Vision Part 2- Deficits And Tx

Front 1

Principles of Vision Therapy

Back 1

Classic approach
Functional Behavior

Front 2

Class appraoch

Back 2

Eye is an independent organ.
Sight and Vision used synonymously.
Vision deficits are problems with anatomy and physiology of the eye.

Front 3

Functional/Behavior Approach

Back 3

Human beings connected to eye.
Considers plasticity of visual system.
More to vision than healthy eyes

Front 4

Function of funcional/behavioral optometrist

Back 4

Assesses and manages functional aspects of vision.
Must be comfortable and have knowledge of neurological injury and presentation and impact on function.

Front 5

Treatment Guidlines

Back 5

Patient must be active participant.
Set realistic goals.
Emphasize that small improvements are significant.
Set up vision sessions to facilitate success.
Stimulate visual attention.
Set up treatment to provide “positive stress.”

Front 6

Effective VT techniques

Back 6

Provides patient visual and proprioceptive feedback.
Raise and Lower Demand as needed.
If the patient can not do the vision activity, it is not the right vision activity for that patient.
Must implement good visual hygiene

Front 7

When completing near activities

Back 7

Harmon Distance-tilted work surface between 20-23 degrees from horizontal
Take a break every 10 minutes and switch focus from near to distant.
Sit upright

Front 8

Visual Hygiene

Back 8

Be aware of objects in periphery when completing near tasks.
Have good lighting during all vision tasks, near and distant.
Blink often to maintain tear flow.
Reduce glare and reflections.

Front 9

Homonymous Hemianopsia is damage to

Back 9

posterior optic chiasm

Front 10

Homonymous Hemianopsia field deficit will present

Back 10

opposite of hemisphere of damage
Loses sensitivity to photic stimulation to varying degrees

Front 11

Quadnopsia is caused by damage to

Back 11

Temporal Lobe
Posterior optic chiasm

Front 12

Behaviors of Visual Field Deficit

Back 12

Searching behaviors
Person scans slowly to side of deficit
Missing visual detail
Narrow search pattern of midline and unaffected side
Hesitant with gait
Coming close to obstacles
Stopping to search

Front 13

3 main purposes of VFD

Back 13

Develop compensation skills.
Learn limits of compensation.
Build awareness of field deficit.

Front 14

Unilateral Spatial Inattention is commonly more severe in what side damage?

Back 14

Right hemisphere
Right poster parietal lob is attention center for left and right side. Left Parietal cortex only responsible for one side

Front 15

Peri Personal Vs Distance visual

Back 15

Peri-personal- may dress and wash with cues- cant find objets within their personal space
Distant Visual- may find stuff within their personal space but will have trouble with gross motor, walking, and larger functional activities

Front 16

If there is USI and field cut, what should you address first

Back 16

USI

Front 17

Occulormotor dysfunction most likley occurs from

Back 17

cranial nerve damage

Front 18

Types of Oculormotor dysfunction

Back 18

Esotropia
Extotropia
Hypertropia
Hypotropia

Front 19

What is oculormotor dysfunction

Back 19

Limitation or paralysis of one or more extraocular muslces
Can have a combo of them (monocular or both)

Front 20

Symptoms of ocularmotor dysfunction

Back 20

Impaired oculomotor control
Reduced fusional vergence ranges
Divergence paralysis
Multiple oculomotor nerve palsies/strabismus
Mechanical restriction of gaze
Diplopia
Blurred vision
Head tilting/turning
Difficulty with pursuits
Headaches

Front 21

Diploplia

Back 21

Ocular motility limitations
Eyes are not fusing/focusing on same point in space.
Incoordination/decreased motor planning on how and where to move eyes.
Spatial perception difficulties on where to place eyes on target.

Front 22

What intervention can you do for diploplia

Back 22

spot patching

Front 23

what is spot patching

Back 23

place translucent tape over central vision to eliminate second image
- this still allows for light and peripheral vision but gets rid of the double
-Can also use prisms

Front 24

Nystagmus

Back 24

Uncontrolled back and forth movement of the eyeball
Can be horizontal or vertical or combination

Front 25

Post Traumatic Vision Syndrome (PTVS)

Back 25

Caused by a disruption of ambient (magnocellular) visual process.
Decreased ability to organize spatial information.

Front 26

Treatment of PTVS

Back 26

Binasal Occlusion
Base in prism to reduce peripheral fusion demand

Front 27

Cortical Visual Impairment is caused by

Back 27

Direct Insult to occipital lobe

Front 28

Symptoms of Cortical Visual Impairment

Back 28

Will look blind
Will not Distinguish color
Distinguish shape
Distinguish fine detail
Describe object or identify object

Front 29

A patient with CVI WILL be able to

Back 29

Find item spatially
Parietal Space Map intact

Front 30

PIeces of the Vision Assessment

Back 30

History and Physical
Vision Screen (Acuity, eye charts, eye alignment)

Front 31

H & P components

Back 31

Radiologic reports
Eye health (premorbid dx or traumatic conditions)

Front 32

If test worse with both eyes than just one may think they have...

Back 32

may have a binocular instability. Bioncular convergence insufficiency

Front 33

Vision screen looks

Back 33

Acuity
Fixation
Pursuits
Saccades
Near point convergence
Cover Test
Visual Field Confrontation
Visual Spatial

Front 34

Pursuits

Back 34

Can patient follow moving target in all planes

Front 35

Which lobe initiates pursuits

Back 35

Occipital lobe

Front 36

Saccades are controlled by what lobe

Back 36

Frontal

Front 37

Saccades

Back 37

Voluntary eye movement to move from target to another (back and forth)

Front 38

NEar point convergence

Back 38

Smallest distance patient can coverge eyes to faces
Normal is 2-4 inches

Front 39

Convergence insufficiency happens at what distance

Back 39

more than 6 inches

Front 40

Cover Test assesses

Back 40

Binocular fusion
Helps to differentiate between trop or phoria of the eye

Front 41

Visual Fusion

Back 41

What you see in each eye makes one

Front 42

How would you know if there is an insufficiency with Binocular fusion

Back 42

Eye will move in the opposite direction

Front 43

someone has esophoric vision will have trouble with what type of vision

Back 43

distance will be more difficult

Front 44

Visual Field Confrontation

Back 44

Assess gross visual field
NEEDS tO BE DONE MONOCULARY

Front 45

Visual Field Confrontation Screen shows homonomous hemi anopsia means what lobe

Back 45

Parietal/Occipital

Front 46

Visual Field Confrontation Screen shows quadnopsia think..what lobe?

Back 46

Temporal Lobe

Front 47

Visual Spatial Screen looks at

Back 47

Can patient localize target?
Eye-hand coordination