Low vision aids dr. d p shah

  • 1,662 views
Uploaded on

 

  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Be the first to comment
No Downloads

Views

Total Views
1,662
On Slideshare
0
From Embeds
0
Number of Embeds
2

Actions

Shares
Downloads
125
Comments
0
Likes
3

Embeds 0

No embeds

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
    No notes for slide
  • {"41":"If cctv enlarges and you bring yourself closer then it is the mutiplication of enlargement times distance \n","4":"I am more a golf instructor than any new information you know you hit the ball in the hole the question is how do you hit it into the hole?\n"}

Transcript

  • 1. LOW VISION AIDS Dr. Divyesh P. Shah Sight First Technical Advisor, MD 322 Lions Clubs International Foundation
  • 2. LOW VISION DEFINITION “A PERSON WITH LOW VISION IS ONE WHO HAS IMPAIRMENT AND /OR STANDARD REFRACTIVE CORRECTION AND HAS A VISUAL ACUITY OF LESS THAN 6/18 TO LIGHT PERCEPTION IN THE BETTER EYE OR A VISUAL FIELD OF LESS THAN 10 DEGREES FROM THE POINT OF FIXATION, BUT WHO USES OR IS POTENTIALLY ABLE TO USE , VISION FOR THE PLANNING AND / OR EXECTUION OF A TASK” (WHO/PBL/93.27)
  • 3. What is Low Vision? • Low vision can be described as reduced vision which cannot be corrected by optical or surgical means World Health Organisation definition: Best corrected VA less than 6/18 to PL or a Visual field of less than 10 degrees in better eye
  • 4. Low Vision and Low Vision Rehabilitation: • A person with a significant reduction in visual acuity due to ocular disease that is not correctable by surgery, conventional eyeglasses or contact lenses has Low Vision • The process of helping a person with low vision achieve the highest level of visual function, independence, and quality of life possible is Low Vision Rehabilitation
  • 5. • The role of a low vision specialist (optometrist or ophthalmologist) is to maximize the functional level of a patient's vision by optical or non-optical means called LOW VISION AIDS
  • 6. A Global Estimate of Low Vision Care Needs • 148 million visually disabled (blind+ low vision, ref. ICD-10) 8 million blind, without any perception of light 140 million partially sighted (of whom 30 million blind, but having some residual vision) 25% 35 million in need of low vision care 75% 105 million in need of cataract surgery and/or routine refraction
  • 7. • Worldwide, for each blind person, an average of 3.4 people have low vision, with country and regional variation ranging from 2.4 to 5.5.
  • 8. 95% of people with low vision have some level of useful vision.
  • 9. • Those with worsening sight and the prognosis of eventual blindness are at comparatively high risk of suicide • These people can be helped with Low Vision Aids
  • 10. Lack of Services – The Impact to Children • For children, the lack of low vision services means: – Developmental delay – Loss of educational opportunity – Isolation – Dependency – Inability to participate in family and society – Put into the category of blind and they are provided with braille instead of general stream.
  • 11. Lack of Services – The Impact to Adults and Seniors For adults, the lack of low vision services means • – Isolation • – Dependency • – Inability to participate in family and society • – Unemployment/underemployment • – For the elderly it may mean increased risk • for psychological and health effects; even
  • 12. Woeful lack of awareness • • • • • Patients Society Doctors Opthalmologists Facilities providing services LACK OF AVAILABILITY OF SERVICES AND TRAINED MANPOWER
  • 13. Conditions causing Low Vision Include : • A R M D- central loss • Diabetes- retinopathy Laser treatment • Retinal Disorders • Stroke +/- Field Loss • Nystagmus • Congenital Conditions • Multiple Sclerosis • Glaucoma
  • 14. Central Loss
  • 15. • Macular Degeneration VISUAL EFFECTS LOW VISION AIDS V a: may vary with the extent of the deg: with dry-stage ARMD,acuity can range from 20/20 to 20/400.With wet-stage (exudative) ARMD,the acuity can show loss worse than 20/400. Main problem is very difficulty to reading or writing. Should be prescribe optical glass & direct illumination should be recommended for all near tasks. Most of the patients respond well to magnification at distance & near. Non-optical aids . CPF lens improved contrast & control glare.
  • 16. Age-related Macular degeneration • The most common cause of visual loss in Western countries • >50% of all registered VI • >70% of all visually impaired over 75 years of age
  • 17. Homonymous hemianopia
  • 18. Glaucoma VISUAL EFFECTS LOW VISION AIDS CCTV or max are useful because increase contrast & brightness along with Photophobia ,seeing halos around light, opacity or haze on lens, central visual acuity magnification,CPF are beneficial in is generally unaffected until the end stage of reducing glare, reverse telescopes can be used to enhance visual field, flashlight can this disease. be helpful for night travel, long cane also Visual loss in end –stage glaucoma pt: creates problem with orientation & mobility. helpful for travel (end-stage). Blurred vision which is gradual.
  • 19. End Stage Glaucoma
  • 20. Albinism VISUAL EFFECTS LOW VISION AIDS Albinism has the most severe effect on visual acuity, ranging from 20/200 to 20/400. Photophobia, may high refractive error, nystagmus, color vision is normal. Correct refractive errors. Controlling illumination sun lenses, CPF & color contact lenses or pin hole cl, visors & hat can often reduce photophobia. Telescope for distance.
