Uploaded byRoyal College of Occupational Therapists
Occupational Therapy Visual Screening Tool
This document describes an occupational therapy visual screening tool developed for use in a stroke unit. It provides a brief history of the tool's development and outlines the screening process. An audit of the tool found it identified visual problems in patients, guided appropriate referrals, and provided benefits to patients and occupational therapists by streamlining the screening and intervention process. Future plans include re-auditing the tool, expanding its education and use, and gathering feedback to further improve visual screening for stroke patients.
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Occupational Therapy Visual Screening Tool
- 1. O.T. Visual ScreeningTool Occupational Therapy Visual Screening Tool Belfast City Hospital – Stroke Unit Lorraine Coll Specialist Occupational Therapist www.COT.org.uk
- 2. O.T. Visual ScreeningTool Presentation Structure • History • Screening Tool Overview • Audit Results • Benefits to Patients/O.T Profession • Future Developments
- 3. O.T. Visual ScreeningTool History 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. O.T. Visual ScreeningTool Screening 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. O.T. Visual ScreeningTool Screening Tool Overview Equipment • Patients own glasses • A red object/marker pen • Pen torch • Stopwatch or clock with second hand • 6m direct ‘Snellen’ chart
- 6. O.T. Visual ScreeningTool Screening Tool Overview Contents 1. Visual History •Glasses •Pre CVA visual problems •Post CVA visual problems (subjective report)
- 7. O.T. Visual ScreeningTool Screening Tool Overview Content 2. Visual Acuity •Distant vision (Snellen Chart) •Near vision (reading task)
- 8. O.T. Visual ScreeningTool Screening Tool Overview Content 3. Oculomotor Ability •Horizontal & Vertical eye movement •Nystagmus •Diplopia (subjective report) •Primary position
- 9. O.T. Visual ScreeningTool Screening Tool Overview Content 4. Visual Fields •Single or two person method •Monocular and binocular testing
- 10. O.T. Visual ScreeningTool Screening Tool Overview Content 5. Visual Attention •Visual Extinction •Severity of inattention (‘dot-to-dot test’) 6. Observed functional problems
- 11. O.T. Visual ScreeningTool Audit Results Nr of patients admitted to the stroke unit 49 Patients Screened Patients unscreened 122
- 12. O.T. Visual ScreeningTool Audit Results Types of CVA / Other Diagnosis Screened 12.70% 36.40% 10.60% PACS TACS 6.30% LACS POCS Other 34%
- 13. O.T. Visual ScreeningTool Audit 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. O.T. Visual ScreeningTool Audit 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. O.T. Visual ScreeningTool Audit 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. O.T. Visual ScreeningTool Audit 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. O.T. Visual ScreeningTool Audit 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. O.T. Visual ScreeningTool Audit 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. O.T. Visual ScreeningTool Benefits 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. O.T. Visual ScreeningTool Future Developments • Re-audit • Education, training and roll-out • O.T. Stroke Assessment Pathway • Feedback workshop (Belfast Trust) • Potential multi-trust roll-out
- 21. O.T. Visual ScreeningTool Thank you for listening www.COT.org.uk
Editor's Notes
- #3 History Timeline with milestones and progress in between each Screening Tool Overview Run through screen content with illustrations and potentially screen shots of screening document Audit Results Overview of result categories to demonstrate the stats that can be obtained Example results from a recent audit (potentially from 3 sections) Future recommendations Belfast Trust OT Stroke Assessment Pathway Further Training Roll out to Belfast Trust
- #4 2006-The initial ‘N.I Visual Screening Tool’ was devised by the O.T subgroup of NIMAST (now disbanded)in consultation with Orthoptists and Optometrists
- #5 To help identify visual problems that impact on functional activities To guide assessment of cognition and perception To identify intervention needed and guide onward referral to Optometry, Orthoptics and Sensory support services