27 Questions
What percentage of individuals experience visual impairment following stroke or brain injury?
72%
What is the primary goal of the adaptation/compensatory approach in managing visual field loss?
Compensate for visual field loss
What type of intervention involves the use of Peli prisms?
Substitutive
What is the primary goal of restorative interventions for visual field loss?
Restore visual function
What type of deficit is characterized by misalignment of the two eyes?
Strabismus
What type of exercise is used in restorative interventions for ocular motility deficits?
Vergence exercises
What is the purpose of the Pelli-Robson Contrast Sensitivity Test?
To assess visual acuity and contrast sensitivity
What type of training is recommended for individuals with visual inattention and neglect?
Scanning therapy and ADL training
What is the primary goal of neuro-optometry in the context of visual perceptual deficits?
To detect and refer patients with visual problems
What type of devices are recommended for individuals with low vision?
Magnifiers and other low vision aids
What is the purpose of the Warren Fixation Test?
To evaluate visual fixation and attention
What is the primary role of confrontation testing in the context of visual field screening?
To assess peripheral vision
What is the prevalence of visual impairment following stroke or brain injury?
72%
What is the main goal of substitutive interventions for visual field loss?
To compensate for visual field defects
What type of visual impairment is characterized by a restriction in the visual field?
Peripheral vision impairment
What is the primary goal of compensatory interventions for ocular motility deficits?
To adapt to ocular motility deficits
What is the name of the prism lens used in substitutive interventions for visual field loss?
Peli lens
What is the primary goal of restorative interventions for ocular motility deficits?
To restore normal ocular motility
What is the name of the disorder characterized by misalignment of the two eyes?
Strabismus
What is the primary goal of neuro-ophthalmology in the context of visual perceptual deficits?
Detection of a problem and referral
What is the purpose of the Double H Convergence test?
To evaluate ocular alignment and range of motion
What type of visual perceptual deficit is characterized by misperceiving visual stimuli?
Visual agnosia
What is the purpose of screening visual acuity?
To determine the need for low vision aids
What type of training is recommended for smooth pursuit eye movements?
Smooth pursuit training
What is the purpose of the Pelli-Robson Contrast Sensitivity Test?
To evaluate contrast sensitivity
What type of devices are recommended for individuals with low vision?
Magnifiers
What is the primary goal of compensatory training for visual inattention?
To adapt to visual deficits
Study Notes
Visual Impairment Following Stroke or Brain Injury
- 72% prevalence of visual impairment after stroke or brain injury
- Types of visual impairments:
- Central vision impairment
- Peripheral vision (visual field loss)
- Eye movement disorders
- Visual perception disorders (inattention)
Visual Field Loss
- 3 main approaches:
- Adaptation/compensatory (more favorable option)
- Substitution
- Restitution
- Interventions:
- Compensation: Scanning and search training
- Substitutive: Peli prisms
- Restorative: Light stimuli to border area of visual field loss to increase visual field
Ocular Motility Deficits
- Causes:
- Strabismus (misalignment of the 2 eyes)
- Ocular abnormalities (from cranial nerve problems)
- Interventions:
- Pharmacological: Botox
- Compensatory: Occlusion to eradicate 2 image; adaptive head postures and increase in lighting
- Substitutive: Prisms to reduce diplopia
- Restorative: Vergence exercises or in more chronic cases with ocular muscle surgery
Reduced Central Vision
- Characteristics:
- Reduced visual acuity and contrast sensitivity
- Treatment:
- Retest vision after BI
- Adjust glasses
- Low vision aids (e.g. magnifiers)
- Modification of light and environment
Visual Perceptual Deficits
- Characteristics:
- Visual inattention/neglect
- Interventions:
- Substitutive: Perceptual retraining and visual scanning
- Compensatory: Scanning therapy, ADL training and provision of aids and modifications; smooth pursuit training
Screening and Examination Techniques
- Visual acuity
- Contrast sensitivity
- Pelli-Robson Contrast Sensitivity Test
- Visual Fixation/Attention Testing
- Warren Fixation Test
- Ocular Alignment/Range of Motion Testing
- Double H Convergence Depth Perception
- Straw and stirrer test
- Screening Visual Field:
- Peripheral testing
- Confrontation testing
- Tests for neglect
Role of Physical Therapist
- Detection of a problem
- Consultation and referral
- Collaboration with Neuro optometry and Neuro ophthalmology
This quiz covers the common visual impairments that occur after stroke or brain injury, screening and examination techniques used by physical therapists, and basic intervention methods for managing visual impairment. Based on the 2017 study by Hanna et al. in Brain Behavior.
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