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Occupational Therapy Visual Screening Tool

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Occupational Therapy Visual Screening Tool

  1. 1. O.T. Visual Screening ToolOccupational Therapy Visual Screening ToolBelfast City Hospital – Stroke UnitLorraine CollSpecialist Occupational Therapist www.COT.org.uk
  2. 2. O.T. Visual Screening ToolPresentation Structure • History • Screening Tool Overview • Audit Results • Benefits to Patients/O.T Profession • Future Developments
  3. 3. O.T. Visual Screening ToolHistory 2006 Original Screen used 2008 Amendments 2009 Pilot used 2010 Audit 2011 Meeting held to Pilot discuss potential Completion improvements Original NI OT Visual Updated screening Commencement of Screening Tool tool piloted in BCH OT Stroke Developed Stroke Unit Assessment Pathway
  4. 4. O.T. Visual Screening ToolScreening Tool Overview Key Objectives • Assess visual problems • Guide assessment of cognition and perception • Identify intervention requirements • Guide onward referral to Optometry, Orthoptics and Sensory support services
  5. 5. O.T. Visual Screening ToolScreening Tool Overview Equipment • Patients own glasses • A red object/marker pen • Pen torch • Stopwatch or clock with second hand • 6m direct ‘Snellen’ chart
  6. 6. O.T. Visual Screening ToolScreening Tool Overview Contents 1. Visual History •Glasses •Pre CVA visual problems •Post CVA visual problems (subjective report)
  7. 7. O.T. Visual Screening ToolScreening Tool Overview Content 2. Visual Acuity •Distant vision (Snellen Chart) •Near vision (reading task)
  8. 8. O.T. Visual Screening ToolScreening Tool Overview Content 3. Oculomotor Ability •Horizontal & Vertical eye movement •Nystagmus •Diplopia (subjective report) •Primary position
  9. 9. O.T. Visual Screening ToolScreening Tool Overview Content 4. Visual Fields •Single or two person method •Monocular and binocular testing
  10. 10. O.T. Visual Screening ToolScreening Tool Overview Content 5. Visual Attention •Visual Extinction •Severity of inattention (‘dot-to-dot test’) 6. Observed functional problems
  11. 11. O.T. Visual Screening ToolAudit Results Nr of patients admitted to the stroke unit 49 Patients Screened Patients unscreened 122
  12. 12. O.T. Visual Screening ToolAudit Results Types of CVA / Other Diagnosis Screened 12.70% 36.40% 10.60% PACS TACS 6.30% LACS POCS Other 34%
  13. 13. O.T. Visual Screening ToolAudit Results Referral Pathway Overview Visual Problem Visual Field Visual Acuity Ptosis Ptosis Diplopia Nystagmus Deficit Problem Unilateral Bilateral Optometry Sensory Optometry Orthoptics Support Onward Referral
  14. 14. O.T. Visual Screening ToolAudit Results Referral Pathway Overview Visual Problem Visual Field Visual Acuity Ptosis Diplopia Nystagmus Deficit Problem Advise patient on ADLs Sensory Optometry Support Sensory Optometry Orthoptics Support Onward Referral
  15. 15. O.T. Visual Screening ToolAudit Results Referral Pathway Overview Visual Problem Visual Field Visual Acuity Ptosis Diplopia Diplopia Nystagmus Deficit Problem • Nausea Application • Which eye? of Eye Patch • Gauge patient reaction Sensory Orthoptics Support Sensory Optometry Orthoptics Support Onward Referral
  16. 16. O.T. Visual Screening ToolAudit Results Referral Pathway Overview Visual Problem Visual Field Visual Acuity Ptosis Diplopia Nystagmus Deficit Problem Impeding Rehabilitation Sensory Optometry Optician Support Sensory Optometry Orthoptics Support Onward Referral
  17. 17. O.T. Visual Screening ToolAudit Results Referral Pathway Overview Visual Problem Visual Field Visual Acuity Ptosis Diplopia Nystagmus Nystagmus Deficit Problem Oscillopsia (wavy images) Sensory Orthoptics Support Sensory Optometry Orthoptics Support Onward Referral
  18. 18. O.T. Visual Screening ToolAudit Results Onward Referral 45.0% 40.0% 35.0% 30.0% 25.0% 20.0% 42.5% 15.0% 29.7% 10.0% 5.0% 12.7% 12.7% 12.7% 0.0% Orthoptics Optometry Sensory Community No Referral Support Stroke Rehab
  19. 19. O.T. Visual Screening ToolBenefits to Patients/O.T Profession• Change of practice (bypass need for medical referral)• Timely screening for patients• Increased knowledge and understanding of visual problems• Immediate intervention on ward• Increased volume of referrals
  20. 20. O.T. Visual Screening ToolFuture Developments • Re-audit • Education, training and roll-out • O.T. Stroke Assessment Pathway • Feedback workshop (Belfast Trust) • Potential multi-trust roll-out
  21. 21. O.T. Visual Screening ToolThank you for listeningwww.COT.org.uk

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