low vision
CASE PRESENTATION
DATE: 23/8/2000 48Y/M
Accomp.by: Wife and Son
CAUSE OF LOW VISION: Stargardts Macular Dystrophy .
VISUAL HISTORY: Subnormal vision since 1968
FAMILY HISTORY: Younger brother having the similar eye problem
MEDICAL HISTORYH/O: Joint pain since 1yr.
EDUCATION: Msc Ph.D. (Geology)
Working as a scientist at N.G.R.I.
USES OF GLASSES- H/O:using glasses since 1968
PGP 2yr old
PREVIOUS LV CARE - Yes
CURRENTLY BEING USED: (self-purchased)
Binocular spectacle mounted telescope (2.8x28)
Book top dome magnifier (approx. +27.00D)
Hand held magnifier (4x, 10x)
Using incandescent reading lamp at home
PRESENT GLASS POWER:
(OD): -2.50D/-0.75X90
(OS): -2.50D
Single distance vision glasses
Photogrey
CHIEF COMPLAINTS:
Difficulty in reading news paper, maps even with Book top magnifier due to reduced distance
C/O Eccentric view especially while driving
C/O Increased sensitivity to bright light (comfortable with his photogrey
C/O Delayed dark adaptation with prolonged after image
CLINICAL EXAMINATIONS
VISUAL ACUITY – HCVA (CC) under room illumination
OD 3/15,6/30,20/100
OS 3/15,6/30,20/100
NEAR VISUAL ACUITY – under room illumination (SC)
B/O N25/3.2M at 40cms with Bailey-Lovie chart.
REFRACTION
OBJECTIVE
OD – 2.50D/-2.00X60
OS – 2.5D/-1.50X120
SUBJECTIVE
OD -2.50/-1.5X80(3/15,6/30,20/100)
OS –2.50D/-1.75X120 (3/15,6/30,20/100)
OCULAR MOTILITY: Full
COVER TEST: Orthotropia
PUPIL: R/R/R
CONVERGENCE: WNL
COLOR VISION: Defective
VISUAL FIELDS: Central relative scotoma and Metamorphopsia with Amsler chart
BINOCULARITY: 800 sec of arc
SLE WNL
OPTHALMOSCOPY (OU)
Stargardts Macular Dystrophy
TRIAL OF DISTANCE VISION TELESCOPE:
(OD) 4x telescope (3/4.8,6/9.6,20/32)
B/O telescope (2.8x) self: (3/6,6/12,20/40)
(OD) Pt. Prefers4x M/O telescope
NEAR VISION (reading/writing):
Under room illumination
B/O with +5.00DS BI-PRISM Spectacle magnifier (B-H) able to read N8/1M print size with English newspaper (good speed).
Prefer to read the footnotes (N6/0.8M) with 6x-stand magnifier at
4-5cm from the lens
Prefer to write using felt tip pen (black ink)
REHABILITATION PLAN
Counseling done
To continue with distance vision habitual glasses
Spectacle magnifier (half –eyes +5.00D) for regular reading
Stand magnifier (6x) for reading footnotes
Need felt tip pen (black ink) for writing task.
To stop driving two wheeler and car
REHABLITATION SERVICES
Training instruction in using spectacle magnifier and stand magnifier given
Environmental modification: close working distance adviced
1st follow up 29/3/2004
OCULAR STATUS: Stable
VISUAL OOBJECTIVES:
Came to get information about Ocutech telescope
Difficulty in reading small preint in news paper , documents,text books even after using the magnifiers
Difficulty in recognizing faces bus numbers beyond 3m.
CURRENTLY USED OPTICAL DEVICES
DISTANCE: Has binocular (2.8x)-uses rarely for spot use
(did not bring)
NEAR: +5.00D Base-in prism half eyes (B&H)-uses occationally
6x stand magnifier –uses mostly for reading news paper at home and office
2.5x Dome magnifier-uses often at home and office for text and map reading
PGP: (OD)-2.50D/-1.00X90
(OS)-2.50D
Single vision glasses
Photogrey lenses
VISUAL ACUITY(CC)Under fl.room illumination
DISTANCE:
HCVA
(OD): 3/30p,6/60p,20/200p
(OS): 3/30p,6/60p,20/200p
LCVA
(OD):2/38,6/114,20/380
(OS):2/38,6/114,20/380
NEAR(SC):Able to read N12/1.6M with 25cm with Baile-Lovie reading chart with good speed
REFRACTION
OBJECTIVE:
(OD): -2.50D/-1.50X70
(OS):-2.50D/-1.50X130
SUBJECTIVE:
(OD): -2.50D/-1.50X70(3/30p,6/60p,20/200p)
(OS): -2.50D/-1.50x130(3/30p,6/60p,20/200p)
Feels the same with PG and new Rx
Telescope trial
(OD)with 4xLVPEI telescope (3/7.5,6/15,20/50)
(OD)with4xSpecwell telescope(3/6,6/12,20/40)
Prefers 4x Specwell
Ocutech telescope :
Demonstrated showing the computer screen –finds comfortable at reading distance
Demonstrated outside for the distant use – finds useful
Dome magnifier: Megabite(4x) &Coil(4.42x)shown-prefers
Megabite (4x)
Focusable Bioptic telescope trialed-comfortable with the adjustable reading distance
Microsoft inbuilt magnification in computer demonstrated
ADVICE:
To continue with the prescribed devices
Assistive devices and additional devices were tried and demonstrated and addresses provided.
