Vision

Question 1

What are the two types of central vision loss in older adults?

Answer 1

1) cataracts

2) age-related macular degeneration (AMD)

Question 2

What are cataracts?

Answer 2

when the lens of the eyes becomes more opaque and a reduction of light going to the retina occurs

Question 3

What are the typical manifestations of cataracts?

Answer 3

1) reduced visual acuity
2) blurry vision
3) decreased ability to distinguish colors
4) reduction in ability to drive at night
5) distortion of visual images
6) increased glare sensitivity
7) increased difficulty distinguishing similarly colored objects from the background (reduced contrast sensitivity)

Question 4

What are the typical manifestations of age-related macular degeneration?

Answer 4

1) impaired mobility
2) reduced ability to perform ADLs and IADLs
3) decreased ability to recognize faces and perform detailed work (reading, needlepoint)
4) difficulty with social participation because can’t recognize facial expressions

Question 5

What causes peripheral vision loss?

Answer 5

glaucoma

Question 6

What are the two types of glaucoma?

Answer 6

primary open-angle and angle closure

Question 7

Describe primary open-angle glaucoma.

Answer 7

occurs when pressure inside the eye rises to a level that may damage optic nerve. This type of glaucoma has a slow onset with major risk factor being increased intraocular pressure

Question 8

Describe angle closure glaucoma

Answer 8

it’s an emergency, acute condition in which aqueous fluid becomes blocked and causes intraocular pressure

Question 9

What causes fluctuating vision loss?

Answer 9

diabetic retinopathy

Question 10

What causes diabetic retinopathy?

Answer 10

changes in blood vessels of the retina…

Question 11

What are the typical manifestations of diabetic retinopathy?

Answer 11

1) blurry vision
2) reduction in contract sensitivity
3) decrease in ability to drive at night
4) reduction in color discrimination
5) patchy spots of visual field loss
6) total blindness

Question 12

What’s the eval protocol for OT with clients who have vision issues?

Answer 12

1) gather background data through reading medical records, complete occupational profile, interview/questionnaires
2) standardized or structured assessments
3) environmental assessment at client’s work or home

Question 13

Assessments for low vision to check for ADLs and IADLs

Answer 13

Melbourne low vision ADL index and COPM

Question 14

Assessments for low vision to check for visual acuity

Answer 14

near visual acuity: Lighthouse near visual acuity test

far visual acuity: Snellen Chart or Tumbling E chart (for individuals who are illiterate)

Question 15

Assessments for low vision to check for visual fields?

Answer 15

peripheral: confrontation testing- gross measurement of visual fields
central: amsler grid

Question 16

Assessments for low vision to check for contrast sensitivity

Answer 16

Pelli-robson contrast sensitivity chart

Question 17

What are OT interventions for clients w/ low vision?

Answer 17

1) use of nonoptical devices to improve independence and safety (i.e. large print items, talking clocks, technological stuff)
2) use of contrast to improve visibility (colors that are opposite to each other (coffee in light-colored mugged… basically, try not to camouflage sh**)
3) reduce clutter (visual and physical) and improve organization
4) modify the environment (lighting, etc.)
5) refer to appropriate low vision specialist
6) instruct adults in using prescribed optical devices, magnification during activities
7) maximize use of remaining vision during ADLS (i.e. teach client to rotate or turn head to use peripheral vision (eccentric viewing), scan in organized manner, rotate head and trunk more to see entire visual field)
8) use their other senses to help compensate (i.e. tactile markers like bump dots to mark most used settings on microwave)
9) driving assessments
10) fall prevention
11) community resources