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PHTY3130 M1 > M1 L5: Assessment Vision > Flashcards

M1 L5: Assessment Vision Flashcards

1
Q

What is the visual system

A

Visual system is a most complex sensory system: consider varied anatomical structures needed for visual function.

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2
Q

The retina is contains the specialized cells _____ (rods which lie in the _______ (peripheral/central) area of retina and cones which lie more _____ (peripherally/centrally) and these specialised cells convert light into signals which travel along optic nerve fibres through to the various areas of the brain.

A

photoreceptors; peripheral; centrally

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3
Q

The six _____ muscles enable pull the eyeball in varying directions upwards, downwards laterally and medially. Eye movements can be voluntary and involuntary. Cranial nerves: iii (_____), iv (____ SO4) and vi (____ LR6) control the extraocular muscles.

A

extraocular; ocular motor; trochlear; abducens

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4
Q

What is the purpose of assessment of vision in physio?

A
  • How the eyes move?
  • Not looking and refractive ability
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5
Q

How can the optokinetic nystagmus be tested (as an involuntary eye movement)?

A

Examiner moves a strip with parallel stripes in front of individual’s eyes and asks them to watch the stripes go by – rhythmic eye movements will be observed: e.g. alternating slower phase (slow pursuit movements in the direction of strip movement and a rapid phase back to midline.

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6
Q

What are smooth purpose eye follow as voluntary eye movements?

A
  • eyes follow (track) in conjugate manner through full horizontal, vertical, oblique and circular planes of movement.
  • 4 weeks of age (auditory and visual)
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7
Q

What are vergence eye movements as voluntary eye movements?

A
  • Convergence and Divergence: angle between the eyes change: moving from distant to near object accommodation reflex
  • 4 months
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8
Q

What are saccades/saccadic eye movements as voluntary eye movements?

A
  • fast jumps : movements may be so fast from one object to another.
  • Eg. reading (starting at 5 yrs of age –> no need to move head when reading –> saccades is present
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9
Q

When can babies smile?

A

6 months - babies can smile (imitate) while not using the limbic system

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10
Q

What is the purpose of the central visual system (dorsal vision pathway)?

A

it provides vision for action - amalgamates movement with object and location – identifies fast approaching car. If anomalies with this pathway child may difficulty identifying information in busy environments.

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11
Q

What is the purpose of the central visual system (ventral vision pathway)?

A

processing details/spatial/patterns - makes sense of objects and faces - vision for perception. If anomalies with this pathway child may display poor facial recognition and identifying facial expressions.

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12
Q

What is the International Classification of Functioning Health and Disability (ICF) : Seeing and related functions?

A
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13
Q

What is the definition of a visual impairment (VI)?

A
  • moderate VI and severe VI are grouped under the term ‘low vision’: low vision and blindness represents all VI
  • Over 12 million Australians report at least one long-term vision disorder and 10% of this population are children (aged 0-14 years)

Vision disorders can be present from birth (Eg. CP, cataracts), result from acute illness (Eg. measles) or injury or develop over time because of chronic eye disease. The most common long-term vision disorder relate to refractive error (RE) ( longand short sightedness (Short or long sighted (can get problems with not adjusting/negating if it is not corrected –>diuse–> brain will stop developing that system if its not working))

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14
Q

What are the 5 causes of vision impairment (VI)?

A
  1. congenital malformations of the eye
  2. amblyopia caused by: strabismus(misaligned eyes); refractive (uncorrected RE) deprivational (interference in visual development)
  3. nystagmus: congenital and acquired (eg. nystagmus at rest)
  4. Cortical vision Impairment (damage to areas within brain that process vision
  5. Retinopathy of prematurity (disruption of normal retinal vascularization)
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15
Q

What is the problem with pre-mature birth?

A
  • 36-40 weeks = normal birth period
  • <36 weeks = can survive but can have problems (retinal destruction, maturity)
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16
Q

How do infants learn how to use their visual system?

A

Infants learn how to use their visual system. The infant’s extraocular muscles will become progressively stronger and co-ordinated so that their eyes will move in unison to track objects initially horizontally , then vertically and then in circular and diagonal planes of movements.

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17
Q

The infant will gain the ability to focus on _____ (near/far) objects (convergence of eyes) and fixate on faces ( mother/family) and commence laying down _____ memories. Furthermore, their ability to fix and release their gaze on near objects and far objects gradually develops as does ______ as child reaches out to touch objects (_____ grasp). This occurs at ____ months.

A

near; visual; eye hand co-ordination; ulnar; 4

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18
Q

When does visual- auditory integration occur?

A

Visual-auditory integration commences in infancy (e.g. infant turning to sound to visually search for the object making the sound) as infant looking behaviours are related to audio-visual behaviours

  • If they are not doing this (not looking when hearing noise) –> should have a look at vision

4 months

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19
Q

Child’s vision continues to develop throughout early childhood. The child will continue to improve in ______ and _______and their visual system is a most important sense for ever more skilled mobility and learning. For example ______ and ______ is associated with reading performance. Takes _____ years for alveoli to start developing

A

eye hand co-ordination; depth perception; visual processing; auditory processing; 8

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20
Q

Not surprisingly impaired vision can have implications for _____, _____, _____ and ______

A

education, employment, social participation, independent living

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21
Q

What is the Password to Practice for Sensation?

