Vision Checkoff Flashcards

1
Q

Vision

A
  • Primary sensory system used to acquire information about the environment
  • 80-90% of all learning occurs through visual channel
  • 90% of all sensory info supplied to CNS is visual
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2
Q

Vision if the most far reaching sensory system because it…

A
  • First to alert us to danger or pleasure
  • Enables us to be anticipatory
  • Helps plan for situations
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3
Q

Contributions of Vision

A
  • Supplies info for congitive functions (problem solving, decsion making)
  • Supplies info/clues needed to interpret social interactions
  • Supplies input for motor and postural control
  • Provides speed in info processing
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4
Q

Supplies input for motor and postural control (Contributions of Vision)

A
  • Facilitates motor development

- Warning system for challenges to postural control (100ft)

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5
Q

Provides speed in info processing (Contributions of Vision)

A
  • Speed is critical when it comes to adapting to dynamic environment
  • Rapid processing of visual info for adaptive response
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6
Q

Visual Perception

A
-The ability to organize and interpret the info that is seen and give it meaning 
Includes:
-Form constancy
-Figure-Ground
-Visual Closure
-Visual Memory
-Spacial Orientation
-Visual Discrimination
-Spacial Relationships
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7
Q

Normal Vision

A

20/20-20/30

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8
Q

Near Normal

A

20/30-20/60

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9
Q

Moderate Impairement

A

20/70-20/160

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10
Q

Severe Impairment

A

20/160-20/240

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11
Q

Profound Impairment

A

20/400-20/1000

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12
Q

Near Blindness

A

20/1000-20/2500

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13
Q

Total Blindness

A

No light perception

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14
Q

Legal Blindness

A

Term coined by the federal government to describe visual impairment criteria qualifying individuals for benefits and services

  • Best corrected VA 20200 or less in better eye or
  • VF of 20 degrees or less in better eye
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15
Q

Can occur at birth or from…

A

-Disease
-Trauma
-Aging
-or Combination
(Age-related Macular Degeration, Diabetic Retinopathy, Glaucoma, Enucleation)

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16
Q

Visual Impairments

A
  • Alter the quality/quanity of visual input to CNS
  • Alter the CNS ability to process visual input
  • Result in decreased ability to use vision for occupational performance
  • Alter cognitive performance
  • Can contribite to anxiety, decrease confidence, social isolation, etc.
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17
Q

OT Role in Low Vision Rehab

A
  • Focus should always be on occupational performance
  • Purpose of eval is not to diagnose but to link presence of visual deficit or disorder to limitation in occupational performance
  • Observation of patients funcitonal performance and environment are critical
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18
Q

Two Treatment Approaches (OT Role in Low Vision Rehab)

A
  • Client Centered: Emphasis on changing the person, improving ability to take-in and process visual infor
  • Environment-Centered: Emphasis on altering the environment to achieve better person environment fit, enables person to engage with remaining capabilities
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19
Q

Cataracts

A
  • Lens becomes opaque or cloudy
  • Cataracts prevent light from reaching retina, causing difficulty with night vision
  • Cataract surgery is common, new lens is implanted
20
Q

Macular Degeneration or Age-Related Macular Degeneration (ARMD)

A
  • Loss of Central Vision
  • Leading cause of vision loss in adults
  • Responsible for fine-detail visions (reading, needlework, recognizing faces, writing)
  • Dry degeneration is more common
  • Wet degeneration can be treated with laser surgery
21
Q

Glaucoma

A
  • Loss of peripheral vision
  • High pressure inside eyeballl results from buildup of excess fluid in the eye, Pressure eventually damages the optic nerve or the blood vessels that supply the optic nerve
  • If left untreated, leads to total blindeness
  • Treated easily with eye drops or surgery
  • Two Types: Open Angle and Closed Angle
22
Q

Open Angle Glaucoma

A

Progresses slowly with a gradual buildup

23
Q

CLosed Angle Glaucoma

A

Progresses rapidly with symptoms

24
Q

4 Stages of Diabetic Retinopathy

A
  1. Mild Nonproliferative Retinopathy
  2. Moderate Nonproliferative Retinopathy
  3. Severe Nonproliferative Retinopathy
  4. Proliferative Retinopathy
25
Q

Functional Implications of Diabetic Retinopathy

A

Such as glaucoma, varies depending on early diagnosis and severity of the disease

26
Q

Homonymous Hemianopia

A

Partial or complete loss of vision in one half of each eye

27
Q

Vision and Functional Mobility

A
  • Simultaneously process info from both central and peripheral VF
  • Primarily used to gather info about obstacles, objects to be manipulated or acted upon
  • Used to plan movement & postural adjustments (motor planning), movement is visually triggered
  • Environmental qualities (static/dynamic, new/familiar, simple/complex)
  • Must consider other environmental features (brighness, glare) contrastinh features (curb drop-offs, stairs)
  • PVF loss (glaucoma, central retinal artery occlusion) result in collisions, balance disturbances, and disorientation)
28
Q

