Pang 2 low vision Flashcards
A vision rehabilitation examination is an exam to determin how someone ____ with their current vision level and provide strageties to ___ their funcitioning for performing desired activities
functions, improve
A vision rehabilitation examination (is/is not) a general eye exam to determine the general refractive and health status of the eye(is/is not) treating the disease
is not, is not
- Detailed functional history
- Obtain VA differently
- Trial frame refraction
- Central field test
- General observations
- Ocular & medical history
- Visual acuity
- Gross visual field
- Ocular health assessment
- Contrast sensitivity
- Optical device testing
- pick the ones that are the same in a vision rehabilitation and general eye exam
General observations Ocular & medical history Visual acuity Gross visual field Ocular health assessment
- Detailed functional history
- Obtain VA differently
- Trial frame refraction
- Central field test
- General observations
- Ocular & medical history
- Visual acuity
- Gross visual field
- Ocular health assessment
- Contrast sensitivity
- Optical device testing
- pick the ones that are different in a vision rehabilitation and general eye exam
Detailed functional history Obtain VA differently Trial frame refraction Central field test Contrast sensitivity Optical device testing
T/F in a vision rehabilitation you are not treating the eye disease, but treating patients functional abilities
T
how would you know if someone has a hearing impairment?
ask! duh
T/F when greeting a person with a visual impairment you should help them without needing to be asked
F. ask the patient first!
where on your arm should the visually impaired person grab your arm?
above your elbow
where should the visually impaired person stand when doing a sighted guide?
half step behind you
what are some of the things you want to tell the pt in a sighted guid when approaching stairs?
Always alert visually impaired person once your approach stairs
Inform them if stairs are going up or down
Inform them where the handrail is located
Tell them when there is one last step
T/F observations begin the moment you greet the patient and continue throughtout the entire exam
T
what is different in obtaining a distance visual acuity in low vision exam?
technique and chart
what must you try to do in a distance visual acuity exam during a low vision exam
try to quantify the visual acuity
Poor measurement of
standard projector
Poor measurement of <20/100 vision
Less optotypes per line
Set test distance
Limited by size of screen
-are disadvantages of a (standard projector/computerized acuity system)
computerized acuity
Doesn’t require room lighting
Lines can be isolated
-are benefits for a (standard projector/computerized acuity system)
standard projector chart
Many choices of optotypes
Eliminate patient memorization
High contrast optotypes
-are benefits for a (standard projector/computerized acuity system)
computerized acuity systems
what does ETDRS stAND FOR?
Eearly treatment for diabetic retinopathy study
which chart improves standardization adn accuracy in measuring VA
-(EDTRS/feinbloom chart)
EDTRS
Benefits: Portable Test at any distance High contrast numbers Large optotypes Can measure
fleinbloom chart
Useful for:
Children or adults who are unable to read letters
Non-verbal (i.e. stroke, developmental delay, etc)
Communication barrier (different language)
–describe (EDTRS/fleinbloom chart/lea symbols)
lea symbols or numbers, tumbling E or C
Fleingbloom chart is in (meters/feet)
feet
EDTRS is in (meters/feet)
meters
Visual acuity in M notation is (test disnace/letter size) over (test distance/letter size)
test distance over letter size
when using the EDTRS you start at __meters
A)2
B)3
c)4
2 meters
when recording distance VA you alwasy record the ___ test disance you used and the ___ letter size
exact, actual
T/F when recording distance VA you want to not the extrapolations i nparentheses and not the chart you used
T
why do we record VA differently in vision rehabilitation
more accurate measure of visual acuities
- can repeat the same testing conditions as previeous clinician
- easily determine if any changed in vA
- avoids confusion
for the feinbloom distance VA you want to start at ___feet
A)20
B)30
c)10
10
is a pinhole acuity done in a vision rehabilitation exam?
rarely becuae we already know the cause of patients reduced acuity , we dotn need pinhole to determine if the etiology is refactive or ocular disease
what is most common goal for patients with vision loss is ?
