__/_________

Answer 5

<20/1000

Question 6

Total visual impairment, or total blindness: __________________.

Answer 6

No light perception

Question 7

Legally blind is defined as corrected vision of ____/_______ in the best-seeing eye with the use of corrective lenses

Answer 7

20/200

Best-corrected vision is the best vision attainable using the best eye, with corrective lenses or contact lenses.

Question 8

_____________ is a model of processes that interact with and subserve each other, including visual cognition, visual memory, pattern recognition, visual scanning, and visual attention and alertness.

Answer 8

Visual–perceptual processing hierarchy

Question 9

Which aspect of the visual–perceptual processing hierarchy is described below?

using saccadic eye movements “to focus on the object with the fovia, the area of the retina with the greatest ability to process detail

A. visual cognition
B. visual memory
C. pattern recognition
D. visual scanning
E. visual attention and alertness.

Answer 9

D. visual scanning

Question 10

Which aspect of the visual–perceptual processing hierarchy is described below?

identifying salient features of an object and using these features to distinguish the object from its surroundings

A. visual cognition
B. visual memory
C. pattern recognition
D. visual scanning
E. visual attention and alertness.

Answer 10

C. pattern recognition

Question 11

Which aspect of the visual–perceptual processing hierarchy is described below?

the ability to create, retain, and recall memories of images to use for comparison during visual analysis

A. visual cognition
B. visual memory
C. pattern recognition
D. visual scanning
E. visual attention and alertness.

Answer 11

B. visual memory

Question 11

Which aspect of the visual–perceptual processing hierarchy is described below?

the ability to manipulate visual input and integrate vision with other sensory information to gain knowledge, solve problems, formulate plans, and make decisions

A. visual cognition
B. visual memory
C. pattern recognition
D. visual scanning
E. visual attention and alertness.

Answer 11

A. visual cognition

Question 12

Which aspect of the visual–perceptual processing hierarchy is described below?

attending to an object or information in the environment while ignoring irrelevant sensory information

A. visual cognition
B. visual memory
C. pattern recognition
D. visual scanning
E. visual attention and alertness.

Answer 12

E. visual attention and alertness

Hemi-inattention occurs when visual search patterns are confined to one side of the visual array, creating an asymmetric search pattern in which the client misses information on the other side. Visual spatial neglect is the most severe form of hemi-inattention.

Question 13

______________ enables eye movements to be completed quickly and accurately, and keeps the image focused on the fovea to ensure it can be clearly seen.

Answer 13

Oculomotor control

Question 14

__________ is the ability to focus at various distances. It can be affected by brain injury, disease, or age. Dysfunction is a common part of the normal aging process, causing presbyopia.

Answer 14

Accommodation

Question 15

___________is the muscle action of moving the eyes inward in adduction to allow focusing on nearby objects.

Answer 15

Convergence

Question 16

______________ causes the perception of double images of a single object. Diplopia results from weakened or paralyzed muscles in one eye, which decreases that eye’s ability to move in accordance with the other eye and focus on the object.

Answer 16

Diplopia

Question 17

____________ is the ability to see visual details and color.

Answer 17

Visual acuity

Question 18

The ________________ is the most common visual acuity measurement. 20/20 vision means that when standing 20 feet away, the viewer can see the letter that a person with normal vision can see at 20 feet.

Answer 18

Snellen fraction

Likewise, 20/200 visual acuity means that the viewer can see the letter at 20 feet that a person with normal vision can see at 200 feet.

Question 19

________________ is difficulty focusing on near objects and is a common age-related change in adults over age 50. The lens of the eye becomes less flexible, reducing the ability to read small print.

Answer 19

Presbyopia

Question 20

_______________, or nearsightedness, is a normal deficiency in visual acuity in which near objects are seen more clearly than distant objects; myopia can be corrected with glasses.

Answer 20

Myopia

Question 21

______________, or farsightedness, is a normal deficiency in visual acuity in which distant objects are seen more clearly than near objects; can be corrected with glasses.

