Test 1: Optical and Non-Optical Devices Flashcards by Nicolle Ostrander

first visit at MCO

review consulting letters and questionnaire - understand goals
perform exam to understand function - VA, VF, CS, know better eye or binocular, consider conventional spectacles, predict starting magnification
demonstrate devices and near goals
ocular health screening
loan useful devices

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second and subsequent visits

review how the loaned devices helped or why they weren’t successful
demonstrate more devices to help goals
device training of final devices recommended - record time spent face to face with patient
order devices
dispense devices

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prescribing rational

case history - tasks
VA - level of magnification 
VF - limitations 
CS - lighting needs
monocular - better eye
binocular - fusion possible 
refraction - conventional bifocal vs SV
optical devices

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optical device categories

microscopes
magnifiers 
telemicroscopes 
telescopes 
electro-optical

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optical characteristics of devices

magnification
FOV
working distance
mobility
each optical system has its own optical characteristics
advantages and limitations of each optical system must be appreciated relative to the functional properties
which devices or functional optical properties will help your patient

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microscope (chart)

mag 8-48D
FOV largest comparable
work distance shortest comparable
mobility generally precludes

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magnifier (chart)

mag 2.5x hand, >5x stand or pocket
FOV adjustable, personal comfort
work distance adjustable, personal comfort
mobility portable, acceptable

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telemicroscope (chart)

mag 2-8x
FOV smallest comparable
work distance longest comparable
mobility generally precludes

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telescope (chart)

mag 2-10x handheld, 2-6x bioptic, >10 binoculars
FOV small, hand largest, bioptic smallest
work distance not applicable, distance use
mobility full field precludes, bioptic ok

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electro-optical (chart)

mag 2-60x
FOV larger and faster processing
work distance more normalized
mobility precludes

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telescopes

hand-held
clip on
spectacle mounted - bioptic, full diameter, miniaturized 
binoculars 
CL designed 
intraocular lens designed 
intraocular telescope

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telescopes FOV

smaller field of view with greater mag
adequate FOV with powers 10x
less than 6 deg FOV not practical 
larger FOV with shorter vertex distance
keplerian have larger FOV than galilean 
compensate law of optics by making telescope physically larger

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handheld telescopes

hand occupied
mobility less restricted
powers up to 10x
variable vertex distance - with or without glasses, affects FOV

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bioptic telescope

hands free
smaller size reduces field
mobility less restricted
powers up to 6x - can go higher but not feasible
may include refractive error in telescope
most expensive

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full field telescope

mounted geometrical center of frame 
larger diameter - larger FOV
precludes mobility 
powers up to 8x
may include refractive error in telescope 
varied cost

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clip on telescopes

full field characteristics
removable 
affordable 
powers 2-4x
wear habitual glasses
longer vertex distance
increased weight 
instability

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binoculars

physically bigger 
larger FOV
better light gathering capability 
consider when power needed is greater than 10x
usually has at home

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telescopes

rule of thumb 
handheld 2-10x
full field 2-8x
bioptic 2-6x
binoculars 2-18x

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telescopes formula

to calculate mag needed - dist VA/desired task size at distance

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telemicroscopes

intermediate distances
handheld 
clip on 
binocular spectacle - geometrical center
monocular spectacle - geometrical center 
bioptic mounted 
bifocal position

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handheld tele microscope

appropriate for tests at intermediate distance 20-100 cm
focusable or fixed focus
very small field of view
if a reading cap is built into the scope - set working distance if nonfocusable, determined by internal lens, 4D cap = 25 cm fixed - focusable 25 cm and closer
hands not free
mobility not affected
difficult to master

clip on telemicroscope

intermediate tasks
small field of view 
optics internal (not a cap)
focusable or fixed at near 
mounts in geometrical center - full field mounted, heavy poor centering
monocular 
mobility not a factor

binocular tele microscopes

intermediate tasks
binocular spectacle - geometrical center usually, full field mounted, may mount as angled bifocal, can order monocular, may include refractive correction
internal optics or cap - 20-100 cm working distance, cap determines working distance - 2D to 6D
mobility a factor
hands free
small field of view
same as a surgical telescope

bioptic mounted telemicroscope

telescope mounted above the frames geometrical center - bioptic position, may include correction
lens is a frame referred to as a carrier - corrects refractive error
hands free - move head to position scope
mobility possible
smallest field of view - small diameter
internal optics or a reading cap - cap converts telescope to intermediate or near use (telemicroscope)