reading
T/F you can use reduced snellen notation if distance is different than 40 cm
F you can not use reduced snellen notation if test distance is different than 40 cm
T/F for near visual acuity in low vision exam you record meter units not reduced snellen
T
Based in typography
Measures size of typeface height of a letter
Not entirely standardized, but useful in determining acuity for typing (computer use)
-describes (automaticiy/point notation/loading)
point notation
to convert snellen to point you A) divide by 6 B)divide by 8 C)multiply by 50 for near VA
divide by 6
to convert from point to meters you A) divide by 6 B)divide by 8 C)multiply by 50 -for near VA
divide by 8
to convert from meters to snellen A) divide by 6 B)divide by 8 C)multiply by 50 -for near VA
multiply by 50
Limit of acuity to be able to recognize print
Example: Looking at price tags, reading a food label, reading mail, looking at medicine bottle label
- describes the (spot/sustained) reading acuity
spot
Limit of acuity for reading print for a longer period of time (~10 minutes or more)
Text must be larger than threshold near VA in order to sustain reading for this amount of time
Example: Reading books, magazines, newspapers
- describes the (spot/sustained) reading acuity
sustained
visual field testing determines the ___ and ___ of teh peripheral field
limits, sensitivity
Stimulus changes in brightness Techniques: Confrontation fields Humphrey automated perimetry Octopus perimetry -describes (static/kinetic) visual field testing
static
Points tested are moving from an unseen area to a seeing area Stimulus brightness is the same Techniques Tangent screen Humphrey SSA Kinetic Test Goldmann perimetry Octopus perimetry
-describes (static/kinetic) visual field testing
kinetic
central field testing assess the (size/location/brightness/sensitivity) of central or paracentral scotomas –pick two
size, location
Amsler grid Humphrey automated perimetry California Central Visual Field Test Octopus perimetry -test the (peripheral/central field)
central
SLO stands for and is the gold standard in mapping scotomoas
scannign laser ophtalmoscope
what does CCVFT stand for
california central visual field test
the CCVFT is done at \_\_ cm and each cm is _ degree A)40,2 B)57, 2 c)40, 1 D) 57, 1
57 , 1
(static/kinetic) CCVFT presents in all 8 quadrants to locate scotomas
static
(static/kinetic) CCVFT presents from seeing to non-seeing areas to determine size of scotoma
kinetic
static CCVFT (locates scotoma/determines size of scotoma)
locates scotoma
kinetic CCVFT (locates scotoma/determines size of scotoma)
determiens size of scotoma
T/F Sk read is designed to allow words to be easily confused and facilitate mistakes encountered while reading . the pattern of mistakes differentiate left and right sided scotomas
T
why is eye dominance important?
to determine which eye will be the primary functioning eye
why is hand dominance important?
to determine which hand will be holding optical devices
T/F seeing contrast sensitivity is part of our daily life
T
Sloan letters of the same size
Differ in contrast by every letter triplet (0.15 log units)
Distance chart, tested at 1 meter
(1 cpd spatial frequency)
NEI gold standard
Quick & easy to administer
Reliable results
-describe which test (pelli-robinson/vistech)
pelli robson
Uses sine wave gratings to measure 5 spatial frequencies along CSF curve
Distance chart, tested at 1 or 3 meters
Time consuming
Poor test-retest reliability
-describe which test (pelli-robinson/vistech)
vistech
how many letters need to be missed within a triplet for the pelli robson test in order to log final contrast sensitivity
2
Sloan letters of the same size
differ in contrast with each letter (0.04 log units)
Near chart, 50cm test distance
(0.5-2 cpd spatial frequencies)
Quick & easy to administer
Good reliability
describe which test ((pelli-robinson/vistech/MARS)
MArs
what is the testing distance for the MARS contrast sensitivty test_cm
A)50
B)40
C)35
50cm
when scoring the MARS test put it in order by steps :
- log-value of the last correct letter identified
- subtract the number of individual misses
- x0.04
- log value of the last correct letter identified
- subtract number of individual misses
- X 0.04
match to correct one for MART test interpretation prfound CS loss a)0 - 0.48 logMAR b)0.52 – 1.00 logMAR c)1.04 – 1.48 logMAR D)1.52 – 1.76 e)1.72 – 1.92
a)0 - 0.48 logMAR
match to correct one for MART test interpretation
Severe CS loss
a)0 - 0.48 logMAR
b)0.52 – 1.00 logMAR
c)1.04 – 1.48 logMAR
D)1.52 – 1.76
e)1.72 – 1.92
b)0.52 – 1.00 logMAR
match to correct one for MART test interpretation
Moderate CS loss
a)0 - 0.48 logMAR
b)0.52 – 1.00 logMAR
c)1.04 – 1.48 logMAR
D)1.52 – 1.76
e)1.72 – 1.92
c)1.04 – 1.48 logMAR
match to correct one for MART test interpretation
Typical for age 60 and older
a)0 - 0.48 logMAR
b)0.52 – 1.00 logMAR
c)1.04 – 1.48 logMAR
D)1.52 – 1.76
e)1.72 – 1.92
D)1.52 – 1.76
match to correct one for MART test interpretation
Typical for middle age & young adults
a)0 - 0.48 logMAR
b)0.52 – 1.00 logMAR
c)1.04 – 1.48 logMAR
D)1.52 – 1.76
e)1.72 – 1.92
e)1.72 – 1.92
what is JND?
it is the miniumum lens change that a patient can appreciate
what units are used in JND?
diopter
what is the formula for loose trial lenses to use in refraction ?
