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Refracting Skills 2 > Unit 4 > Flashcards

Unit 4 Flashcards

1
Q

What is low vision or visually impaired

A

-Significant vision loss that cant be corrected with glasses or contacts, medication, treatment or sx

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2
Q

Moderate visual impairment

A

20/70 to 20/60

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3
Q

Severe visual impairment (legally blind)

A

20/200 to 20/400
or a visual field of 20 degrees or less

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4
Q

profound visual impairment

A

20/500 to 20/1000
or a visual field of 10 degrees or less

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5
Q

WHO - meaning

A

world health organization

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6
Q

WHO classifys near total visual impairment as..

A

less than 20/1000 or a visual field of 5 degrees or less

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7
Q

WHO classifys total visual impairment as..

A

no light perception (NLP)

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8
Q

WHO classifys functional visual loss as..

A

when an individual is unable to see well enough to perform the activites of daily living (ADLs) needed to survive

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9
Q

Disorders associated with low vision

A

-cataracts
-glaucoma
-macular degeneration
-retinal dystrophies
-diabetes

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10
Q

is vision loss slow or fast with cataracts?

A

Slow, gradually progressive process

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11
Q

How to help vision when you have cataracts

A

-A change in gls rx may be helpful up to a point until sx is required
-Sx removal of the cataract and insertion of a lens implant

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12
Q

what are other symptoms of cataracts besides blurry vision?

A

glare around lights
difficulty with night vision
color distortion

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13
Q

what causes cataracts?

A

-age
-diabetes
-smoking
-excess alchohol use
-eye injury
-prolonged use of corticosteroids
-prolongers exposure to sunlight or radiation

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14
Q

types of cataracts

A

-age related cataracts
-traumatic cataract
-radiation cataract
-congenital or pediatric cataract
-“secondary cataracts” PCO / capsule thickening (happens after cataract sx)

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15
Q

what are 3 kinds of age related cataracts?

A

-nuclear sclerotic
-cortical
-posterior subcapsular cataract

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16
Q

what is secondary cataract

A

-occurs after cataract sx
-called a posterior capsular opacification
-most common complication after cataract sx
-capsulotomy performed with YAG laser

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17
Q

prevention of cataracts

A

-UV protection
-protective (safety eyewear)
-quit smoking
-diet (Fruit, veggies, leafy greens, whole grains, nuts)

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18
Q

treatment of cataracts

A

-updated gls rx
-brighter (increased) light
-anti glare coating (Cut down light scatter / glare )
-magnifying lenses
-sx

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19
Q

types of lenses

A

-monofocal
-extended depth of focus (vivity)
-multifocal

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20
Q

PCO - posterior capsular opacification

A

-film or haze that forms on membrane/behind lens implant after cat sx

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21
Q

Refractive lens exchange

A

cat sx procedure but without the patient having a significant cataract
-Done mainly for refractive puposes (ppl that dont qualify for LASIK, PRK)
-RLE often used for “self play” procedures
ex px has very early cat but wants to “que jump” to have it removed before its “riped”

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22
Q

Glaucoma

A

-Causes vision loss and blindness by damaging the optic nerve
-second most common cause of blindness worldwid

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23
Q

hallmarks of glaucoma

A

-loss of peripheral vision
-high intraocular pressure
-optic nerve damage

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24
Q

can glaucoma be irreversible?

A

if left untreated it is irreversible and can result in drastic visual field loss

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25
Q

glaucoma treatment

A

-medication
-laser treatment (trabeculoplasty)
-surgery (trabeculectomy)

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26
Q

retinal dystrophies

A

degenerative diseases of the retina
-Retinitis pigmentose is the most common

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27
Q

what is retinitis pigmentost

A

-low vision and legal blindness occur from as early as childhood to as late as the fourth decade of life
-at this time, there is no specific cure or treatment for RP

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28
Q

what does retinitis pigmentosa affect?

A

-the light receptor cells
1. Rods
-loss of vision begins in the periphery
-causes problems with night vision
2. Cones
-responsible for central and color vision
-affected later

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29
Q

treatment for retinitis pigmentosa

A

-low vision aids
-correcting other eye problems (refractive error, cataract)
-experimental treatments (gene therapies)

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30
Q

type 1 diabetes

A

lack of insulin

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31
Q

type 2 diabetes

A

not enough insulin
-insulin is not working properly

32
Q

types of daibetes

A

-type 1
-type 2
-gestational diabetes (during pregnancy)

33
Q

risk factors of diabetes

A

-length of time w diabetes (more than half of ppl w/ diabetes will develop DR)
-uncontrolled diabetes
-high blood pressure
-high cholesterol

34
Q

most common eye disease in diabetics

A

diabetic retinopathy

35
Q

diabetic retinopathy

A

-significant cause of blindness in adults of working age
-can be progressive and usually affects OU
-worsens if blood sugars are uncontrolled
-

36
Q

symptoms of diabetic retinopahty

A

early stages usually dont have symptoms
changes may come and go

37
Q

proliferative retinopathy

A

-most severe stage
-growth of leaky blood vessels, vitrous hemorrhages lead to severe vision loss or blindness

38
Q

macular edema

A

-collection of fluid in the macula
-can occur in every stage
-causes blurred and/or distorted central vision
-resulting in difficult w. reading and daily activites

39
Q

treatment for diabetes

A

-early stages
(moniotring)
-later stages
injections (anti-VEGF)
laser treatment (PRP)
sx (vitrectomy)

40
Q

macular degeneration

A

-results from damage to the macula
blurs central vision
makes it harder to see faces, read, drive
-May not notice vision loss in early AMD

41
Q

DRY Macular Degeneration
(nonexudative)

