Red Flags for Sensory and Visual Impairment

Question 1

What are red flags for special sensory impairment to olfaction?

Answer 1

• Anosmia, or loss of smell
• Inability to distinguish between scents
• Inability to identify spoiled foods by smell

Question 2

What are red flags for special sensory impairment to vision?

Answer 2

• Complaints of blurry or fuzzy print
• Difficulty reading print
• Complaints of lighting issues
• Shifts page position
• Views out of the corner of the eye
• Difficulty reading signs
• Poor navigational skills
• Abbreviated scanning
• Bumps into objects
• Complaints of image and objects being darker on one side

Question 3

What are red flags for special sensory impairment to gustation?

Answer 3

• Decreased or lost taste sensation on anterior tongue for sweet taste
• Decreased or lost taste sensation on posterior tongue for bitter taste
• Inability to identify spoiled food by taste

Question 4

What are red flags for special sensory impairment to hearing, balance, and equilibrium?

Answer 4

• Decreased or absent hearing
• Missed pieces of conversation
• Decreased balance
• Decreased or impaired ambulation
• Increased falls
• Complaints of vertigo

Question 5

What are red flags for primary somatosensory impairment to light touch?

Answer 5

• Difficulty with fine motor tasks
• Difficulty manipulating fasteners or coins
• Decreased awareness of body segment being touched
• Difficulty shaving or applying makeup

Question 6

What are red flags for primary somatosensory impairment to pain?

Answer 6

• Burning or aching pain sensation
• Inability to concentrate secondary to pain
• Sleep difficulty secondary to pain
• Recurrent self-injury secondary to decreased sensation
• Avoidance of specific self-care tasks secondary to infliction of pain

Question 7

What are red flags for primary somatosensory impairment to temperature?

Answer 7

• Recurrent burns
• Difficulty (or inability) distinguishing temperature changes on the skin surface
• Difficulty (or inability) responding to extreme temperature changes

Question 8

What are red flags for primary somatosensory impairment to proprioception?

Answer 8

• Difficulty with purposeful movement
• Difficulty with object manipulation
• Noted or increased clumsiness during functional UE reach
• Poor fine motor control
• Poor gross motor control
• Difficulty with transitional movements

Question 9

What are red flags for primary somatosensory impairment to tactile localization?

Answer 9

• Difficulty with object manipulation
• Awkwardness and clumsiness during movements
• Difficulty scratching an itch

Question 10

What are red flags for primary somatosensory impairment to vibration?

Answer 10

• Difficulty or inability to detect vibration

Question 11

What are red flags for cortical/secondary somatosensory impairment to 2-pt discrimination?

Answer 11

• Poor regulation of grip
• Difficulty writing
• Drops utensils during grooming and eating

Question 12

What are red flags for cortical/secondary somatosensory impairment to astereognosis?

Answer 12

• Difficulty or inability identifying objects with vision occluded
• Difficulty or inability identifying objects in pant pocket
• Difficulty or inability identifying items in a grocery bag
• Difficulty or inability finding keys in handbag

Question 13

What are red flags for cortical/secondary somatosensory impairment to ahylognosia?

Answer 13

• Difficulty using texture in ADL tasks
• Difficulty manipulating hook-and-loop fasteners
• Difficulty discriminating between clothing materials in a dark closet

Question 14

What are red flags for cortical/secondary somatosensory impairment to amorphagnosia?

Answer 14

• Difficulty using shapes in ADL tasks
• Difficulty discriminating between coin sizes in pockets
• Difficulty selecting the correct-sized measuring cup in a meal preparation task
• Difficulty discriminating packets of sugar, salt, pepper, and artificial sweetener at a restaurant
• Difficulty discriminating self-care items for morning grooming

Question 15

What are red flags for cortical/secondary somatosensory impairment to extinction of simultaneous stimulation?

Answer 15

• Difficulty with bimanual tasks
• Drops items when held in 2 hands
• Difficulty with bilateral coordination
• Difficulty manipulating a knife and fork

Question 16

What are red flags for visual impairment to visual acuity: near?

