test room Flashcards
store accessibility for disabled patients
- no stairs
- all test rooms etc on one floor
- both stores have at least one long form room with a movable chair
- disabled toilet access
how to adapt clinical routine for disabled px
- longer test time may be required (consider 2 appts)
- remove any obstacles
- face px (talk slowly + clearly)
- use letter matching/ Kays pictures/ single letter optotype
- direct ophthalmoscopy
- bracketing (refract in larger steps)
- Perkins
hand magnifier instructions
- lay magnifier on page + slowly pull away from page until image clear
- use distance rx (near rx only for short magnifier-eye distance)
- larger FOV holding magnifier closer to eye
hand magnifier advantages
- low cost
- compact, lightweight, portable
- can have long eye to magnifier distance
- used with DV rx because emergent light is parallel
hand magnifier disadvantages
- difficult for px with arthritis etc
- increased distortions as lens held further from the eye
stand magnifier advantages
- incorporated illumination
- good for px with hand tremors
- small and portable
- relatively inexpensive
stand magnifier disadvantages
- can be bulky
- limited field of view
- posture + fatigue problems
- wear SVN
bar/ flat field magnifiers advantages
- normal reading posture possible
- very bright - light gathering
- useful for px with hand tremor
- clear image across whole lens (minimal aberrations)
bar/ flat field magnifiers disadvantages
- large lenses (heavy)
- low magnification
- reading material must be flat + on firm surface
CCTV
closed circuit television
EVES
electronic vision enhancement systems
what is CCTV?
- example of real image (electronic) magnification of retinal image
- good for px with central loss as allows to train for eccentric viewing and to adopt steady eye strategy (eye still + material/ target moves)
CCTV advantages
- aberration free
- max mag up to 70x
- zoom control
- electronic contrast reversal
- binocular viewing
- normal viewing distance/ posture
CCTV disadvantages
- cost (to buy or service/ repair)
- size
- practice required to use
- depth of field
disability and equality act 2010
person cannot be discriminated against because:
- they have a disability
- someone thinks they have a disability (discrimination by perception)
- they are connected to someone with a disability
low vision leaflet
issued by optometrist
self referral form to eye clinic for assessment and determination of eligibility for RVI
RVI form
- registration of VI px
- voluntary and confidential
- referral to eye clinic by optom/GP
CVI
officially certified px as sight impaired or severely sight impaired
ophthalmologist examines eye health and vision to determine whether px is eligible for certification
benefits for CVI
- free bus/ rail travel
- assessment by social services
- UC/ pension credit/ tax credit
- council tax reduction
if SSI
- blue badge, 50% off TV license, blind person tax allowance
ECLOs
eye care liaison officers - run low vision clinics
sight impaired criteria
VA 3/60 - 6/60 with full VF
VA up to 6/24 with mod VF reduction or central part of vision cloudy/blurry
VA 6/18 or better if large VF reduction (whole half of vision/ peripheral)
severely sight impaired criteria
VA less than 3/60 with full VF
VA between 3/60 - 6/60 with severe VF reduction (e.g., tunnel vision)
VA 6/60 or less with very reduced VF (especially if missing in lower part)
acuity reserve
1:1 for spot reading, 2:1 for fluent reading
spot reading = min mag required
fluent requires higher mag so less strain for px
typoscopes
matt black card with window cut in width of a line
if px has had stroke and lost RHS VF reading is difficult as eye scanning into nothing
