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AOTA - Low Vision
Terms in this set (36)
a client with age related macular degeneration has difficulty knitting. what strategy should be used to facilitate ability to continue knitting?
-have client rotate head and trunk to the side.
-rotating to side would allow to use remaining peripheral vision to see the pattern.
a client with presbyopia has difficulty reading small print. what is the client's problem described as?
-difficulty focusing on images as they move closer.
client with age related macular degeneration reports difficulty completing meal preparation activities. which intervention would be MOST appropriate?
-provide background contrast in kitchen area. allowing items to be seen easier.
glaucoma would have the MOST difficulty with what?
age related macular degeneration would have the MOST difficulty with what?
-reading printed material.
diabetic retinopathy would have MOST difficulty with what?
-seeing well at nighttime caused by spots or floaters in peripheral vision, blurred vision in central vision.
- reduction of contrast sensitivity, decrease in ability to drive, reduction in color discrimination, patchy spots of visual field loss, and total blindness
cataract would have MOST difficulty with what?
-tolerating glare from lights which produce blurred or hazy vision.
what are the 3 MAIN problems with vision impairment?
-social isolation and depression because of dissatisfaction with performance in valued occupations.
-loss of life roles.
-increased risk of falls.
what are the differences between age related macular degeneration versus glaucoma?
-AMD has impaired central vision and inability to see details.
-glaucoma has impaired peripheral vision, difficulty with night vision and mobility.
what IADL activities might be difficult for glaucoma?
-locating an item on a shelf.
-engaging in mobility.
-searching for items.
a client is displaying signs of visual field loss. how would COTA BEST determine whether visual field loss is present?
-refer to an eye care professional for automated perimetry testing. determining a vision is not OT scope of practice.
what is the BEST compensatory strategy for glaucoma?
-rotating the head would help client use remaining peripheral vision loss.
what would be a safety concern for a low vision client who lives alone?
what are the characteristics of visual field deficit?
-narrowing of visual search and slow scanning.
-affects mobility, reading, writing.
-anxiety due to challenging scanning and visual searching through environments.
what is the fundamental strategy for cognitive orientation to daily occupational performance CO-OP ?
-ask, dont tell approach.
-asking the client to breakdown the sources during performance of occupations.
what is the OTR basic assessment of low vision?
-visual acuity, visual fields, contrast sensitivity.
what strategy would reduce risk of falls fro a client with history of falls and glaucoma?
-placing contrasting color stripes on each stair edge.
what would be the BEST caregiver training for a client with glaucoma?
-sighted guide training by guiding client safely through environments.
what intervention approach would be MOST beneficial for a client who has age related macular degeneration and has difficulty seeing overhead menus at restaurants?
-moving closer to an object makes it relatively larger.
what is a typical symptom attributed to visual aging changes?
-slowing ability to adapt to light and dark.
Low vision impairment
best-corrected visual acuity less than 6/12 (<20/40) in the better-seeing eye
"defined by the US definition is the best-corrected visual acuity of 6/60 or worse (=20/200) in the better-seeing eye
difficulty focusing on near objects
Central or focal vision system
analyzes a visual target in terms of its details; color, shape, and texture
Peripheral or ambient visual system
provides background information about one's position in relation to the environment and is quick to detect motion
Functional impairments related to aging changes
- Ability to see close objects and coordinate eyes decreases
- Images become blurrier
- Ability to see at night decreases
- Eyes adapt more slowly to light-dark conditions
- Contrast sensitivity decreases
- The ability to view objects with low light decreases
- The ability to distinguish certain colors diminishes
- Visual fields become narrower
typical manifestations of cataracts
- reduced visual acuity
- blurry vision
- decreased ability to distinguish colors
- reduction in ability to drive
- distortion of visual images
- increased glare sensititivty
- increased difficulty distinguishing similarly colored objects from the background
Dry AMD vs. Wet AMD
- dry AMD is the most common type of AMD
- causes deposits of yellow-colored extracellular material within the macula of the eye
- WET- proliferation of abnormal blood vessels that leak blood and fluid into the macula
ADLs and IADLs evaluation for low vision
Melbourne Low vision index- assesses the impact of a person's visual impairment on ADLs and IADLs'
Visual acuity evaluations
Near visual acuity- Lighthouse Near visual acuity test
Fair visual acuity- Snellen E chart
Visual fields evaluation
Amsler Grid (central)
Confrontation testing- which provides a gross measurement of visual fields (peripheral)
Pelli-Robson Contrast Sensitivity Chart
Central vision adaptations
- rotate their head or turn trunk to use peripheral vision using a technique called eccentric viewing
Peripheral vision adaptations
- rotate their head and trunk to ensure they are seeing the entire visual field
- teach clients how to scan in an organized manner
Use other senses for visual impairments
- Use tactile markers (bump dots) to mark most frequently used settings on appliances
- Educate clients about writing guides that use tactile skills to help an individual write on the line
- use auditory or talking items
Hints for treating older adults with low vision
- Use adequate lighting without glare
- Organize and declutter physical and visual environments
- Improve contrast between objects and work surface
- Increase font of written material
- Write with a dark marker or use dark text on a white surface
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