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Low Vision > Packet 1: low vision rehabilitation > Flashcards

Packet 1: low vision rehabilitation Flashcards

1
Q

most common cause of low vision in the US is

A

macular degeneration

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2
Q

1 reason for hereditary vision loss is

A

retinitis pigmentosa

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3
Q

the definition of legal blindness in the US is based off what categories

A

visual acuity and visual fields

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4
Q

definition of legal blindness in the US is

A
  • 20/200 or less in better seeing eye, best corrected

- less than 20 degrees of visual field in better eye

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5
Q

what does legal blindness definition NOT account for for other types of vision loss

A
  • decreased contrast sensitivity
  • visual distortion
  • glare disability
  • ocular motility deficits
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6
Q

do you have to be legally blind to have low vision?

A

no

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7
Q

what is low vision but not legally blind definition usually

A

20/70 or worse in the best eye based on most insurance criteria and medicare

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8
Q

ICD10 code “0”: mild or no visual impairment

A

equal to or better than 20/70

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9
Q

ICD10 code “1”: moderate visual impairment

A
  • worse than 20/70

- equal or better than 20/200

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10
Q

ICD10 code “2”, severe visual impairment

A
  • worse than 20/200

- equal or better than 20/400

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11
Q

ICD10 code “3”: blindness

A
  • worse than 20/400

- equal or better than 20/1200

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12
Q

ICD10 code “4”: blindness

A
  • worse than 20/1200

- equal to or better than light perception

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13
Q

ICD10 code “5”: blindness

A

no light perception

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14
Q

what is “any loss or abnormality of psychological, physiological, or anatomical structure or function”

A

impairment

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15
Q

what is “any restriction or lack of ability to perform an activity in the manner or within the range considered normal for a human being”

A

disability

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16
Q

does a visual impairment always cause a visual disability?

A

no

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17
Q

overview of case history in low vision

A
  • chief complaint
  • near needs/ abilities
  • distance needs/abilities
  • activities of daily living issues
  • social history
  • illumination and glare needs
  • mobility needs
  • job related needs
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18
Q

what is light projection (vs. light perception)

A

light projection= direction of light (better than LP only)

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19
Q

3 most common charts used in low vision

A
  • Snellen
  • EDTRS/ Bailey Lovie
  • Feinbloom
20
Q

what are some problems with using Snellen charts?

A
  • may not have enough lines
  • not enough characters per line (more so for higher acuity loss)
  • projector charts may vary in contrast as background illumination changes
21
Q

why is Bailey Lovie/EDTRS charts considered the Gold Standard?

A
  • 5 letters in each row
  • standardized spacing between letters and rows
  • progression of letter sizes constant and follows log scale (log MAR)
  • every 3 lines down on chart represents a change in acuity of 1/2
22
Q

what is the highest level of acuity in Bailey Lovie/ETDRS

A

10/125

23
Q

if patient has worse than 10/125, what do you do?

A

use Feinbloom chart or move in to 5 feet

24
Q

pros/cons of Feinbloom chart

A

pros: numbers, portable, large type (700ft), generous spacing
cons: limited number of optotypes, psychological advantage (can guess)

25
Q

what are some special things to include when you record low vision acuity

A
  • type of chart used
  • no + or - notation
  • test distance where measured (so 10ft usually)
  • note illumination conditions during testing
  • style and efficiency of how patient read chart
26
Q

what chart should you use if patient has central scotoma and has poor eccentric viewing skills

A

feinbloom chart with single optotype may be easiest

27
Q

what strategy should you use to measure VA on a patient with overall reduced visual field?

A 
start smaller
(because larger optotypes may be out os patients field and unable to be fully viewed)
28
Q

what are 4 ways to notate near visual acuity

A
  • Jaeger
  • Reduced Snellen (RS)
  • Point size
  • M units
29
Q

what are some cons of Jaeger notation

A
  • style and size vary from chart to chart
  • no constant ratio between type sizes (not easily converted to standard notation)
  • least useful of all the resting methods
30
Q

pros/cons of reduced snellen

A
  • same notion as distance snellen

- but reduced snellen assumes testing distance at 40cm so if any other distance, confusion begins

31
Q

what is point size or N way of measuring near acuity

A
  • used by school teachers, librarians, printers
  • refers to the size of the printing press letters are set in
  • not an exact system of recording VA (no good)
32
Q

what is the “N system” way of recording near acuity

A

“British N”

  • variety of point size notation using Times Roman
  • ex: N16 at 30cm
33
Q

the gold standard for near acuity is

A

Metric (M) notation

34
Q

how is metric (M) notation work and how is it recorded

A
  • standardized for test distance of 1 meter
  • M notation is linear (follows logMAR)
  • record test distance in meters over M size
35
Q

types of near vision charts that can be used

A
  • lighthouse cards (used the most)
  • reduced snellen (bad)
  • SK read
  • MN read
36
Q

what are some unique things about SK read (Smith-Kettlewell reading test)?

A
  • determines critical print size, magnification requirements, scooters interfering with reading
  • can be used as a training tool to promote awareness of scotoma location
37
Q

what are some unique things about MN read (minnesota low vision reading acuity charts)

A

-used to assess how reading performance depends on print size (max reading speed, critical print size, reading acuity)

38
Q

what can you use to plot a person’s contrast sensitivity function?

A

detailed contrast sensitivity measurements that include both size (spatial frequency) and contrast

39
Q

your CSF is essential a plotting of the curve that defines the:

A

lowest contrast sensitivity level you can detect for each spatial (size) frequency tested

40
Q

what spatial frequencies must have significantly higher contrast to be detected by the human visual system?

A

higher spatial frequencies (sine-wave gratings with very thin bars)

41
Q

normal contrast sensitivity function is ___%

A

2-3%

42
Q

at 2.5-5% CS function, patient would have difficulty with:

A

determining facial expressions, recognizing friends, detecting curbs and drop offs

43
Q

at 10% CS function, patient would have difficulty with:

A

detecting changes in surfaces, black and white photographs, water on the floor

44
Q

at 25% CS function, patient would have difficulty with:

A

safe mobility, night driving

45
Q

what is considered a functional impact of contrast acuity?

A

greater than 2 line loss on low contrast acuities

Low Vision (4 decks)

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