Test 1: Legal Blindness & Common Eye Diseases Flashcards
legal blindness in USA
20/200 or worse - better eye, best corrected
or constricted VF 20 degrees or less in the better eye
legal blindness in the USA with the new rules
VA must be worse than 20/100 on all charts
on snellen it must be 20/200
on log chart must be worse than 20/100
legal blindness in the USA visual fields new rules
to count a point as seen it must be over 10 dB
must use humphrey 30-2, 24-2, threshold with 10 dB stimulus
kinetic perimetry such as humphrey SSA test kinetic
goldmann with III4e target
vector plotting for VF extend - see federal register website
determining the extend of the VF using the pseudoisopter
draw line b/w pts 10 dB or higher to make pseudoisopter
6 b/w each #
subtract scotomas
find line of longest extent of seen area vert, horizontal, or drag
must 20 degrees or less to qualify based on VF
other determinations of legal blindness
can use visual efficiency score which combines VA and VF into complex formula
see federal register website for more info
ramifications of legal blindness pros
easier to get social security and disability
qualifies patient for services through bureau of services for blind persons and other agencies
patient may self limit attempting dangerous activities
ramifications of legal blindness cons
cannot get a legal driver's license in many states harder to get a job if desire to work negative social implications may lose hope or struggle emotionally may become crutch to limit independence
AMD
dry (geographic), wet (exudative)
associated with aging
deteriorates center of vision - detail
accumulation of retinal waste products - dry
small, leaky blood vessels (wet) - swelling
AMD effect on daily life
problems with detail trouble seeing faces distortion or waviness of vision trouble reading and writing need for increased lighting light sensitivity loss of color vision loss of contrast vision hallucinations - charles benet syndrome misjudging depth
AMD rehab strategies
eccentric viewing use dark bold pens to write writing guides - typoscopes directional lighting - natural daylight vs standard incandescent contrast enhancing filters home adaptations - stairs, dial markings
AMD magnification strategies
distance or near illuminated or not hands free or handheld stronger the mag the less FOV using devices while eccentrically viewing - is it possible, is it best
AMD rehab referrals
vision rehab
support groups
counseling or social work
other considerations of AMD
UV protection
not smoking
healthy diet
driving - cognitive factors, reaction time, recent studies
stargardt’s
affects young and remains youth version of ARMD central, detailed vision problems same symptoms as ARMD school and workplace demands driving considerations - bioptic
diabetic retinopathy
weak, leaky blood vessels that nourish the retina
retinal swelling
center of vision may be affected
scattered vision loss all over field of vision - islands
DR effect on daily life
vision fluctuations overall blur light sensitivity may need more light to read poor contrast loss of color vision reduced peripheral vision
DR rehab strategies
need to understand VF eccentric viewing if helpful use dark bold pens to write writing guides directional lighting - natural daylight vs standard incandescent contrast enhancing filters home adaptations - stairs, dial markings
DR mag strategies
distance or near illuminated or not hands free or handheld the stronger the mag, less FOV problems with mag - enlarging scotoma, missing or distorted pieces of vision
rehab referrals for DR
vision rehab
occupational rehab
support groups
counseling or social work
other considerations of DR
control of diabetes
overall health
driving - cognitive factors, reaction time, control
RP
hereditary disease
affects retinal layer that captures light
peripheral vision affected first, then moves inward - tunnel vision
RP effect on daily life
poor side vision - bumping into things, safety, travel and mobility driving unsafe needs more light to see poor night vision contrast problems