A

-Drusen - tiny yellow/white deposits in the retina
-Results from the eyes inability to dispose of water products
-Can be hard, small and scattered
-Can be large, soft, and closer together
-No treatment for late dry AMD
-Special dietary supplements may be able to stop intermediate AMD from turning to late AMD

42
Q

geographic atrophy

A

the main cause of vision loss in dryMD

43
Q

vitamins for macular degeneration

A

-vitalux
-AREDS 2

44
Q

WET AMD (exudative)

A

-affects only 10-15% of ppl who have AMD
-vision loss is due to bleeding and leaking of abnormal blood vessels as well as scarring
-treated using intravitreal injections that inhibit the growth of new, abnormal blood vessels

45
Q

symptoms of macular degeneration

A

-early dry AMD doesnt have any symptoms
-intermediate dry AMD may be associated with mild blurriness in central vision or trouble seeing in low light
-Late AMD can cause straight lines to appear wavy or crooked

46
Q

risk factors of macular degeneration

A

-age 55+
-family history
-race (Caucasion)
-smoking

47
Q

how to lower risk for AMD

A

-quit smoking
-get regular physical activity
-maintain healthy blood pressure and cholesterol levels
-eat healthy foods (leafy greens)

48
Q

reduced contrast sensitivtity

A

-the ability to disinguish between finer and finer increments of light vs dark

49
Q

altered colour vision

A

-some disorders are associated with specific color vision changes;
-blue/yellow loss in retinal disease
-red/green loss in optic nerve disease
-blue/yellow loss in early glaucoma

50
Q

Optical low vision aids

A

-magnifiers
-specs
-bioptics
-telescopes

51
Q

Non optical low vision aids

A

-special lighting
-talking devices
-audio books
-plastic typoscope signature guide
-large print calendar
-talking tape measure / talking scales
-liquid level indicator
keyboard label
-stick on foam dots
-orange tape
-braile
-apps

52
Q

Magnifiers

A

-Need to ask what near activites they enjoy
-Remember: The more plus power the short the working distance
-Adaptation can be challenging

53
Q

Hand held magnifier

A

-Must maintain proper focal distance
-half way between the matieral and the eye

54
Q

stand magnifier

A

rests on page and is moved across reading material

55
Q

page magnifier

A

lies flat on page, enabling hands-free use

56
Q

Dome magnifier (brightfield)

A

magnification 4x power
lens diameter; 65mm
-distortion free lens

57
Q

Prismatic spectacles

A

-range in power +4D to +10D and include base in prism in OU to help the px converge easily
-the prism power is typically two more than the dioptric power of the spec
-+10D will have 12 base In in each eye for a total of 24PD
-the stronger the lens the closer working distance is required

58
Q

what are bioptics

A

-they are miniature telescopes mounted to the top of eyeglasses

59
Q

how does bioptics improve vision

A

make the image larger and lets many low vision individuals see clearer and further away

60
Q

video magnifier portable

A

-full HD camera
-3x to 15x magnification

61
Q

OrCam MyEye

A

-consists of a camera that is affixed to gls
-3 main functions
1. reading text
2. product recognition (describe objects, colours, barcodes)
3. facial recognition
-helps visually impaired know what is around them

62
Q

OrCamRead

A

costs less but is only used for reading
-used for ppl with mild low vision, reading fatigue and reading difficulties -including dyslexia
-reads text aloud

63
Q

important tests to establish levels of low vision

A

-VF
-contrast sensitivty
-glare testing
-color vision
-extraocular muscles
-pupil evaluation

64
Q

vision testing for low vision pxs

A

-important to get the most accurate VA (may take more time)
-using charts such as ETDRS, bailey-lovie, feinbloom
-ETDRS is considered the best due to its standardization
(equal letters per row, spacing of letter and spacing between rows)
-

65
Q

refraction sequence may need to be altered for low vision pxs by using…

A

-often using a trial frame instead of phoropter
-use larger steps when changing lenses
-use high powered JCC lenses

66
Q

diff types of VF tests

A

-confrontation
-compuarized (automated)
-goldmann perimetry

67
Q

conditions that can affect contrast sensitivty?

A

-cataracts
-posterior capsule opactiy (following cat sx)
-glaucoma
-refractive sx
-diabetic retinopathy
-Contact lenses

68
Q

what can be done for pxs with contract sensitivty?

A

-ensure appropriate lighting conditions
-use of high contrast colors to label commonly used items
-accessibility functions on smart devices, bold text, reverse contrast
-appropriate filters for outdoor glare

69
Q

examples of vision aids to help improve contrast sensitiviy?

A

daylight floor lamp
-acetate yellow print enhancer
-fit over polarized sunglasses

70
Q

glare disability

A

decrease in vision that occurs when glare causes a reduction in contrast between the background and the object of regard
-generally caused by some sort of media opacity

71
Q

how is glare testing done

A

-with a brightness acuity tester or brightness acuity meter
-using several diff levels of glare

72
Q

examples of low vision aid to reduce glare

A

-plastic typoscope signature guide
-black/grey polarized

73
Q

Types of extraocular muslces

A

-Covertest / if px can fixate for cover testing, may be limited to
-Hirschberg
-Krimsky

74
Q

Hirschberg test

A

-light is shone from 33cm away and the cornea light reflexed are observed

75
Q

Krimsky test

A

-way to approximately measure strabismus
-horizontal/vertical prism is placed over the deviating eye until both reflexed are central

76
Q

schedule follow up appts for low vision pxs

A

to assess adaptation and effectiveness
initally every 3 to 6 months to monitior progress and make neccessary adjustments

Refracting Skills 2 (5 decks)

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