Enhancing Daily Living for Patients with Low Vision


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Enhanced Vision webinar on February 26th 2014. "Enhancing Daily Living for Patients with Low Vision"

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Enhancing Daily Living for Patients with Low Vision

  1. 1. Enhancing daily living for patients with low vision CORONA HOANG, OD VIEWFINDER LOW VISION RESOURCE CENTER 1830 SOUTH ALMA SCHOOL RD. STE. 131, MESA,AZ 85210 480.924.8755 10001 WEST BELL RD. STE. 115, SUN CITY, AZ, 85351 623.583.1556
  2. 2. What is a visual impairment?  According to the American Optometric Association:  Anyone with noncorrectable reduced vision is visually impaired, and can have a wide range of problems.  Few people are totally without sight. Most individuals today classified as "blind" actually have remaining sight and, thanks to developments in the field of low vision rehabilitation, can be helped to make good use of it, improving their quality of life.
  3. 3. Levels of visual impairment  World Health Organization has a classification system:  When the vision in the better eye with best possible glasses correction is:  20/30 to 20/60 Mild  20/70 to 20/160 Moderate  20/200 to 20/400 Severe  20/500 to 20/1,000 Profound
  4. 4. Levels of visual impairment cont.  less than 20/1,000 Near-total visual impairment, or near total blindness  No light perception Total impairment, or total blindness  There are also levels of visual impairment based on visual field loss (loss of peripheral vision). Visual acuity alone is not a good predictor  Someone with relatively good acuity (e.g., 20/40) can have difficulty functioning, while someone with worse acuity (e.g., 20/200) might not be having any real problems.
  5. 5. VA alone not a good predictor Visual acuity 20/40  With visual field loss Visual acuity 20/200  With no visual field loss
  6. 6. Visual Impairment  A person with a visual impairment may have “difficulty accomplishing visual tasks, even with prescribed corrective lenses, but who can enhance his or her ability to accomplish these tasks with the use of compensatory visual strategies, low vision and other devices, and environmental modifications" (Corn and Koenig, 1996).
  7. 7. Common causes of visual impairment or low vision  Age-Related Macular Degeneration  Diabetic Retinopathy  Glaucoma  Cataracts  Primary causes of low vision are eye diseases, but may be inherited or caused by an eye injury or brain injury
  8. 8. Age-related Macular Degeneration It is the most common cause of low vision in patients over the age of 60 years.  It is a progressive eye disease that effects the macula. The macula is part of the retina responsible for central vision.  There are two forms, wet and dry.  Wet ARMD is less common, it can have a greater effect on decreasing central vision.  Dry ARMD is more common, approximately 85-90% of patients have dry form. It has less vision loss than wet. 
  9. 9. How does ARMD cause low vision  Retinal photo of ARMD  There is a gradual breakdown of light-sensitive cells that convey information to the brain, and the supporting tissue underneath the macula.  This causes central vision loss
  10. 10. Central vision loss with ARMD  Normal  ARMD visual impairment
  11. 11. Glaucoma  It is the second leading cause of blindness in the US.  It is a group of eye diseases that effects the optic nerve. The optic nerve sends information from the eye to the brain to form an image.  There are different types of glaucoma, the most common is Open Angle Glaucoma which accounts for 95%.  Open angle glaucoma is a slow painless progressive disease that can effect peripheral vision loss if left untreated.
  12. 12. How does Glaucoma cause low vision? Retinal Photo of Glaucoma  Elevate pressures in the eyes can lead to glaucoma  Without treatment there is a gradual loss of side vision causing tunnel vision.  Patients will miss objects to the side and the corners of their eyes
  13. 13. Peripheral Vision loss due Glaucoma  Normal  Glaucoma visual impairment
  14. 14. Cataracts      Cataracts is the leading cause of visual impairment for those over 55 years of age. The lens is made of mostly water and protein. Protein is arranged in the lens to let light pass through. As we age, the protein may clump causing a cataract. Cataracts is the clouding of the lens inside the eye that effects vision. The most common cause of cataracts is age related. However, it may also be caused by diabetes, eye injury, or medications.
  15. 15. How does Cataracts cause low vision?  When protein clumps in the lens it reduces the amount of light reaching retina causing blurry vision.  Symptoms may include double vision.  Diminished ability to see colors.  Increase sensitivity to glare and light.  Poor night vision.
  16. 16. Cataracts  Normal  Cataracts
  17. 17. Diabetic Retinopathy  It is one of the four leading causes of severe visual impairment in the US.  It is a result of Diabetes and effects the retina  In some with diabetic retinopathy blood vessels may swell and leak fluid.  Others may have abnormal new blood vessel growth on the surface of the retina.
  18. 18. How does Diabetic Retinopathy cause low vision? Retinal photo  If blood vessels leak in the macula, vision will be blurry.  Fragile new blood vessels may grow into the eye, leak and block vision  May experience floaters  More difficulty at night  Hemorrhaging may cause retinal detachment.
  19. 19. Visual impairment due to DR  Normal  Diabetic Retinopathy
  20. 20. Effects of visual impairment on daily living  Quality of life  Emotional distress  Read small print, such as labels on medicine bottles, a telephone book, or food labels.  Reading a newspaper or book.  Recognizing people when they are close to you.
