Low Vision Final Study Guide Part 2

Question 1

Assistive technology/optical devices

Define the term “magnification.”

Answer 1

The process of enlarging the apparent size not physical size of something

Question 2

Assistive technology/optical devices

Describe what is meant by “relative distance magnification.”

Answer 2

If you move** closer** to the object, the object becomes **relatively bigger **

Question 3

Assistive technology/optical devices

Describe what is meant by “relative size magnification.”

Answer 3

• Size of object is made larger
• If viewed at the same distance, it appears relatively larger

Question 4

Assistive technology/optical devices

How does angular magnification work?

Answer 4

• achieved using am optical lens
• makes objects at a distance appear closer to the eyes, therefore larger.

Question 5

Assistive technology/optical devices

What shape of lens do angular magnifiers use?

Answer 5

Traditional magnifiers use convex lenses

Question 6

Assistive technology/optical devices

What will happen if a visual object falls outside of the focal range of a magnifier?

Answer 6

If an object is outside the focal range, it will appear upside down.

Question 7

Assistive technology/optical devices

What is the name for the visible area inside the magnifier?

Answer 7

Field of view

Question 8

Assistive technology/optical devices

What are the three general rules of magnifier strength?

Answer 8

• shorter the focal distance
• smallest field of view
• heavier the magnifier

Question 9

Assistive technology/optical devices

Describe the proper technique for positioning a magnifier.

Answer 9

It is okay to hold the magnifier anywhere in relation to the ye as long as the object being viewed is within focal distance of the magnifier.
* focal distance must be maintained
* viewing distance can be flexible

Question 10

Assistive technology/optical devices

The refractive strength (power) of a magnifier is measured in what units?

Answer 10

Refractive strength of lens is measured in diopters (D)

Question 11

Assistive technology/optical devices

Be able to calculate the diopter strength of magnifier given its focal length.

Answer 11

Divide by 100 by the focal length of the magnifier.
100/5= 20 diapters of strength

Question 12

Assistive technology/optical devices

Are X-units equivalent to diopters?

Answer 12

• Strength of magnifiers is sometimes given ‘X Units’ instead of diopters
• There is NO standardization of X units, however, 1X = approximately 4 diapters

Question 13

Assistive technology/optical devices

Should a person wear their eyeglasses when using a magnifier?

Answer 13

Yes!! Person should always wear their eyeglasses when using any magnifier

Question 14

Assistive technology/optical devices

Be able to tell if an eyeglass prescription corrects for nearsightedness or farsightedness.

Answer 14

• Concave lens- Corrects for myopia (nearsighted)
• Helps see things in distance
• Convex lens- Corrects for hyperopia (farsighted)
• Helps see thing near

Question 15

Assistive technology/optical devices

Know the proper technique for using a handheld magnifier.

Answer 15

1. Find the focal distance
   a. Begin by laying the magnifier on the page, then pulling it away until the print comes into focus
2. View through the distance portion of eyeglasses (if worn)
3. Move the magnifier across the line of text you are reading
4. Trace the line just read back to the left side of page
5. Drop down to next line of text

Question 16

Assistive technology/optical devices

What are the advantages of using a stand magnifier.

Answer 16

• Self-maintains the focal distance
• Can use stronger powers
• Less hand strength and coordination

Question 17

Assistive technology/optical devices

Know the proper technique for using a monocular telescope.

Answer 17

1. Locate the target without using the telescope
2. Bring the telescope to the eye
3. Hold the telescope as close to the eye as possible
4. Stabilize the support arm
5. Blur out the object, then slowly bring it into focus

• If client has difficulty locating target, you can eliminate all light sources except telescope window, occlude the other eye, occlude peripheral vision in viewing eye.

Question 18

Assistive technology/optical devices

What are some considerations for recommending a desktop CCTV?

Answer 18

• Requires dedicated space (not generally portable)
• Requires practice – person must now look up at screen while reading or writing instead of down
• Ergonomics – how to setup to support sound body mechanics
• Cost – Expensive

Question 19

Assistive technology/optical devices

What are some considerations for recommending a portable electronic magnifier?

Answer 19

* Screen size may not accommodate all text, depending upon how large – Means person may have to move device around
* Often not efficient for handwriting tasks
* Typically for near tasks only, no distance viewing
* Must remember to charge device (also where it was placed)
* **Cost **– Midrange

Question 20

Are ADLs and IADLs equally impaired by low vision conditions? Why?

Answer 20

**IADLs are more impaired **by low vision conditions than basic ADLs because they are more vision
dependent.

Question 21

Should the initial OT evaluation only focus on ADL and IADL performance? What additional 2 factors should be included?

Answer 21

No – Goes beyond ADLs and IADLs to address self management of chronic diseases and safety

Question 22

Be able to provide examples of secondary safety factors for assessment.

