LowVision_Test1 Flashcards by Caleb Saint

Name the four categories that involves Eleanor Faye’s approach to functional loss?

No field defects: blurred vision through entire field
No field Defects: reduced vision involving fovea
Central field defect: reduced vision with central scotoma
Peripheral field defects: peripheral scotoma with variable central vision

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What do pt complain of with 1. blurred vision through entire field?

Blurry vision and decreased contrast sensitivity
Glare and haze
Decreased color vision

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How to manage case 1?

Contral glare and contrast with tints, filters, hats
-Yellow enhanc contrast
-Grey reduce glare
Orientation and mobility training if absorptive lenses are ineffective

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Name examples of conditions for reduced vision involving the fovea?

Achromatopsia
Albinism
Aniridia
Congenital nystagmus
post retinal detachment surgery
Vitreoretinal adhesion

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Visual complaints of number 2?

Lack of dist acuity for activities.
Seeing blackboard, driving, reading music, glare, and mod diff w/ print.
Their abilities are often underestimated.

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Management for number 2?

EV training is unnecessary
Don’t underestimate your pt’s abilities when det mag; address other complaints like glare.
Use absorptive lens for glare control, hats, with brim.

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Which of Dr. Faye’s conditions make up the majority of low vision patients?

Central field defects

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Visual complaints of number 3?

Principally inability to read, write, and see fine details.
VA: better than 20/400; affects reading more than mobility.
VA less than 20/400 may feel the need for assistance in unfam surroundings.
NO black spots

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Management options for number 3?

Refraction
Magnification, contrast, illumination
Tints and filters

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Peripheral field defects

poor travel vision
fall hazard
Mag needs to be minimal

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Name some conditions that cause peripheral field defects

RP
Demyelinating disease
Glaucoma
CVA
Diabetes

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Visual complaints of periph field defects

Cone shaped w/ apex toward the eye.

Pt learn to look ahead using the larger field

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How to manage periph field defects

Prisms
Reverse telescope
Orientation and mobility
Vision restoration therapy

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Where do u place sector prism to expand the field of view?

Over the limbus.

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If prescribe prism, how much do u increase a person’s field by?

2pd = 1 degree field of view.

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How do you orient the prism to expand FOV

Base toward direction of VF loss.

There is a jack in the box effect with this.

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What is the purpose of Eli Peli horizontal fitting?

To help with mobility and navigation, not for reading

Help with peripheral awareness; an early alert system.

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What r some things u need to consider for your low vision pt?

Contrast sensitivity
Glare sensitivity
Color discrimination
Scotoma size and location
Peripheral field loss
ocular motilities and BV

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When dealing w/ contrast, name the color cars that are hard to see?

Silver and black cars

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Name a new test that test contrast?

MARS chart

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T/F?

Albino have a CV defect?

False

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What is glare?

Poor resolution
Light scatter
Poor adaptation

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Name some testing for Glare?

Brightness acuity test
M&S glare test
Photo-stress test

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Tell me about Amsler Grid

Test central 20 degrees when held at 33cm

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What is california central visual field test?

Tests the central 15 degrees

Can u use central 10-2 for Social Security administration?

Nope | Need to use kinetic HVF

Which part of the visual system does Scanning Laser ophtlamoscope test?

Central

For binoc vision testing, when do you occlude an eye?

``` High add is required MOnoc VA is better than OU High metamorphopsia in worse eye Larger usable field vs other eye Ring scotoma ```

What are the four methods for specifying visual acuity?

Detection Pattern Resolution Localization Recognition.

Name some examples of localization?

Hyper(vernier) acuity | Steres

Name some examples of Recognition?

Snellen Letters | Landolt C's

what is the Minimum angle of resolution in humans?

1 minute of arc

What does MAR allow us to do?

It allows us to size letters. You size the letter in terms of the distance at which they subtend 1 min of arc

T/F? | Jaeger is equivalent to Snellen?

False

Which near Visual acuity is used by printers to measure the lead block that contains the letter?

Point Notation

Which near visual acuity uses Times Roman.

British N system

T/F | FOr an uncorrected hyperope using a Kep and Gal telescope; the tube length needs to be increased?

True

FOr an uncorrected myope using a Kep and Gal telescope; the tube length needs to be decreased?

True

T/F | For an uncorrected hyperope using a Keplerian lens; the magnification of the TS is reduced

True

Name the five skills needed to use a TS

