Delivery Of Low Vision Care Outside Of The Office Flashcards
(35 cards)
KY school for the blind outreach h
- school aged kids with known visual impairments
- 12 clinics throughout the state
- purpose is to determine whether an individual with low vision can benefit from optical and non optical devices, as well as adaptive techniques, to enhance visual functioning
In patient consultations for vision rehab on the go
- traumatic brain injury patients of all ages
- vision is potentially interfering with other therapies
- purpose: determines if any devices or adaptive techniques can improve the patient’s independence and visual functioning
Visual impairment
Vision is not correctable with glasses or CL
-WHO designates classifications of visual impairment based on VA
Legally blind: 20/200 or less and/or visual field 20 degrees or less
-blindness does not equal NLP
KSB outreach clinics; process
- referral by TVI
- functional visual observations
- eye examination within the past year
- patient is scheduled to closest clinic in proximity
- TVI and often parents are present at evaluations
KSB outreach clinics common conditions
RP ROP Achromatopsia Albinism Aniridia Coloboma Nystagmus Optic atrophy Optic nerve hypoplasia Stargardts Functional loss
Pediatric low vision exam
Detailed history
Functional assessment
Device calculation and demonstration
Assessment and plan
Pediatric low vision history
- CC
- parent concerns
- teacher concerns
- previous LV exam and/or devices (specifical low vision goals)
- ocular history
- past medical history
- social history
Functional assessment of ped low vision
VA Continuous text VF Contrast color vision Ret/refract Pupils EOM Binocularity
VA for peds in low vision
Distance
-snellen, feinbloom, lea shapes, numbers
Near
-letters, lea shapes, children’s books, numbers
Continuous text for peds low vision
MNRead
3rd grade text
Can use to calculate mag
Typically correlates somewhat with single letter
VF for peds low vision
Confrontations
Arc perimeter
-typically no provided in referral info
-important functional component, O/M needed?
-confrontations: finger count, grossly measured
Contrast for peds low vision
MARS perceptrix
Numbers
Hiding Heidi
Color vision for low vision peds
Ishihara HRR D-15 -arrange by hue -determine type and severity of color deficiency Objects
Refractive error in kids
- glasses may or may not be new
- over ret
- trial frame refraction
- typically prescribe if functional improvement
Near device assessment
- bifocal
- miscoscope/half eyes
- HH magnifiers
- dome/stand magnifiers
- large print
Distance device assessment low vision peds
Monocular
Placement in classroom
Smart board technology
Assessment and plan for low vision peds
What were initial functional goals What recommendations can be made -devices -placement in classroom -lighting considerations -audio formats -vision breaks -other service: OT, O/M
Reports, reports, reports
-consider who report is going to
In patient consultations: process
TBI diagnosis
-includes brain tumor, elective surgery, stroke, TBI/multi truama
Referral by rehab physician, OT, PT
Functional visual observations
Consultations provided weekly
OT and often family are prestn at evals
Common conditions at inpatient consultations
TBI
- stroke
- concussion
- blast injuries
- post surgical
- trauma
Sequela of TBI
- double vision (CN palsy)
- hemianopsia
- variable scotomas (blind spots)
- processing deficits
TBI exam
Detailed history
Functional assessment
Ocular health assessment
Assessment and plan
TBI history
CC Occupational therapist concerns or observations Ocular history Past medical history History of current injury Social history
Foundational assessment fo TBI
VA VF Color vision Ret/refract Binocularity Ocular health
Distance VA for TBI
Snellen, feinbloom, lea shapes, lea paddles, OKN
Near VA for TBI
Letters, lea shapes