  • 21. Retinopathy VISUAL EFFECTS Depending on the severity of retinopathy, visual acuity ranges from 20/20 to total blindness. Loss of color vision. Most commonly , decreased vision is a result of lens changes (due to fluctuation in blood sugar level) or macular edema. LOW VISION AIDS Correct refractive error.CPF & sun lenses that block blue wavelenths may inprove contrast & eliminate glare & photophobia. Direct illumination for near tasks is generally helpful. Prismetic glass ,hand mag & CCTV may helpful for near task.
  • 22. Diabetic retinopathy
  • 23. Retinitis Pigmentosa VISUAL EFFECTS LOW VISION AIDS Central vision ranges from 20/20 to no light perception. In early stages of the disease, acuity usually remains normal. In later stages, acuity may become moderately to severely decreased secondary to lens or macular changes. Photophobia, night blindness, color vision problem. Slow reading & mobility problem. Refractive error should be evaluated carefully. CCTV or Max are useful (increasing contrast & brightness along with magnification ). Prismatic lens & good illumination helpful for near task.CPF lenses are helpful for improving contrast & reducing glare. Reverse telescope for distance. Vision rehabilitation is also needed.
  • 24. Purpose of Low Vision Assessment • Low vision rehabilitation allows people to resume or continue to perform daily living tasks, reading being one of the most important • This can be achieved by providing non optical and optical devices as well as training in the use of residual vision
  • 25. Assessment • Establish patient’s understanding of eye condition • Explanation given if necessary, backed up with written or taped information if required • Aim to dispel myths: -Tend to retain peripheral vision in ARMD -Can’t ‘use up’ remaining vision -Don’t feel guilty about using sight
  • 26. REFRACTION • Encouraged to have up-to-date refraction • Many patients with low vision benefit from having separate readers, rather than using bifocals or varifocals, especially if a magnifier is to be used, or eccentric viewing taught
  • 27. Low Vision Examination Vision Test Prescription of Visual Devices
  • 28. Counseling and Emotional Support • Counselling and Emotional SupportPatients may experience similar feelings to the various stages of bereavement • Charles Bonnet syndrome- patients need reassurance that their visual hallucinations are a common symptom of visual loss
  • 29. Establish visual needs and requirements • Near / Distance • Hobbies / Leisure • ‘Survival’ reading such as : correspondence labels / prices food packets & use-by dates medication instructions/syringe markings
  • 30. Optical Aids • Magnification: aim to use lowest possible • Higher magnification =smaller magnifier lens, therefore smaller field of view
  • 31. Optical Aids • Choices: hand/stand/lighted/ dome depends on: • Patient choice • General health issues • Task
  • 32. Stand Magnifiers • May be non-illuminated or illuminated with an LED • Location of image inside of the focal point of the F1 requires accommodation or an add to resolve the image.
  • 33. Distance and Near Magnification Systems
  • 34. Distance Telescopes • Used to magnify the apparent size of a distant object when the patient cannot move closer to the object • Tasks: viewing faces across a room, grocery store isle markers, bird watching, sporting events, tv
  • 35. Tints/Filters/Glare Control  Wrap around filters available to control both indoor and outdoor glare.  Optical coatings such as AR, and Polaroid lenses may reduce glare
  • 36. Binoculars and Monoculars TV glasses and Clip ons
  • 37. Macular Degeneration • UVShields with UV protection.
  • 38. Field expanding spectacle
  • 39. •Touch screens -are devices placed on the computer monitor(or built into it) that allow direct selection or activation of the computer by touching the screen. 10/30/13 40
  • 40. Magnification with CCTV • If the CCTV is viewed from a distance closer to the screen than 40cm, the total magnification. Achieved is the product of RDM x RSM.
  • 41. Recent Advances in Low Vision • Bioptic & Auto focus Telescope • Computer soft wares • Speech recognition softwares • Multilingual. • Braille output printers. • CCTV / LCD display/portable
  • 42. • Large /bold print bank statements and Utility bills • Clipboards and reading stands • Shades and Visors • Large button phone • Aids:Talking clocks, watches, tins. • Talking microwave, measuring jug and scales, spirit level and rulers • Electronic colour detectors
  • 43. 1. 2. 3. 4. 5. Listen, Listen and Listen.. Detail explanation low vision rehab programme. Psychological management. Friendly advise & counseling. Important of follow up. 10/30/13 44
  • 44. • The sooner the patient receives support, the better • NSF for older people states that patients should be enabled to retain their independence
  • 45. • Low vision care AND Vision rehabilitation is the crying need of the day • Low vision rehabilitation offers the practitioners a feel good niche and the patient a real choice to regain visual independence. • A large section of totally underserved partially blind population is waiting to be served WE HAVE TO MAKE SURE THAT WE ARE READY TO SERVE 10/30/13 46
  • 46. THANK YOU