Answer 21

Hyperopia

Question 22

________________ is the ability to detect the borders of objects reliably as they decrease in contrast (rather than size) from their background

Answer 22

Contrast sensitivity

Question 23

_________________ is what the person sees when looking straight ahead. Most of the ________ is binocular.

Answer 23

Visual field

Question 24

The _____________ or ambient visual system is composed of rod photoreceptors. It provides background information about one’s position in relation to the environment and is quick to detect motion. It consists of the scope of vision in each eye.

Answer 24

peripheral visual field

Question 25

The _______________ is composed of the macula and fovea. It encompasses the central 20° of vision.

Answer 25

central visual field

Question 26

Name 2 changes in vision over time.

Answer 26

• Subcutaneous fat around the eye decreases.
• Muscle strength, tone, and the transparency of the corneas decrease, while the cornea itself thickens.
• The sclera and iris show signs of degeneration.
• The pupils become smaller.
• The lens of the eye becomes thicker, less flexible, and more opaque.
• Eye diseases become more common.

Question 27

Name 2 functional impairments in vision related to aging.

Answer 27

• The ability to see close objects and coordinate the eyes decreases.
• Images become blurrier.
• The ability to see at night decreases.
• The eyes adapt more slowly to changes in lighting conditions.
• Contrast sensitivity decreases.
• The ability to view objects in low light decreases.
• The ability to distinguish certain colors (e.g., blue and green) diminishes.
• Visual fields become narrower.

Question 28

___________ leads to blind spots in the macula, the central portion of the eye that is responsible for providing the fine detail required for near-distance activities.

Symptoms: Objects appear distorted, straight lines appear crooked. Reading-dependent IADLs become difficult (e.g., reading labels); difficulty with functional mobility as identifying low contrast is challenging.

Answer 28

Age-related macular degeneration

Question 29

_________ occurs when the intraocular fluid becomes blocked, resulting in increased intraocular pressure. This pressure reduces blood flow to the optic nerve, causing loss of peripheral vision and eventual blindness.

Symptoms: Difficulty with functional mobility (client may not see objects), objects and people outside client’s residual vision can suddenly appear startling client, difficulty with reading and writing, difficulty with night vision.

Answer 29

Glaucoma

Question 30

_____________ is caused by high sugar in blood vessels in the retina, which start to bleed in the vitreous. It can cause vision loss and blindness.

Symptoms: fluctuating vision, blurred vision, loss of central and peripheral fields, decreased contrast sensitivity (e.g., can’t see water on the floor), difficulty with night vision and color discrimination

Answer 30

Diabetic retinopathy

Question 31

________________ occur when the lens of the eye becomes more opaque or clouded, reducing the light going into the retina and altering vision. Mostly related to aging and is common in older adults.

Symptoms: Cloudy or blurry vision, reduced visual acuity (e.g., difficulty reading), colors appear faded

Answer 31

Cataracts

Question 32

What are some interventions for individuals with low vision?

Answer 32

• Use adequate lighting without glare.
• Organize and declutter the physical and visual environments.
• Improve contrast between objects and work surfaces.
• Use large print (14/16 pt or higher)
• Educate on fall prevention
• Refer clients to certified orientation and mobility specialists when they have difficulty with or must learn new strategies for crossing streets, planning routes, detecting curbs or drop-offs, walking along rural roads without sidewalks, following public transit routes, using a long white cane, or staying oriented within a particular (often complex) environment).
• Refer clients to driving specialist

Question 33

Which tool used for low vision evaluation and assessment is described below?

assesses the impact of a person’s visual impairment on ADLs and IADLs.

A. Canadian Occupational Performance Measure (COPM)
B. Model of Human Occupational Screening Tool (MOHOST)
C. Melbourne Low-Vision ADL Index

Answer 33

C. Melbourne Low-Vision ADL Index

Question 34

Which tool used for low vision evaluation and assessment is described below?

a semistructured interview used to identify a person’s perception of his or her performance in the areas of self-care, productivity, and leisure. It is also used to rate the importance of activities to the person and how the person’s perception of performance changes over time.

A. Canadian Occupational Performance Measure (COPM)
B. Model of Human Occupational Screening Tool (MOHOST)
C. Melbourne Low-Vision ADL Index

Answer 34

A. Canadian Occupational Performance Measure (COPM)

Question 35

Which tool used for low vision evaluation and assessment is described below?

provides information regarding the impact of volition, habituation, skills, and the environment on occupational performance. It can be used during informal observation.

