_VISION nystagmus低视力眼球震颤课件.ppt

LET’S TALK LOW VISION Suleiman Alibhai, O.D. Retina Group of Washington Krista M. Davis, O.D., F.A.A.O. Columbia Lighthouse for the Blind Eye Anatomy Definitions Legal Blindness Best corrected distance visual acuity of 20/200 or worse in better eye Horizontal visual field of 20 degrees or less at widest point in the better eye Low Vision Worse than 20/60 in the better eye Significant field loss Impaired function Goals of Low VisionManagement Increase functionality Make the most of the remaining vision Provide link to community resources and support services Education Common Conditions Macular Degeneration Glaucoma Diabetic Retinopathy Stroke/ brain injury Retinitis pigmentosa Optic Nerve disease Albinism Nystagmus Cortical Visual Impairment Functional Effects of Low Vision Loss of central vision (visual acuity) Loss of peripheral vision (visual field) Glare and contrast Issues Related to Decreased Acuity Difficulty reading Problems writing/ completing paperwork Inability to recognize distance objects and faces Issues Related toVisual Field Loss Location of scotoma important! Generalized loss of visual field difficult to compensate for Mobility and independent travel Reading may require adaptations Issues Related to Contrast Need for additional lighting Problems with glare Increased adjustment to changes in illumination Visual discomfort and fatigue Exam Sequence History/ intake Visual acuity Visual field testing Pupils Extraocular muscle testing Refraction Color vision and Contrast Testing Ocular Health Types of Acuity Charts Distance Snellen (projection) Feinbloom/ SOSH ETDRS Lea Symbols Near Single letter Continuous text Distance Charts Near Charts Interpreting Near Acuity Threshold acuity Difference between single letter and continuous text 1.0 M = 20/50 = 8-10 point font Need to look at working distance Jaeger charts nonstandard Typical sizes Newspaper = 1.0M Children’s books = 1.2 – 1.6M Large print = 1.6 – 2.0M Newspaper headlines = 4.0 – 5.0 M