``` Localization Focusing Spotting Tracing Tracking ```

What is a contact lens telescope

A minus contact lens on eye and a plus lens in specs

Ads of CLs telescope

Wide usable FOV | Better cosmetic apperance

Disad of CLs telescope

Limited range of mag | CLs mvt makes the world move and shift

Candidates for an Implantable miniature telescope

Have AMD in both eyes. Be 75 y.os. Be phakic w/ a cataract Distance vision b/w 20/160 and 20/800

What is an imp thing to consider (BV-wise) when giving a pt a high add

Base in prism to compensate for base out prism created when converging. Use diffractive optics. Makes lens a lot thinner. Basically grounded fresnel prism into the lens.

The diff b/w increased add for bifocals/NVO vs microscopes

MIcroscopes have shorter working distance and cosmesis are issues.

Cool thing about telemicroscope that gives it an edge over microscopes?

It has increased working distance.

T/F | When increase tube length; things get more magnified and closer

True

What happens as magnification increases?

Working distance decreases | FOV decrease

T/F | Dome magnifier is another type of stand mag?

True | Thus need to use your bifocal

Troubleshooting: | For a stand mag, the pt feels the image is more clear when lifted off page

Give the pt a stronger magnifier

Ads of electronic mag

Reverse polarity Greatest mag No decrease in WD w/ increased mag

What's so special about bar manifiers

Stretch in one principle meridian. | Only makes the words taller, not wider.

What do pts with poor contrast benefit from?

Illumination: -AMD Optic nerve issues RP

Name some conditions that perform better under lower illumination

Albinos Rod monochromatism Achromatopsia

WHat do you do if the pt comes in and is not eccentrically viewing?

Whip out the big clock and have pt look at the center; ask pt which number is the clearest. Train pt to look in the opp direction of the clearest number. Ex: 7 o clock is the clearest while looking ahead. Train pt to EV at 2 o'clock We r pushing the scotoma up and out of the way.

Which is the most most diff EV angle?

3 o'clock position

What did the Framingham eye study find?

Visual impairment increased with age | Blindness and visual impairment higher in women

Ages of ppl in the Atlanta study

10 year olds | Look at the rate of legal blindness amongst them

Significance of the Atlanta study

Most of the conditions causing legal blindness at this age were congenital

What did Beaver dam eye study find

BVA decreased with age | Rates of blindness and visual impairment in those aged 75 and older were greater in nursing home residents and women

What was so special about Mud Creek Eye survey

Aged 40 and older Home screenings complete ophthalmological exam for those with PH VA less than 20/60

Significance of Mud Creek Eye survey

Leading cause of blindness Cataract ARMD -2 ppl found with trachoma

What was so special about Baltimore Eye Study

First study to determine blindness and visual impairment rates among an urban, multiracial population in the U.S. A lot of participants Aged 40 and older Equal numbers of black and white participants

Findings in Balt Eye Study

Blindness and visual Impairment increased with age in both groups Age adjust rates were twice as high for blacks as for whites No gender diff in rates

What was so special about Salisbury Eye eval

Eval of visual impairment using multiple tests of visual function -VA, Refraction, CSF, glare, stereo, VF THey found that all these suckers decline with AGE

What is the leading cause of new blindness in adults

diabetes

What r the leading causes of blindness

Cataract AMD Glaucoma

Name the two studies that busted out ophthalmic instruments

Salisbury Eye evaluation | Mud Creek Eye Survey

DO not assume that the pt has the same EV for dist and near

Okee

Define Kestenbaum method

The ADD required to read 1M at near is equal to the reciprocal of the distance VA.

Name an example of a geometric progression chart

Bailey Lovie

Define modified Kestenbaum method

THe same add from the original method and multiply by 1.5

Define sloan rdg cards and M-notation

LEtter size u want to read times the add that is req'd to read at that distance.