Post on 12-Jul-2015
Low vision management strategies for patients with severely constricted visual fields
Content prepared by
Dr Meri Vukicevic
Lionel Messina
• Lionel
• 45y/o
• Dx with RP age 30
• C/o: decreased peripheral VA, night blindness, difficulty with light/dark adaptation, problems with mobility
Lionel – Initial consultation
GH: Good, no medicationsPOH: Glasses since teenagerVert: R) -0.50/-1.00x45 L) -0.75/-1.00x60 (Single vision distance gls)VA cc: R) 6/12 L) 6/9Near vision BEO = n5 slowly (takes glasses off to read)Subj Refn: R) -0.75/-1.00x50 = 6/9 pt L) No changeAdd +1.00 = n5 with light, BEO
Contrast (Pelli Robson):0.90 log BEO (moderately reduced contrast)Colour vision (CUCVT): non-specific colour vision loss, greater in the tritanzoneVisual field (Humphrey): severely constricted R&L to within 10 degrees from fixation
Peripheral vision – basic functions
Image from Wikimedia CommonsAuthor: Sanet Steyn
http://www.medicine.mcgill.ca/physio/vlab/other_exps/eog/images/yargirl.gif
http://adhidas-adhi.blogspot.com.au/2012/11/my-ever-busy-indian-road.html
http://www.dzineblog360.com/2011/03/30-night-time-photographic-images-to-die-for-2/
Scanning training
• Simple object
• Uncluttered table
• Instruct patient to search by moving their eyes
– ‘sweeping’ movement
– Up, down, left, right
Scanning training
Start 1
2 3
4 5
6 End
Scanning training
A B C
External service
https://www.guidedogsvictoria.com.au/our-services/acquired-brain-injury/
Further reading