A
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22
Q

What does S stand for in SENSATION for vision?

A

Senses (registers / detects / notices) stimuli

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23
Q

What are the 2 types of Sense in SENSATION for vision?

A
  1. Low visual registration (doesn’t detect)
  2. Hypersensitivity to visual stimuli (over sensitive)
24
Q

What is a characteristic of Low visual registration (doesn’t detect)? What is an example for? (vision)

A
  • Visual impairment – may be partial or full in one or both eyes (Peripherally detect- is light coming in and hitting the photoreceptor)
  • Eg. Retinopathy of prematurity and hypoxic/ischaemic damage are 2 main causes of acquired visual impairment in a childhood population
25
Q

What is a characteristic of “Hypersensitivity to visual stimuli (over sensitive)”? What is an example? (vision)

A
  • Hyper–vigilance to particular visual stimuli e.g. able to see and fixate on tiny detailing on small objects.
  • Eg. Autism spectrum disorder
26
Q

What are features of the subjective interview (1), observation (1) and physical examination (2) in “Sense” in SENSATION? (vision)

A

Subjective interview

  1. Parent / teacher / child questionnaire / interview

Observation

  1. Child interacting with his/her environment. For example, an infant/child with visual impairment may not turn to explore a loud sound.

Physical examination

  1. Many examples of quantification of vision, e.g. Traditionally visual acuity testing (eye chart) and visual field testing, perimetry (computer program providing maps of visual sensitivity and throughout visual field), colour deficiency testing, contrast sensitivity and flicker sensitivity testing.
  2. Many of these tests would be administered by an optometrist or ophthalmologist à an understanding of these investigations and results would be helpful when working with a child with a visual impairment.

Give them visual time –> don’t rush when building rapport with the child (before touching)

27
Q

What does E stand for in SENSATION? (vision)

A

Engages appropriately with sensory tasks &/or environments

  • All of us have these in moderation –> its whether this is impacting on life?
  • What is an appropriate activity and toy for that age (interactive visually?)
28
Q

What are 2 types of Engage in SENSATION? (vision)

A
  1. Avoids/dislikes
  2. Over-seeks / Perseverates
29
Q

What are 2 characteristics of “Avoid/dislikes” in Engage? What are 2 examples?(vision)

A
  1. Experiences motion sickness when watching/playing computer games
  2. Experiences discomfort with bright light/glare/flickering lights
  • Individuals who experience migraine or seizures.
  • Individuals who have low sensory threshold to visual stimuli.
30
Q

What is a characteristic of “Over-seeks/perseverates” in Engage? What is an example (vision)

A
  • Fixates on items that spin or turn
  • Autism Spectrum Disorder: children may have more intense repetitive patterns of sensory engagement.
31
Q

What are features of the subjective interview (2), observation (2) and physical examination (2) in “Engage” in SENSATION? (vision)

A

Subjective interview

  1. Parent / teacher / child questionnaire / interview
  2. Reports of ‘unusual’ behavioural interaction with sensory stimuli in the child’s natural environments (e.g. ‘Sensory profile’ : age-appropriate questionaries : the Infant/Toddler sensory Profile and the Adolescent/Adult sensory Profile)

Observation

  1. Behaviour of child in therapy during tasks with visual elements
  2. Does the child perseverate on tasks with ‘pleasing’ visual stimuli, (e.g. ceiling fan)

Physical examination

  1. No formal test available
  2. Could develop criteria for goal attainment scale, e.g. frequency of eye contact (Children with ASD have trouble looking directly at you (eye contact)
32
Q

What does N stand for in SENSATION (vision)?

A

Nominates (perceives) meaning of a stimulus location, timing, intensity & specific characteristics (e.g. colour)

  • Nominates (perceives) meaning of a stimulus location, timing, intensity & specific characteristics: color deficiency and figure ground issues
33
Q

What are 2 types of “Engage” in SENSATION (vision)?

A
  1. Unable to perceive elements
  2. Unable to supress irrelevant stimuli
34
Q

What are 3 characteristics of “Unable to perceive elements” in Nominates? What is an example?(vision)

A
  1. Difficulties with skills requiring visual perception of location and timing, e.g. catching a ball (requires co-incidence timing)
  2. Misses detail: does child recognize people from photographs
  3. Is the child able to see moving objects or are they seen only when they are stationary?
  • Child with cortical visual impairment (difficulties of interpretation of visual input) or child with red-green colour blindness or blue -yellow colour blindness (colour vision
35
Q

What are 4 characteristics of “unable to supress irrelevant stimuli” in Nominates? What is an example?(vision)

A
  1. Over-stimulated by visual stimuli
  2. ‘Distracted’ in normal environments
  3. Can be environment oriented, rather than people oriented
  4. Can tend to want to over-organise environment
  • Attention Deficit Hyperactivity Disorder
36
Q

What does “S” (2) stand for in SENSATION (vision)?

