LOW VISION REHABILITATION OF CHILDREN WITH ANIRIDIA - PowerPoint PPT Presentation

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LOW VISION REHABILITATION OF CHILDREN WITH ANIRIDIA

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Polycarbonate lenses provide protection in cases of ... REDUCED APERTURE CONTACT LENSES. TINTED CONTACT LENSES. LAMPS. NON OPTICAL DEVICES. LAP DESKS ... – PowerPoint PPT presentation

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Title: LOW VISION REHABILITATION OF CHILDREN WITH ANIRIDIA


1
LOW VISION REHABILITATION OF CHILDREN WITH
ANIRIDIA
  • Sarah Appel, O.D.
  • William Feinbloom Vision Rehabilitation Center

2
ANIRIDIA
  • Visual Acuity
  • typically 20/100 to 20/200
  • Visual Field Defects
  • none unless glaucoma present
  • Contrast Sensitivity
  • decreased due to presence of anterior polar
    cataract
  • decreased if glaucoma is present

3
ANIRIDIA
  • Light Adaptation
  • photophobia due to lack of pupil
  • associated polar cataract and corneal clouding
    further increase photosensitivity and glare
    sensitivity
  • increased photosensitivity due to scattering of
    light by cataract

4
ANIRIDIA
5
ANTERIOR POLAR CATARACT
6
LOW VISION EXAMINATION
  • HISTORY
  • VISUAL ACUITIES
  • REFRACTION
  • EYE MOVEMENT EVALUATION
  • EYE ALIGNMENT EVALUATION
  • VISUAL FIELDS ANALYSIS

7
LOW VISION EXAMINATION
  • CONTRAST SENSITIVITY TESTING
  • COLOR VISION TESTING
  • OCULAR HEALTH EVALUATION
  • EVALUATION OF LOW VISION DEVICES
  • INSTRUCTION IN THE USE OF LOW VISION DEVICES

8
HISTORY
  • Explore ocular history
  • Surgeries lensectomy, strabismus, nystagmus,
    glaucoma
  • Medication glaucoma
  • Previous examination results corrective eyeware,
    low vision devices
  • Visual concerns
  • Goals for examination

9
HISTORY
  • Explore systemic history
  • Surgeries
  • Developmental age
  • Medication explore potential visual side effects
  • Explore visual concerns
  • Mobility
  • Learning based visual issues
  • Identify goals for evaluation

10
VISUAL ACUITIES
  • Developmental ages of infancy to 3 years

11
VISUAL ACUITY
  • Developmental ages 3 years and older

12
VISUAL ACUITIES
  • Children with reading ability

13
REFRACTION
  • Ensure optimal focus which results in increased
    visual attention, safer mobility
  • Polycarbonate lenses provide protection in cases
    of significantly reduced vision
  • Correct prescription may reduce eye turns,
    enhance visual efficiency

14
REFRACTION
  • Consider correction for near tasks in cases of
    significantly reduced viewing distances
  • In cases of aphakia or pseudophakia , make sure
    that child has a near prescription incorporated
    into corrective lenses

15
EYE MOVEMENT EVALUATION
  • Evaluate range of eye movements
  • Evaluate nystagmus for null point
  • Identify head turns to achieve a null point
  • Identify positions of gaze that intensify
    nystagmus
  • Evaluate for latent nystagmus with occlusion

16
EYE ALIGNMENT EVALUATION
  • Hirschberg light reflex test
  • Cover testing

17
VISUAL FIELDS ANALYSIS
  • Confrontation testing in adults or
    developmentally older children
  • Confrontation testing in developmentally younger
    children

18
VISUAL FIELD TESTING
  • Peripheral Visual Field Testing

19
CONTRAST SENSITIVITY TESTING
  • Evaluates visual discrimination of lower contrast
    items
  • Translates to ability to identify lower contrast
    targets curbs, drop-offs, identifying faces
    etc.
  • Especially important in cases of cataracts,
    corneal clouding and optic atrophy

20
COLOR VISION TESTING
21
OCULAR HEALTH EVALUATION
  • External evaluation
  • Cornea
  • Evaluation of intraocular pressure
  • Evaluation of lenses for anterior polar cataracts
  • Retinal/optic nerve evaluation
  • Identify optic nerve changes related to glaucoma

22
EVALUATION OF LOW VISION DEVICES
  • PROVIDE MAGNIFICATION FOR DISTANCE VISUAL TASKS
  • PROVIDE MAGNIFICATION FOR NEAR VISUAL TASKS
  • PROVIDE LIGHT FILTRATION
  • PROVIDE CONTRAST ENHANCEMENT

23
HAND HELD TELESCOPES
24
SPECTACLE MOUNTED TELESCOPES
25
MaxTV
26
Designs for Vision Bioptic Telescope
27
Selsi Sportglasses
28
Ocutech VES Telescope
29
HAND MAGNIFIERS
30
STAND MAGNIFIERS
31
SPECTACLE MAGNIFIERS
32
CLOSED CIRCUIT TELEVISION READING SYSTEMS
33
PORTABLE CCTV (Quicklook, Clearview)

34
ADAPTIVE TECHNOLOGY
35
MAGNILINK S CCTV
36
ENHANCED VISION ACROBAT
37
ABSORPTIVE LENSES SUNLENSES
38
REDUCED APERTURE CONTACT LENSES
39
TINTED CONTACT LENSES
40
LAMPS
41
NON OPTICAL DEVICES
42
LAP DESKS
43
READING STANDS
44
WRITING AIDS
  • Bold line paper
  • 20/20 pen
  • Clip board

45
Enlarging Mirrors

46
INSTRUCTION IN THE USE OF LOW VISION DEVICES
47
REPORT TO TEACHERS
  • description of visual status
  • print size recommendations
  • print media recommendations
  • recommendations for optical devices
  • adaptive technology recommendations
  • environmental modifications

48
ENVIRONMENTAL MODIFICATIONS
  • seating close to board
  • enhanced contrast boards
  • directed illumination
  • seating away from windows

49
REHABILITATION SERVICES
  • State agencies
  • orientation and mobility
  • rehabilitation teaching
  • transition to college
  • counseling/support
  • social work
  • psychology
  • peer support groups

50
RESOURCES
  • Special education programs
  • Early intervention programs
  • State agencies for visually impaired
  • Schools for visually impaired

51
SUPPORT GROUPS
  • American Council for the Blind
  • American Foundation for the Blind
  • National Association for Parents of the Visually
    Impaired
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