+/- JND/2
- Distance optical devices is specified in terms of its angular magnification
- Units are “X”
-Angular magnification: using an optical system to increase the angular subtense of the image compared to the angular subtense of the object itself
describes which one?
- Distance magnification formula
- Kestenbaum formula
- Lighthouse method
- Equivalent viewing distance
- Distance magnification formula
determing the starting power of optical devices used to demonstrate to the patien is useful when predicting(magnificaion/automaticity)
magnification
the distance magnificaiton formula is denominator of (actual/goal) VA over denominator of (acutal/goal) VA
actual over goal
what units is near magnification recorded in ?
diopters
Reciprocal of distance vision describes which test 1. Distance magnification formula 2. Kestenbaum formula 3. Lighthouse method 4. Equivalent viewing distance
- Kestenbaum formula
Reciprocal of near vision x Reference add describes which test 1. Distance magnification formula 2. Kestenbaum formula 3. Lighthouse method 4. Equivalent viewing distance
- Lighthouse method
(Actual near VA denominator/Goal near VA) X(accommodative demand or reference add)
- Distance magnification formula
- Kestenbaum formula
- Lighthouse method
- Equivalent viewing distance
- Equivalent viewing distance
Purpose of _____ devices: allow an individual to see print or objects or materials by magnification.
optical
T/F Handheld magnifiers and high-plus reading glasses need to have the proper working distance
T
T/F Telescopes need to be focused & held in the proper position to see the desired object
T
T/F CCTV and electronic video magnifiers can be used for many tasks, and need training for each task
T
Spectacles: High plus spectacles, microscopic lenses, base-in prism spectacles, doublet lenses
Hand magnifiers
Stand magnifiers
Reading telescopes
are used for : A)near B_intermediate C)distance D)adaptive/assistive technologies E)non-optical
near
Loupes, Telescopes are used for : A)near B_intermediate C)distance D)adaptive/assistive technologies E)non-optical
intermediate
Monocular telescopes, spectacle mounted telescopes, binocular telescopes are used for : A)near B_intermediate C)distance D)adaptive/assistive technologies E)non-optical
distance
Desktop CCTV, handheld CCTV, CCTV with distance/near camera, computer software programs, OCR technology, GPS navigation systems are used for : A)near B_intermediate C)distance D)adaptive/assistive technologies E)non-optical
D)adaptive/assistive technologie
Absorptive filters (sunglasses), fitover sunglasses, typoscope, check writing guide, liquid level indicator, lamps, felt tip pens, talking watch/clock, tactile (bump) dots, talking glucometer, etc are used in : A)near B_intermediate C)distance D)adaptive/assistive technologie E)non-optical
nonoptical
Near spot Near sustained Intermediate spot Intermediate sustained Distance spot Distance sustained
Kinds of tasks: Reading prices at a store Reading med bottle labels/insulin syringes Reading mail, bills Looking at photographs Kinds of devices: Handheld magnifiers Kind of therapy: Finding focal point of magnifier -match description to correct category
near spot viewing
Near spot Near sustained Intermediate spot Intermediate sustained Distance spot Distance sustained
Kinds of tasks: Reading newspaper, books, magazines Writing letters or cards Crocheting and/or sewing Kinds of devices: High-plus reading glasses Stand magnifiers Head borne loupes Near telescopes Kind of therapy: Train use of device Train patients to use bold lined paper and felt tipped pens -match description to correct category
Near sustained
Near spot Near sustained Intermediate spot Intermediate sustained Distance spot Distance sustained -match description to correct category
Kinds of tasks: Read a street sign Read an aisle sign in market Identifying people’s faces Seeing board at school Kinds of devices: Handheld telescopes Kind of therapy: Locating item to view, getting TS to eye and positioned on item to view, focusing TS Functionally walking and spotting signs or objects
distance spot viewing
Kinds of tasks: Watch TV or movie Bird watching Concerts, sporting events, theater Kinds of devices: Spectacle mounted telescopes Kind of therapy: Finding object of interest and maintaining fixation Scanning techniques to visualize entire performance
Near spot Near sustained Intermediate spot Intermediate sustained Distance spot Distance sustained -match description to correct category
distance sustained viewing
