Low Vision Evaluation

Question 1

Brief examinations that look for potential vision problems and disorders.

Answer 1

Vision Screenings

Question 2

• Intended to identify people with undetected vision problems
  Not diagnostic in nature

Answer 2

Vision Screenings

Question 3

Evaluate the integrity of the eye and visual system, usually last for 30 - 60 minutes, and are performed by an ophthalmologist or optometrist.

Answer 3

Comprehensive Eye Exams

Question 4

• Often include dilation and/or refraction
  Are diagnostic in nature

Answer 4

Comprehensive Eye Exams

Question 5

Who can perform a basic vision screen?

Answer 5

Primary care providers, eye care providers, and other trained health-care providers

Question 6

When do I perform a basic vision screen?

Answer 6

• When functional performance seems to be outside usual limits
• With certain diagnoses known to impact vision
• As part of the standard OT evaluation process

Question 7

Pediatric populations

• Early detection and treatment of childhood vision disorders are essential in ensuring healthy vision for children
• ____ may develop at any age
• ____ are the “GOLD STANDARD” but not all children have ready access due to education and language barriers, etc.
• Optimal care can be achieved through ____ and referral to an eye care professional when comprehensive eye exams are warranted.

Answer 7

• Vision disorders
• Comprehensive eye exams
• Vision screening

Question 8

Pediatric Screening Recommendations

A “red reflex” (like seeing red eyes in a flash photograph)
* blink pupil response

Answer 8

Newborns

Question 9

Pediatric Screening Recommendations

• Red reflex
• Blink and pupil response
• Check for healthy eye alignment and movement

Answer 9

6 to 12 months and 12 to 36 months

Question 10

Pediatric Screening Recommendations

• Check for healthy eye alignment and movement
• Visual acuity
• Color identification (males)

Answer 10

3 to 5 and 5 years +

Question 11

True/False: Alabama, Idaho North Dakota, South Dakota, Wisconsin, and Wyoming had no vision screening requirements or recommednations.

Answer 11

TRUE

Question 12

Adult Populations

• Vision screening in working age adults is more ____
• Recommendations for comprehensive eye exams vary by decade
• Normal age-related changes to the eye begin to occur after age ____ and continue throughout middle age.
• Visison screening in this population should occur if the person is complaining of ____ issues related to vision.
• If they have experienced an acute event, physiological or neurodegenerative change that could impact functional ____.

Answer 12

• Variable
• 40
• Occupational performance
• visual performance

Question 13

Adults Screening Recommendations:
* Younger than 40 years >
* Ages 40 to 54 years >
* Ages 55 to 64 years >
* Ages 65 and up >

Answer 13

• Every 5 to 10 years
• Every 2 to 4 years
• Every 1 to 3 years
• Every 1 to 2 years

Question 14

Early signs and symptoms

Which population is being affected based on the following visual delays:
1. Eyes may move quickly side-to-side (nystagmus)
2. Their eyes dont follow your face or object
3. They dont make eye contact with familiar people
4. Their eyes turn towards their nose or drift outward towards the side

Answer 14

Infants

Question 15

Performance Implications

Which population is being affected based on the following visual performance implications:

1. Learning to walk safely
2. learning colors and basic shapes
3. coloring in lines, drawing shapes, letters
4. play

Answer 15

Vision problems in Toddlers

Question 16

Early signs and symptoms

Which population is being affected based on the following visual delays:

1. Hold things up close to their face
2. Rub their eyes a lot or say they are tired
3. Turn or tilt their head or cover one eye
4. Have crossed eyes
5. Are clumsy or often trip over things

Answer 16

Older child

Question 17

Performance Implications

Which population is being affected based on the following visual performance implications:
1. Reading skills
2. Copying from the whiteboard
3. Maintaining attention/Concentration
4. interacting on playground
5. Playig sports

Answer 17

Vision problems in School-Aged Children

Question 18

Early signs and symptoms

Which population is being affected based on the following visual delays:
1. Start holding things further
2. complain of glare or light sensitivity
3. complain of eye fatigue or headaches
4. Bump into things when walking
5. Miss parts of words when reading
6. Be involved in car accidents
7. Start to wear clothing that does not match

Answer 18

Adults & Older Adults

Question 19

performance implications

Which population is being affected based on the following visual performance implications:
1. Driving a car
2. Managing medications
3. Financial management
4. Meal Preparation
5. Computer Accessibility
6. Home management

Answer 19

Vision Problems in Adults

Question 20

Visual Acuity is dependent on 3 points:

Answer 20

1. The sharpness of the image entering the eye
2. The health and functioning of the retina/visual pathway
3. The interpretive capability of the brain

Question 21

Measure of a person’s ability to discern small details, with precision, at a given distance

Refers to the clarity of vision

Includes high contrast acuity (distance and near), low contrast acuity and **color **

Answer 21

Visual Acuity

Question 22

What are two types of high contrast acuities that are measured:

Answer 22

Distance (no Accommadations/ lens flattens)
Reading (requires accommadation/ Spherical lens)

Question 23

What type of visual acuity is being exhibited:

• Commonly measured at 20 ft or 6 meters
• Decreased distance acuity suggests a person may be nearsighted
• Need to rule out refractive error

Answer 23

Distance visual acuity

Question 24

What type of visual acuity is being exhibited?
* Commonly measured at 16 in or 40 cm
* Decreased near acuity suggests a person may be farsighted
* Has trouble with accommodation (common in those over 40)

Answer 24

Near Visual Acuity

Question 25

** Measures the ability to distinguish an object from its background.** * Decreased contrast sensitivity suggests retinal degeneration, neurodegeneration, or cataract (for example).