telescope with a reading cap

is a tele microscope
determining magnification and working distance of a telescope with a reading cap - focal distance of the plus cap dictates the working distance 4D=25 cm
total power of tele microscope is the power of the telescope times the magnification power of the cap
4x telescope with 6D cap
4x (6D/4D) = 6 x or 24D
6D cap gives 16.6 cm working distance
24D microscope gives working distance of 4.16cm

microscopes

full field 
half eye 
executive bifocal 
round segment bifocals 
press on bifocals 
loupes 
uncorrected myopia 
high plus contact lens 
fresnel lens

full field microscope

larger diameter
largest field of view 
necessary close working distance 2-20 cm
power 2x to 15x - 12.5 to 1.7 cm
generally monocular 
may correct refractive error 
precludes mobility - swim effect

half eye microscope

half a lens
less field of view
close working distance
binocular - powers 4D to 16D, with base in prism - 4D has 6BI, 8 D has 10BI
monocular - powers 2x to 12x may correct refractive error
no distance correction
limited mobility

bifocal and clip-on microscopes

executive, round, press-on - smaller diameter, reduces field of view, close working distance, more mobility, powers 1x to 6x, distance correction
clip-on - larger diameter and field of view, WD longer due to loupe holder, removable for mobility, powers 1x to 12x, affordable, peak/AGFA styles available

microscope magnification factors

power of a microscope in X equals diopters divided by 4 - 25cm used as relative distance
20D lens provides 5x magnification
formula for calculating magnification needed to read 1M (20/50) V=MxD = mag needed in D to read 1M

magnifiers

handheld
pocket
stand
illuminated or non-illuminated - handheld, stand, pocket 
dome/bar

handheld magnifiers

hands aren't free
find focal point (focused) 
difficult if tremor 
powers practical to 20D - >20D  difficult to maintain focus 
variable working distance
portable
mobility not a factor 
affordable
illuminated or non illuminated

pocket magnifiers

very portable
powers 5D to 56D
use for short term tasks - spotting 
affordable
mobility not a factor
find focal point 
variable working distance 
difficult if tremor

stand magnifiers

fixed focal point
ease of use - even if tremor, arthritis, etc.
diverging rays - requires 2.5D accommodation or bifocal to clear image
powers 8-60D
hands not free
mobility not a factor
use for longer reading tasks

illuminated magnifiers

handheld, pocket, stand
often preferred vs non-illuminated devices - improves reading, especially if reduced high contrast frequency
incandescent, halogen, LED available (LED most popular)

stand magnifiers magnification

D/4 +1 = power for european devices

dome and bar magnifiers

fixed focal point
not diverging rays
affordable
powers 2D to 6D
hands not free
type of stand magnifier

electro-optical devices at MCO

primer/max
magni-cam
acrobat/transformer
CCTVs
merlin
pebble

primer and max with track

handheld mouse

magnicam

better handheld mouse magnifier

transformer/acrobat

kind of like a projector

CCTVs

closed circuit TV

so expensive so a lot of patients want it used

enhanced vision merlin

has OCR - text to audio

VES autofocus telescope

Jordy was the first one but no longer made

far view by optelec

distance and near both

freeze frame and then magnify capability

computer magnification/accessible reading

zoomtext
magic
lowbrowse 
victor stream 
kindle/nook
ipad/android tablets

the iPad as a visual aid

app list handout 
use of iPad as a magnifier using apps
pinch and drag function
reverse contrast 
voice over and verbal texting 
applevis.com

accessible technology

cellphones - jitterbug, apple iPhone, knfbReader mobile (nokia) takes photos then reads text

non-optical devices

reading stands
typoscopes
tints
bold writing pens
lamps

tints

glare reduction - grey (decreases contrast), amber (increases contrast), any other to lesser degree
enhanced vision - yellow, red, orange, amber, red (color deficiencies achromatopsia), magenta (blue cone monochromatism), blue (rod or retinal dystrophies, RP)
NOIR
corning and chadwick

lamps

incandescent
fluorescent
natural
Ott light / Verilux

non-optical rehabilitation products

clocks
drop dispenser 
remote
measuring cups
watches 
all kinds of stuff

Brainscape's Knowledge GenomeTM

Test 1: Optical and Non-Optical Devices Flashcards

Brainscape's Knowledge Genome^TM