  21. 21. Effects of visual impairment on daily living continued  Seeing steps, stairs, or curbs.  Reading traffic, street, or store signs.  Doing fine handwork such as sewing, knitting, crocheting, or carpentry.  Writing checks or filling out forms.  Playing games such as bingo, dominos, or card games.
  22. 22. Effects of visual impairment on daily living continued  Taking part in sports such as bowling, handball, tennis, or golf.  Cooking.  Watching television.  Daytime driving.  Night time driving.
  23. 23. Low vision rehabilitation for treatment of visual impairment  An Optometrist or Ophthalmologist whose practice focuses on low vision is skilled in the examination, treatment and management of patients with visual impairments.  Each type of low vision problem requires a different therapeutic approach.  Treatment plans may include prescription of glasses, specialized optical systems, therapeutic filters, nonoptical options, and/or video magnification, and the prescription of rehabilitation therapy to effectively maximize visual functioning for activities of daily living. Information from AOA.org
  24. 24. Low vision aids and devices to enhance vision  Patients with a visual impairment can maximize their remaining vision through the use of low vision aids and devices.  The main principles behind low vision is to enhance contrast, control glare, and increase magnification.  Most people use multiple low vision aids because each is designed to serve a very specific purpose.  It is not unusual for someone to have five or more vision aids. Source: Thevisioncouncil.org
  25. 25. Improving contrast and glare  Optical filters can improve vision for distance and near and decrease eye fatigue while protecting the eyes from UV rays
  26. 26. Magnification  Is essential for low vision devices to enhance daily living activities  Helps seeing objects, texts, or images better  Many different types of devices and options for specific tasks
  27. 27. Low vision devices for different tasks Short term near Long term near Intermedieate Reading price tags, menus, medicine bottles, telephone book, food labels Hands free near work sewing, crocheting, reading books, newspapers Playing cards, bingo
  28. 28. Low vision devices for different tasks continued Distance spotting Distance viewing Seeing signs Watching TV, driving, sports events Non optical Talking watches, large print books, large font phone, computer programs
  29. 29. Some disadvantage of devices  Reading glasses may require extremely close working distance.  Smaller field of view on higher magnification devices , limiting the amount of words.  Good lighting needed for devices.  If patient has a restricted field of view or large scotoma, it may inhibit use of device.  Some devices only allow for single magnification or power.
  30. 30. Video magnifiers for enhancing daily living  Capable of magnifying while maintaining good working distance and larger field of view.  Video magnifiers can enhance distance and close-up viewing.  They are electronic devices, and typically consist of a camera and viewing screen to aid people in tasks including reading, writing, grooming or even cooking.  Material placed under the camera is magnified and displayed on the video magnifier’s monitor.  Video magnifiers exist as desktop units, which use a closed circuit television for viewing, as well as portable or hand-held video magnifiers for use on the go or during short tasks.
  31. 31. High performance desktop video magnifier (CCTV). Featuring Sony HD, text-to-speech 3-in-1 camera-far, intermediate, & near. Experience the joy of reading with the push of a button. 28 viewing modes allows customization. Slide mechanism provides flexibility for various camera arm positions. (888) 811-3161
  32. 32. High performance desktop video magnifier (CCTV). Featuring Sony HD and text-to-speech. Experience the joy of reading with the push of a button. Screen easily pivots horizontally and vertically-providing the most comfortable viewing position. 28 viewing modes allows you to personalize. (888) 811-3161 www.enhancedvision.com
  33. 33. Desktop CCTV Combines large magnification range with large field of view. Enhances contrast. Allows for smooth reading even at higher magnification levels. Comes in 20’,22’, and 24’ monitors Screen pivots 7 viewing modes (888) 811-3161 www.enhancedvision.com
  34. 34. Portable desktop CCTV. Sony HD camera. Ideal for patients who travel for extended periods of time. No longer have to purchase two desktop CCTVs. Moving camera head allows patient to use device for multiple tasks, working with hands, seeing their own face; shave, make up, other people faces, distance. 28 modes. In 22’,24’, &27” Remote control, line markers, obj. locator
  35. 35. Similar to Acrobat with few extras Even more portable. <3lbs Able to capture images. 28 custom modes. Excellent option for students or people who attend presentations/conferences often. Camera rotates 330 degrees Battery operated (up to 4 hours) Built in LED lighting (888) 811-3161 www.enhancedvision.com
  36. 36. Crisp, high-definition image Lightweight and portable 3.5x to 14x magnification Large 6.5” anti-glare LCD screen tilts for most comfortable viewing angle Large field of view allow the reader to see more of the reading area Freeze frame with adjustable size and contrast 6 viewing modes to optimize contrast and brightness
  37. 37. New HD camera providing a crisp, clear colorful, high definition picture. It’s new ergonomic lightweight compact design makes it the perfect companion whether at home or on the go. Can be used for reading and many near spotting tasks Reading menus Shopping- seeing price tags and labels Seeing household items like stove dials and thermostats Signing documents such as checks and receipts
  38. 38. THANK YOU FOR JOINING US Corona Hoang, OD Viewfinderlowvision.com (888) 811-3161 www.enhancedvision.com