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