A

Symmetry in registration & perception of sensory information

37
Q

What are 2 types of “Symmetry” in SENSATION (vision)?

A
  1. Extinction, hemianopia, hemisensory loss
  2. Localised hypersensitivity
38
Q

What are 2 characteristics of “Extinction, hemianopia, hemisensory loss” in Symmetry? What is an example?(vision)

A
  1. Child is eating food from only one part of the plate and ignoring the rest.
  2. Child is experiencing difficulty distinguishing a line from a step
  • A child with a homonymous hemianopia - a visual field loss on the left or right side of the vertical midline.
39
Q

What are 2 characteristics of “Localised hypersensitivity” in Symmetry? What is an example?(vision)

A
  1. Child may become distracted by colours/patterns of carpet when sitting on floor when listening to classroom.
    * Autism spectrum disorder
40
Q

What does “A” stand for in SENSATION (vision)?

A

Adjusts posture in response to sensory information

41
Q

What are 2 types of “Adjust” in SENSATION (vision)?

A
  1. Poor/delayed position adjustments, looks/is uncomfortable
  2. excessive position adjustment
42
Q

What is a characteristic of “Poor/delayed position adjustments, looks/is uncomfortable”? What is an example?(vision)

A
  1. A child does not keep his eyes and head aligned to the horizon when asked to move onto his hands and knees (but can do so when asked to lift his head).
    • Head righting movement
  • A child with Developmental Co-ordination Disorder
43
Q

What is a characteristic of “excessive position adjustment”? What is an example?(vision)

A
  1. Child excessively ‘locks’ e.g. flexes his head and trunk when sitting/standing on an unstable surface.
    • Or delayed head righting
  • A child with Developmental Co-ordination Disorder; Developmental Delay
44
Q

What does “T” stand for in SENSATION (vision)?

A

Adjusts posture in response to sensory information

45
Q

What is a characteristic of “under-responds to stimulus” in Tune? What is an example?(vision)

A
  1. A child is weaving around a group of people whilst riding a bike in the park and loses her balance as she did not effectively orientate her head/eyes to her body and to gravity.
    * A child with Developmental Co-ordination Disorder
46
Q

What is a characteristic of “under-responds to stimulus” in Tune? What is an example?(vision)

A
  1. Child excessively displaying post rotatory nystagmus when rolling twice across the floor.
    * A child with Developmental Co-ordination Disorder/vestibular issues
47
Q

What does “I” stand for in SENSATION (vision)?

A

Integrates multi-sensory information for movement control

48
Q

What is a characteristic of “under-responds to stimulus” in Integrates? What is an example?(vision)

A
  1. Child not scanning the playground environment - subsequently stepping/tripping on obstacles and or bumping into other children
    * A child with Developmental Co-ordination Disorder
49
Q

What is a characteristic of “Over-responds to stimuli” in Integrates? What is an example?(vision)

A
  1. Child becomes fixated on watching favourite TV cartoon and does not process that their parent is telling them to come to the table for dinner.
    * A child with processing difficulties.
50
Q

What are features of the physical examination (1) in “Integrates” in SENSATION? (vision)

A

Physical examination: Infant is visually exploring toys whilst concomitantly integrating ‘somatosensory information’ (particularly proprioceptive) and vestibular information and achieving weight shifting and positive supporting whilst continuing to play with toys with motivating visual, tactile and auditory properties .

51
Q

What does “O” stand for in SENSATION (vision)?

A

Overrides instances of sensory conflict

52
Q

What are 2 types of “Overrides” in SENSATION (vision)?

A
  1. Unresolved sensory conflict / mismatch
  2. Detects sensory conflict appropriately
53
Q

What is a characteristic of “Unresolved sensory conflict / mismatch” in Overrides? What is an example?(vision)

A
  1. A young child becomes distressed when watching a nearby moving car as he believes that the car he is sitting in is moving even though it is stationary at the red light.
    * A child with reduced vestibular function
54
Q

What is a characteristic of “Detects sensory conflict appropriately” in Overrides? What is an example?(vision)

A
  1. Child calms himself quickly as he realizes that the car he is sitting in is not moving and that it is the car in the next lane which is moving
    * Typically developing child
55
Q

What does “N” stand for in SENSATION (vision)?

A

Normal performance & progression of skills for age/condition

56
Q

What is a characteristic of “Unsafe – accidental injury, risky, poor control” in Normal? What is an example?(vision)

A
  1. Child not watching and gauging distance to stop safely & runs into wall to stop
    * A child with Developmental Co-ordination Disorder
57
Q

What is a characteristic of “Too safe – fear, avoidance, low experience” in Normal? What is an example?(vision)

A
  1. A 6 year old child walks backwards very slowly whilst also turning his/her head watching where they are going.
    * A child with Developmental Co-ordination Disorder

PHTY3130 M1 (20 decks)

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