Week 3.6 Vision Intervention Handout PDF

DPT 6410 Neuromuscular Practice Treatment Methods for Visual Impairment Objectives Identify the common visual impairments following stroke or other brain injury (BI) Identify screening and examination techniques that can be utilized by PT Identify basic intervention methods and strategies for manage...

DPT 6410 Neuromuscular Practice Treatment Methods for Visual Impairment Objectives Identify the common visual impairments following stroke or other brain injury (BI) Identify screening and examination techniques that can be utilized by PT Identify basic intervention methods and strategies for management of visual impairment following stroke or other BI Summarized from Hanna KL, Hepworth LR, Rowe FJ, Brain Behavior, 2017 Overview of the Problem Visual impairment common after stroke 72% prevalence May include impaired: Central vision 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 Pollock et al, Cochrane Rev, 2011 Visual Field Loss - Interventions Compensation: Scanning and search training Substitutive: Peli prisms http://www.chadwickoptical.com/peli-lens-2/ Restorative: light stimuli to border area of visual field loss to increase visual field Ocular Motility Deficits Strabismus: misalignment of the 2 eyes (both eyes don’t point to same target) Ocular abnormalities: from cranial nerve problems Ocular Motility Deficits - Interventions Pharmacological - Botox nd 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 Reduced visual acuity and contrast sensitivity Treatment: Retest vision after BI, adjust glasses; low vision aids like magnifiers; modification of light and environment Visual Perceptual Deficits Visual inattention/neglect Substitutive: perceptual retraining and visual scanning Compensatory: scanning therapy, ADL training and provision of aids and modifications; smooth pursuit training https://www.visionaware.org/info/everyday-living/helpful-products/overview-of-low-visiondevices/common-non-optical-devices/1245 Screening Visual acuity Contrast sensitivity Pelli-Robson Contrast Sensitivity Test Visual Fixation/Attention Testing See during visual tracking Warren Fixation Test - https://www.youtube.com/watch?v=nAEkqSIJlIY Ocular Alignment/Range of Motion Testing Double H Convergence Depth Perception Straw and stirrer test Screening Visual Field: Peripheral testing Confrontation testing https://www.youtube.com/watch?v=Vp7LBSe7DcI Tests for neglect Our Role Detection of a problem Consultation and referral Neuro optometry Neuro othalmology