Treatment of VFD

A
  • Simple Scan Course

- Dynavision D2

29
Q

Indoor Mobility

A
  • Familiar environment (home, school)
  • Trailing
  • Alignement
  • Squaring-Off
  • Room Familiarization (landmar, boundary, grid)
30
Q

Trailing (indoor mobility)

A

Continuous surface between destinations (ambulating down hallway)
-Extend shpuld 45° arm in from of body and use back of hand with fingers curled

31
Q

Alignment (indoor mobility)

A

Use whern there are gaps in trailing surface (countertop, kitchen sink, crossing doorways)
-Client aligns self parallel with surface to establish line of travel, then continues across open area to resume trailing on other side
-

32
Q

Squaring-Off

A

Use when changing directions or crosing a surface with gaps (countertop, kitchen table)
-Client places back against object to determine line of travel away from object

33
Q

Sighted Guide

A
  • Used to safely navigate unfamiliar or dynamic environments
  • Client grips ‘guides’ arm just above elbow tieh fingers on inside of elbow and thumb on outside
  • Guides arm relaxed at side and client with elbow bent at 90°
  • Navigating Narrow Passages (doorways)
  • Stairs/ Curb
  • Guide provides VC as alert to changing environment
  • Effective training will result in improved safety for client in dynamic novel environments
  • Orientation in clinic and practice at home
  • Other mobility options: Long cane training
34
Q

Navigating Narrow Passages/Doorways (Sighted Guide)

A

-Guide moves arm back towards center of back and client responds by exending arm and flies in (moves into) single-file, arm held fully extended to prevent tripping

35
Q

Stairs/ Curbs (Sighted Guide)

A

Guide alerts, square off with steps, cue for handrail, guide initiates step then client, guide cues client at/before landing

36
Q

Oculomotor Review

A
  • Fixation: Abilityy to focus/fixate on target
  • Localization: Ability to spot different objects/items, move eyes from one place/point to another within VF
  • Saccadic Movements: Shift and fixate from one target to another
  • Smooth Pursuit (aka tracking): Following/ Tracking targets
37
Q

Oculomotor Review Steps

A

Fixation (maintianing the picture) > Localization (looking for target anywhere in VF) > Saccades (looking btw 2 objects) > Smooth Pursuits (following objects/targets)

38
Q

Visual Assessments

A
  • Pupillary Contriction
  • Saccadic Eye Movements
  • Snellen Eye Chart (VA)
  • Eye Dominace Testing
  • Smooth Pursuit (visual tracking)
  • Convergence/Divergence
  • Visual Field Testing
  • Central Cisial Fiels
  • Confrontation Testing (Red dot & 2 Person Kinetic Tests)
39
Q

Pupillary Contriction (Visual Assessments)

A

Pen light 3-4” from pupil

40
Q

Saccadic Eye Movements (Visual Assessments)

A

(horizontal/vertical)

  • Hold 2 targets (letters on tongue depressor, different color items), one in each hand 16” from client’s face. targets 8” apart
  • Client looks at one then rapid shift to fixate on other (observe eyes moving together, smoothly finds target; note over/undershooting) 5x. (don’t mention head movement)
41
Q

Smooth Pursuit/Visual Tracking (Visual Assessments)

A
  • Hold target ~16° from clients face, slowly move CWx2, then CCWx2
  • Assess square and diagonal ‘X’ (observe keeping head still while moving eyes to follow target, eyes move together, smoothly follow object, under/overshooting, midline jerk: looks away when object crosses persons midline)
42
Q

Convergence/Divergence (Visual Assessments)

A
  • Hold object ~16” from client’s face, slowly move object towards bridge of nose, stop when client reports object is blurry ~2-4” from bridge of nose
  • Move object back out few inches (re-focus), observe both eyes should be moving equally in, excessive blinking, turn in/out excessively, inability to move in/out, >3” convergence insufficiency)
43
Q

Visual Field Testing (Visual Assessments)

A

All tests are monocular

  • Central Visual Field (CVF)
  • Confrontation Testing (red dot & two person kinetic testing)
44
Q

Central Visual Field (Visual Assessments)

A
  • Focus on center of clock (client identifying any missing #’s), Test fro scotomas in CSF
  • Alternatively, can ask client if any part of examiners face is missing
45
Q

Confrontation Testing: Red Dot & Two Person Kinetic Testing (Visual Assessments)

A
  • These are gross assgessments and may not be sensitive enough to detect subtle changes
  • Defiticits to peripheral VF usually dont interfere with reading/near vision tasks but can cause significant mobility issues
  • Observe: Client remains fixated on target or examiners eys, does not break fixation during testing
46
Q

Visual Perception Hierarchy

A
  1. Adaptation Through Vision
  2. Visual Cognition
  3. Visual Memory
  4. Pattern Recognition
  5. Scanning
  6. Attention (alert and attending)
  7. Oculomotor Control, Visual Fields, Visual Acuity