Tx for Visual Impairment

Question 1

expect visual field deficits if lesion occurred __ the optic chiasm

Answer 1

before

Question 2

brainstem lesions can affect ___, which control the muscles of the eyes

Answer 2

cranial nerves

Question 3

when assessing your patient, you can easily note:

Answer 3

• gaze preference and palsies

- ability of the eyes to cross midline

Question 4

hemianopsia

Answer 4

half blindness (loss of half of the visual field in both eyes)

aware of the deficit

Question 5

hemineglect (2 types)

Answer 5

unaware of the deficit

egocentric: poor ability to attend to objects/stimulus/everything on the left side of the body (whole world is missing)
allocentric: poor ability to see the left side of the OBJECT regardless of position to the body

Question 6

tx potential of hemianopsia

Answer 6

aware, good tx potential, compensatory techniques

• fearful of falling/startled
• lose place when reading
• shave half of face, eat half a meal

Question 7

tx potential hemineglect

Answer 7

unaware, fair to poor potential, compensatory difficult to use

• orient head/body away from neglect
• poor ability to transfer

Question 8

assessments

Answer 8

MVPT (spatial relations, discrimination, memory, f-g, v-c)
Beery VMI
Catherine Bergego scale (unilateral behavioral neglect)
Line bisection

Question 9

diplopia and dysconjugate gaze

Answer 9

• double vision
• lack of smooth tracking

partial occlusion vs full patching

Question 10

contrast sensitivity loss

Answer 10

assess: LEA numbers contrast sensitivity cards, SLOAN low vision cards

• ** fall risk!!!!
• inability to distinguish changes in surface height and texture
• difficulty with reading, seeing hazards on ground

Question 11

depth perception fx limitations

Answer 11

• difficulty filling a cup with liquid
• negotiating steps
• over/under reaching for objects

Question 12

figure ground fx implications

Answer 12

• difficulty locating items in crowded drawer
• reading/copying notes
• navigate computer screen
• picking out a shirt that has been placed on a bed

Question 13

visual extinction

Answer 13

can’t see/understand an entire image; can only pick out single objects at a time

Question 14

tx for impaired acuity and contrast sensitivity

Answer 14

reading magnifiers
environmental modifiers (contrasting tape to stairs)

Question 15

tx for binocular vision and stereopsis

Answer 15

brock string

Question 16

tx for depth perception

Answer 16

restorative: brock string, tactile-kinesthetic guiding with activities, computers
adaptive: colored tape, other sensory systems (touch)

Question 17

interventions for hemianopsia and hemineglect

Answer 17

anchoring: bright on the table (like tape)
lighthouse scanning
partial occlusion and prisms

Question 18

dynavision

Answer 18

peg/light board that requires client to hit the red buttons as they light up

useful in determining reaction time, peripheral awareness, and accuracy of movement

goal: restore visual function

Question 19

novavision

Answer 19

• requires prescription
• 2x a day for 6mo
• focus on central point and respond every time a light stimulus appears

Question 20

BITS

Answer 20

newer tech
incorporates assessments and activities to address neglect and visual field deficits
balance component option