Answer 25

Low Contrast Sensitivity

Question 26

* **Measures the ability to detect/distinguish the difference between colors** * Decreased color vision suggests cone-rod dystrophy, retinal damage, neurodegeneration, or even cataract (for example).

Answer 26

Color Vision

Question 27

* **Measures the visual limits of where a person can see when they look out at the world** * Decreased visual field suggests retinal damage, optic nerve damage, tumor, or other brain damage (for example).

Answer 27

Visual Field

Question 28

* **Measures the ability to eye to move and hold in different directions** * Decreased eye alignment or eye movement suggests nerve palsy, brainstem damage, vestibular disorder, or drug use (for example).

Answer 28

Ocular Motility

Question 29

Match the special measures to the correct definition: 1. Depth perception 2. Focusing ability 3. Pupillometry 4. Tonometry 5. Split lamp exam A) Refraction B) Pupillometry C) Split lamp exam D) Stereopsis E) Tonometry

Answer 29

Stereopsis - depth perception Refraction - focusing ability Pupillometry - pupillary response Tonometry - pressure of the eye Split lamp exam - retina, optic nerve

Question 30

For images to be focused onto retina, the light rays coming into the eye must be bent so that they come to a focus on the fovea

Answer 30

Refraction

Question 31

Light passing from air into the denser curved structures of the eye (cornea and lens) will bend together at a point on the retina

Answer 31

Focal Point

Question 32

Refraction involves the following eye structures from deep to superficial: Put the following eyes structures in the order they go: Lens>> Aqueous>> Iris/Pupil>> Cornea>> Vitreous

Answer 32

Cornea>> Aqueous>> Iris/Pupil>> Lens>> Vitreous

Question 33

True/False: For a normal eye the focal point is not always the Fovea

Answer 33

FALSE: Normal eye> Focal Point is always the FOVEA

Question 34

The correct refraction of light into the eye is influenced by:

Answer 34

1. The quality of the refracting surface 2. Length of the globe ## Footnote Irregularities in either of these things results in common refractive errors, even in persons with normal vision.

Question 35

Cause reduced acuity ONLY if left uncorrected. * Therefore, not considered a cause of low vision * Can be corrected by eyeglasses, contact lenses or surgery

Answer 35

Refractive errors

Question 36

Which type pf refractive error is being exhibited? * Length of globe is perfect * Focal point falls precisely on fovea

Answer 36

Emmetropia

Question 37

Which type pf refractive error is being exhibited? Length of globe is too short Focal point falls behind the retinal surface Vision good for distance, poor for near

Answer 37

Hyperopia

Question 37

OT Specialist in Low Vision or OT Gneralist * Assess how vision impacts occupational performance * Macular scotoma assessment * Reading and writing performance test * Screening of visual function * Develops an intervention plan to address vision loss and occupational performance

Answer 37

OT specialist in low vision

Question 38

Which type pf refractive error is being exhibited? * Length of globe is too long * Focal point falls short of retinal surface * Vision good for near, poor for distance

Answer 38

Myopia

Question 39

**Most common condition affecting smoothness of corneal surface** * Cornea is spoon-shaped or dimpled * Light rays are unevenly refracted - causes more than one focal point

Answer 39

Astigmatism | Can be born with it or develop with trauma and age ## Footnote Corrected for optically with **CYLINDER LENS** (fuses two focal points into one)

Question 40

OT Specialist in Low Vision or OT Generalist * Screening of basic visual function * Determines if a referral is necessary * Determines how to address vision loss within an intervention plan for treatment diagnosis

Answer 40

OT Generalist

Question 41

Low vision examinations are typically completed by a

Answer 41

MD/OD/ OT may complete depending on setting

Question 42

True/False: LV examination is completed **not** to determine what’s gone but **what usable vision remains**.

Answer 42

TRUE

Question 43

True/False LV examination evaluation cannot change attitude by emphasizing **ability to use remaining vision.** The vision clients have left does not matter.

Answer 43

FALSE: Evaluation **CAN **change attitude by emphasizing ability to use remaining vision.

Question 44

What are the 4 primary components that are **ALWAYS** assessed:

Answer 44

* High contrast acuity (intermediate and reading) * Low contrast acuity (aka contrast sensitivity function) * Visual field integrity * Color vision

Question 45

What are some other changes that can be made in visual function:

Answer 45

* Dark light adaptation * Sensitivity to glare and light (photophobia) * Presence of phantom vision * Refraction

Question 46

Which type of assess functional performance is being exhibited? As OT’s we care about functional performance. Can complete activity analysis through observation. Can simply be watching client informally. Can be rating them perform specific activities

Answer 46

Observational

Question 47

What type of assessment is being exhibited in function performance: * Structured interviews exist to guide assessment of vision-dependent ADL tasks. * Self-Report Assessment of Functional Visual Performance (SRAFVP). * Focuses on 38 vision-dependent IADL tasks. * Developed at UAB in collaboration with Eyesight Foundation, Washington University, and University of Florida through grant from AOTA. * SRAFVP

Answer 47

Self-Report