Answer 22

1. Factors that increase risk for disability
– High blood pressure
– Smoking
– Sedentary lifestyle
– Obesity
– Nutrition
– Falls
– Depression

2. Safety
– Ability to accurately identify medications
– Spoiled food/food safety
– Dial emergency numbers

3. Emergency procedures
– Dialing 911 and emergency contacts
– Fire evacuation
– Severe weather safety

4. Unsafe areas of house
– Poor repair

Question 23

Is the R-SRAFVP an objective assessment? How is ADL performance assessed by the R-SRAFVP?

Answer 23

• No – Subjective
• Administer is a quiet environment – 20 minutes to administer
• Explain the rating scale to the client
  – May want to develop a cheat sheet
• Describe each ADL task – description is included with the form
• Instruct the client to rate ability to complete the task using the rating scale
• Circle the corresponding number
• If there is a discrepancy in reporting – complete the observational assessment, observation is
  confirmatory

Question 24

Be able to select an appropriate interview and observational task for assessment of blood pressure, smoking, and medication management.

Answer 24

Blood Pressure
* Interview
– Tell me your average blood pressure reading?
– How often do you measure your blood pressure?
– How do you measure and record your blood pressure?
– Tell me why it is important that you control your blood pressure?
– What medication do you take to control your blood pressure?
– Tell me about health behaviors you follow to help control your blood pressure
* Observation
Smoking
– Have client demonstrate use of home blood pressure cuff and method to record reading.
* Interview
– Do you smoke?
– What do you smoke?
– How often do you smoke or how many cigarettes do you smoke daily?
– How long have you smoked?
– Why do you smoke?
– Tell me why you think it is important to not smoke?
– Have you tried to quit smoking in the past? What have you tried in order to quit?
– Would you like to quit smoking?
* Observation
– If possible, observe safety of smoking- attending to ash, attending to cigarette disposal.
Medication Management
* Incorporates subjective information and direct observation of medication taking behavior
– Knowledge of medications
– Ability to take medications
– Ability to procure medications

Question 25

How is controlling blood pressure associated with eye disease?

Answer 25

1. High blood pressure increases risk of
   – Progressing to wet AMD
   – Developing glaucoma in persons susceptible to the disease
   – Stroke
2. Controlled blood pressure shown to delay onset and reduce severity of diabetic retinopathy

Question 26

How is controlling smoking associated with eye disease?

Answer 26

• Only modifiable risk factor consistently associated with progressing to wet AMD
• Increased risk for diabetic retinopathy and cataract

Question 27

How is healthy eating associated with eye disease?

Answer 27

• Diets rich in Leutin and Zeaxanthin, and low glycemic foods (green vegetables and lean meats) lowered risk for developing dry AMD and progressing to wet AMD
• Good carbohydrate control essential for diabetes self-management
  – < 50 carbs per meal
• Varied and balanced diet to get all essential nutrients

Question 28

How is physical activity associated with eye disease?

Answer 28

• Improves physical function
  – Muscle strength, endurance, power, bone health, body composition
  – Cognition and psychological well being
• Decreases development/progression of chronic health conditions
• Increases potential for successful and independent aging
• Increases longevity

Question 29

What is the most important component of the OT intervention plan?

Answer 29

Participation in daily occupations

Question 30

What additional factors should be considered which contribute to individual differences in occupational performance?

Answer 30

• Individuals with mild to profound vision loss will have difficulties with occupational performance but – ADL limitations are directly tied to level of vision impairment
• IADLs more impaired than basic ADLs
  – Because they are more vision dependent
• When vision is present, the person will rely on it and use it for occupational performance
• As vision loss becomes more profound or if vision is unreliable, there will be an increased need for
  non-visual strategies
• The number one pre-requisite to using vision for occupational performance is reliable and stable
  vision
• 2⁄3 of older adults have at least one other chronic condition that contributes to ADL limitations
  – Complicates case, numerous causes for declines
  – Should be unique and tailored to individual needs
• Need to also consider the interplay of the task complexity and environmental factors

Question 31

Which 3 primary low vision intervention approaches are appropriate for the OT generalist?

Answer 31

1. Train in the use of adaptive equipment and adaptive technology
2. Create environments that support safe and independent occupational performance
3. Consider sensory substitution and cognitive strategies

Question 32

Be able to select an appropriate low tech piece of adaptive equipment or strategy to enhance a client’s occupational performance.

Answer 32

• Hands free magnification
• Self-management equipment
• ADL equipment
• IADL equipment

Question 33

Be able to select an appropriate environmental modification to enhance a client’s occupational performance.

Answer 33

• Increase visibility of environments and tasks
  – Ensure lighting is optimal for task performance
  – Use contrast to increase visibility of key objects and landmarks
  – Minimize background pattern – Enlarge
  – Organize (also a cognitive strategy)

Question 34

Be able to select an appropriate sensory substitution method to enhance a client’s occupational performance.

Answer 34

• Tactual/Proprioceptive
• Auditory
• Olfactory

Question 35

Be able to select an appropriate cognitive strategy to enhance a client’s occupational performance.

Answer 35

• Organization on a cognitive level facilitates the use of visual memory
• Simplify and reduce visual steps
• Facilitating use of visual memory
• Modification of tasks to minimize need for vision