Low vision aids case presentation

1. LOW VISION AIDS
CASE
PRESENTATION
BY
Aswin . J
III rd year

2. CASE
– A 30-year old male
– Farmer by occupation
– Diagnosed with choroiditis 13 years back.
– Referred to Low Vision Care clinic for further management.
– Difficulty with visual tasks for 1 year.
– No signs of systemic abnormalities.

3. Present complaints
– Onset: 13 years
– Distance vision : difficulty in seeing faces beyond 2m,
viewing steps
– Near vision: difficulty in managing accounts, phone numbers
– ADL: The activities of daily living was independent and had no light sensitivity
problems
– Visual problems: spotting bills/ receipts,
currency recognition,
writing tasks

4. EXAMINATION
– DISTANCE VISION(unaided)
OD: 1/30 (6/180)
OS : 3/24 (6/48)
BE : 3/24 (6/48)
– NEAR VISION (UNAIDED)
OD :N64 @ 38 cm
OS: N32 @ 38 cm

5. – REFRACTION ( Retinoscopy)
OD: + 0.50 DS/-3.50 DC x180
OS: -0.50/-2.00DC x180
– SUBJECTIVE REFRACTION
OD : Plano / -3.50 DC x 180( 1/24,6/144)
OS: -1.00 DS / -1.50 DC x 180 (3/15,6/30)
– NEAR:
ADD:
OD : +4.00 DS (N50 – reads partially only) @25cm
OS: +4.00 DS (N32) @ 25 cm

6. – COLOUR VISION: The patient was unable to match any colors on the D 15 test.
– AMSLER : OD :DEFFERED OS: Does not report scotoma
– CONFRONTATION :OU: No Scotoma detected
– TRIAL FOR NEAR:
Required near visual acuity: Need: : N16(currency Spotting)
Calculated magnification:
EVP= 32/12 x 100/38
=approx. 7.0 D or 1.75 x
Need Spotting :N6
Calculated magnification:
EVP =32/12 x 100/38
= 21.0 D OR 5.26 x

7. – TRIAL:1
o +7.00 ADD: N16: ABLE TO SEE SELF WRITTEN TEXT, RECOGNIZE CURRENCY, MOBILE
NUMBERS.(working distance of 14 cm
o HALF EYES : +8.00D (N12) not comfortable
– TRIAL 2:
o 5x pocket magnifier :N6; Able to spot bills and receipts.
– DISCUSSIONS:
• 1 in 140 people in urban aged above 40 years have uveitis
or past uveitis treatment
• 35% people with uveitis have moderate or profound visual impairment in spite
of treatment.

8. – The Patient in this case have moderate visual impairment secondary to uveitis
– The patient did not complain about glare or photophobia which is a part of the
classic triad of uveitis
– FINAL Rx:
New distance single vision Rx
separate near Rx with +6.00DS ADD for writing
5x pocket magnifier

9. – OTHER ADVICE
• Patient was reassured about his closer working distance.
• They explained to him that the Rx would help him to view mobile font
• To see faces he was asked to use magnifiers
• He was asked to get a 75% disability certificate from local district government
hospital.

10. REFERENCES
– Dandona .L .Et al. population based assessment of uveitis in an urban
population in southern India

11. THANK YOU