Answer 16

• Complaints of blurry or fuzzy print
• Unable to read or difficulty reading
• Complains of print being too faint/small
• Complains of lighting issues
• Blinks excessively
• Rubs eyes
• Changes the focal length of the material
• Shifts page position
• Views out of corner of eye
• Has difficulty performing fine motor tasks such as buttoning a shirt or using scissors

Question 17

What are red flags for visual impairment to visual acuity: far?

Answer 17

• Difficulty reading signs
• Difficulty identifying faces and objects
• Difficulty driving
• Squints or blinks excessively
• Adjusts reading material closer to eyes

Question 18

What are red flags for visual impairment to binocular vision: diplopia?

Answer 18

• Complains of double visions in horizontal or vertical sight
• Complains of blurred or shadowed vision
• Complains of headache or eye strain or fatigue
• Has difficulty with depth perception
• Overshoots or undershoots during a reaching activity
• Shuts or squints 1 eye
• Repositions task or self
• Tilts head or positions it abnormally
• Complains of nausea

Question 19

What are red flags for visual impairment to visual acuity: convergence insufficiency?

Answer 19

• Complains of losing place while reading or writing
• Has difficulty performing tasks up close
• Skips words or lines when reading
• Complains of intermittent diplopia or blurred vision
• Squints
• Complains of headache or eye strain or fatigue during reading

Question 20

What are red flags for visual impairment to oculomotor ROM?

Answer 20

• Decrease in ocular ROM
• Displays slowness or unequal eye movements
• Complains of diplopia
• Complains of difficulty focusing
• Has disconjugate gaze
• Complains of headache or eye strain or fatigue
• Displays attentional deficits
• Deficits in depth perception
• Overshoots or undershoots

Question 21

What are red flags for visual impairment to oculomotor pursuits, saccades, and fixation?

Answer 21

• Difficulty reading texts
• Skips words or lines
• Difficulty with page navigation
• Displays unnecessary head movements
• Difficulty coordinating visually guided movements
• Unable to fixate on object and sustain fixation
• Jerky eye movements during reading or tracking
• Complains of losing place during reading or visual searching task
• Complains of swirling print
• Decreases speed or increases time required when looking for objects
• Deficits in balance

Question 22

What are red flags for visual impairment to accommodation?

Answer 22

• Blurred vision while grooming, buttoning, or shaving
• Blinks excessively
• Complains of swirling or moving print
• Difficulty reading or performing tasks up close
• Difficulty focusing
• Headache or eyestrain or fatigue
• Sensitivity to light

Question 23

What are red flags for visual impairment to visual attention deficits?

Answer 23

• Indented or abbreviated visual scanning
• Decreased attention to both intra- and extrapersonal space
• Decreased attention to visual detail on affected side
• Skews body position
• Shows increased obstacle collision on affected side
• Grooms only on 1 side
• Dresses or undresses on only 1 side
• Reads only 1 side of food menu
• Impulsive behavior
• Rushes through task
• Shows disorganized visual scanning
• Reluctant to recheck work
• Wears eyeglasses incorrectly

Question 24

What are red flags for visual impairment to visual field?

Answer 24

• Misreads literature
• Unable to read
• Absent or poor eye contact
• Difficulty judging distances
• Poor navigational skills or gets lost
• Complains of seeing only half an image
• Complains of images or objects darker on 1 side
• Abbreviated scanning
• Omits letters or words
• Scans in disorganized fashion
• Reluctant to change head position
• Increased muscle tone in the UE and LE secondary to postural insecurity
• Trails UE or cruises during ambulation
• Hesitant or unable to ambulate in crowded environments
• Difficulty identifying details of complex information
• Deficits in ADLs
• Drifts off line when writing
• Bumps into objects
• Holds head to 1 side
• Difficulty gathering and identifying objects for morning routine
• Difficulty with clothing selection in large closet

Question 25

What are red flags for visual impairment to contrast sensitivity?

Answer 25

• Difficulty recognizing faces
• Increased falls or tripping
• Difficulty distinguishing among colors
• Difficulty cutting nails
• Difficulty fastening or tying clothing of similar color
• Difficulty pouring liquids
• Difficulty cutting or eating when food and plate are of similar color
• Increased collision in poorly illuminated environments
• Difficulty with stairs