Examination And Assessment

Question 1

Outline potential Adaptations to clinical routine that are required

Answer 1

• prepare to guide px to the room
• adjust speed of the test, skip unnecessary tests, as px can be elderly
• encourage carers or family to be present for test
• px may have other disabilities
• keep talking to the px

Question 2

Ocular history questions

Answer 2

• change in vision
• which eye is better
• registration status
• social circumstances

Ocular condition
- duration and onset
- stable or progressive
- cause or treatment

Question 3

General Health questions

Answer 3

• establish current general health
• Physical infirmities
• registration of vision impairment

Question 4

What to ask about low vision aids

Answer 4

• previous assessments
• previous low vision aids and were they useful
• Current LVA
• record VA with LVA
• do they use LVA
• demonstration

Question 5

What to ask about px daily life

Answer 5

• occupation
• mobility
• reading/writing?
• hobbies
• mental health
• live alone
• visual requirements
  
  • tv
  • text size
  • working distance

Question 6

5 stages of the loss model

Answer 6

• denial and shock
• grief
• anger
• depression and apathy
• acceptance

Question 7

How to measure visual acuity

Answer 7

• if VA unknown, start at 0.5/1m and move back
• don’t start with counting fingers
• might have to adjust room illumination
• record monocular and binocular
• record testing distance

Question 8

How to refract a low vision px

Answer 8

• use large steps
• no smaller than 0.50 D
• direct px to single letters
• ask closed questions. No open questions
• reduce testing distance

Question 9

How to calculate required magnification

Answer 9

• use BVA and target acuity
• M = BVA/TA
• BVA = 6/60 and TVA 6/12
• M= 60/12 = 5X

Question 10

How to estimate Near VA

Answer 10

• estimate NVA
  
  • divide by 3 rule
• measure threshold NVA
  
  • at 25cm
  • +4.00 add
• determine TVA and calculate M
• (N-Point) M=BVA/TVA

Question 11

General clues as to the px level of Vision

Answer 11

• are they bothered by light
• do they look straight at you or eccentric
• can they navigate independently

Question 12

Key things to establish from H&S

Answer 12

• onset of impairment
• duration
• what condition do they have
• ## general health and meds