A. Canadian Occupational Performance Measure (COPM)
B. Model of Human Occupational Screening Tool (MOHOST)
C. Melbourne Low-Vision ADL Index

Answer 35

B. Model of Human Occupational Screening Tool (MOHOST)

Question 36

What are 3 things to consider when evaluating the home of an individual with low vision?

Answer 36

1. Lighting in the home
2. Contrast of items in the environment (e.g., edges of stairs and showers, curbs, dropoffs, and changes in surfaces)
3. Presence of glare.

Question 37

How can you test visual acuity (near and distance)?

Answer 37

Near visual acuity: while the client is wearing prescribed eyewear, hold a newspaper or magazine 16 inches from their eyes and ask them to read headlines, subheadings, and fine print.

Distance visual acuity: while the client is wearing prescribed eyewear, point to objects more than 10 feet away and ask them to read or describe the objects.

Question 38

Confrontation testing, which provides a gross indication of field loss, assessing which kind of visual field?

Answer 38

Peripheral visual field

The client fixes on a central target and acknowledges the appearance of stimuli in the peripheral visual fields.

Question 39

What assessment is used for contrast sensitivity?

Answer 39

Pelli-Robson Contrast Sensitivity Chart

Question 40

What are two assessments of oculomotor function?

Answer 40

1. Brain Injury Visual Assessment Battery for Adults to complete and observe the client’s eye movements.
2. Obtain history and ask about experiences of diplopia

Question 41

The Amsler grid is used to assess what aspect of visual function?

Answer 41

Central field of vision

Question 42

A client was given eccentric viewing exercises during their session. What is this used for and how is it done?

Answer 42

Visual Acuity

Clients with central vision loss are taught to rotate the head or turn the trunk to view an object using an area of the peripheral vision (called the preferred retinal).

Question 43

What are some examples of sensory substitution for low vision clients?

Answer 43

Apply tactile markers (e.g., bump dots, raised or puffy paint) to mark the most frequently used settings on appliances (e.g., dishwashers, stoves, microwaves) or to help in locating numbers on a keypad.

Use auditory or talking items (e.g., talking watches, clocks, thermometers). Set up voice activation on a phone or tablet (e.g. “Siri, call my daughter” or “Google, call Joyce”).

Question 44

Name 2 lighting interventions for a low vision/vision impaired client.

Answer 44

1. Increase the types and locations (e.g., close to task) of lighting available to the client
2. have the client take steps to avoid glare by wearing a hat or tinted glasses both indoors and outdoors.
3. Update lightbulbs or lamps (e.g., to full spectrum or ultra definition) to allow for a full spectrum of colors to be seen.

Question 45

Name 2 contrast interventions for a low vision/vision impaired client.

Answer 45

1. Bold-lined paper and bold-tipped pens
2. Change brightness, background, and text color of electronics
3. Colors that contrast with or are opposite to each other (e.g., blue and yellow, black and white) can be used to help objects stand out from the background
4. Contrast can be improved by eliminating patterned backgrounds in the person’s home.

Question 46

Name 2 interventions for visual field loss.

Answer 46

1. Teach clients with peripheral vision loss to rotate the head and trunk to ensure that they are seeing the entire visual field.
2. Teach clients how to scan in an organized manner (e.g., left to right, then top to bottom) to identify hazards in the environment and locate desired objects).
3. Teach clients strategies for visual search and scanning:
   –Reading: a new pattern for eye movements must be developed due to the narrowed visual field.
   –Mobility: a wider visual search pattern must be developed to promote awareness of items in the environment.

Question 47

Name 2 interventions to improve oculomotor function.

Answer 47

1. Occlusion: covering one of the eyes to reduce diplopia. OT practitioners can provide occlusion only under the direction of an ophthalmologist or optometrist.
2. Prism: used to re-establish single vision. Prisms can be provided only by an ophthalmologist or optometrist.
3. Eye exercises: restore binocular function. Eye exercises are provided under the direction of an ophthalmologist or optometrist.
4. Surgery: changes the position of the eye in the socket to eliminate diplopia. Surgery is performed by an ophthalmologist.