REHABILITATION SERVICES
Demonstration of (Magic magnification 8.0, Jaws, Kursweil) given
2nd follow-up 4/05/2005
Accop.by: wife
OCULAR STATUS:Stable
VISUAL OBJECTIVES:
Came to get information about Ocutech telescope and devices for intermediate distances
Not using +5.00D base in prism spectacle magnifier as he doesn’t have prolonged reading tasks.
CURRENTLY USED OPTICAL DEVICES
DISTANCE:Has a binoculars but never uses them.
NEAR: Hand held magnifier (4x,10x) for spot reading
+5.00D half eyed base in prisms spectacle magnifier ,uses occationally for reading
6x stand magnifier ,uses regularly for reading newspaper at home and at office
4x Dome magnifier ,uses often at home and at office
Uses a incandescent table lamp for reading at home
Uses black gel pens to write.
PGP:(OD)-2.50D/-1.00X90
(OS)-2.25D
photo grey
single vision glasses
ARC coated
VISUAL ACUITY(CC):under fl.room illumination
DISTANCE
HCVA
(OD):3/30,6/60,20/200
(OS):3/30p,6/60p,20/200p
LCVA
(OD):2/38,6/114,20/380
(OS):2/38,6/114,20/380
NEAR(SC):
B/O Able to read N12/1.6M at 20cm with Baile Lovie reading chart with good speed
REFRACTION
OBJECTIVE:
(OD): -2.50D/-1.00X90
(OS):-2.50D
SUBJECTIVE
(OD):-2.50D/-1.00x90(3/30,6/60,2/200)
(OS):-2.50D(3/30p,6/60p,20/200p)
pt.feels the same with the PG and the new Rx
Ocutech telescope (OD)3/9.5,6/19,20/63.3
Prefers ocutech telescope ,could read at 40cm for near
With 4xDome magnifier (his own) –N8/1Mwith english newspaper with good speed. Same with 4x(65mm)Dome magnifier (HK)
Prefers HK 4x Dome magnifier
With (OD) 4x,10x foldable magnifier –N8/1M with english newspaper
With (OD) 6x stand magnifier(L112)-N8/1mM with english news paper with good speed
Demonstratd PICO pocket video magnifier ,prefers It
Using papermate black ink pen for writing
ADVICE
To continue his habitual glasses.
4xDome magnifier (HK) for reading office documents.
Address given about PICO pocket video magnifier
Continue with the foldable pocket magnifier (4x,10x)for spot reading
Needs demonstration of computer magnification software.
REHABLITATION SERVICES
Instructional training provided in using computer software Magic 8.0
Pt prefers to use the same and purchased the same .
DATE: 23/8/2000 48Y/M
Accomp.by: Wife and Son
CAUSE OF LOW VISION: Stargardts Macular Dystrophy .
VISUAL HISTORY: Subnormal vision since 1968
FAMILY HISTORY: Younger brother having the similar eye problem
MEDICAL HISTORYH/O: Joint pain since 1yr.
EDUCATION: Msc Ph.D. (Geology)
Working as a scientist at N.G.R.I.
USES OF GLASSES- H/O:using glasses since 1968
PGP 2yr old
PREVIOUS LV CARE - Yes
CURRENTLY BEING USED: (self-purchased)
Binocular spectacle mounted telescope (2.8x28)
Book top dome magnifier (approx. +27.00D)
Hand held magnifier (4x, 10x)
Using incandescent reading lamp at home
PRESENT GLASS POWER:
(OD): -2.50D/-0.75X90
(OS): -2.50D
Single distance vision glasses
Photogrey
CHIEF COMPLAINTS:
Difficulty in reading news paper, maps even with Book top magnifier due to reduced distance
C/O Eccentric view especially while driving
C/O Increased sensitivity to bright light (comfortable with his photogrey
C/O Delayed dark adaptation with prolonged after image
CLINICAL EXAMINATIONS
VISUAL ACUITY – HCVA (CC) under room illumination
OD 3/15,6/30,20/100
OS 3/15,6/30,20/100
NEAR VISUAL ACUITY – under room illumination (SC)
B/O N25/3.2M at 40cms with Bailey-Lovie chart.
REFRACTION
OBJECTIVE
OD – 2.50D/-2.00X60
OS – 2.5D/-1.50X120
SUBJECTIVE
OD -2.50/-1.5X80(3/15,6/30,20/100)
OS –2.50D/-1.75X120 (3/15,6/30,20/100)
OCULAR MOTILITY: Full
COVER TEST: Orthotropia
PUPIL: R/R/R
CONVERGENCE: WNL
COLOR VISION: Defective
VISUAL FIELDS: Central relative scotoma and Metamorphopsia with Amsler chart
BINOCULARITY: 800 sec of arc
SLE WNL
OPTHALMOSCOPY (OU)
Stargardts Macular Dystrophy
TRIAL OF DISTANCE VISION TELESCOPE:
(OD) 4x telescope (3/4.8,6/9.6,20/32)
B/O telescope (2.8x) self: (3/6,6/12,20/40)
(OD) Pt. Prefers4x M/O telescope
NEAR VISION (reading/writing):
Under room illumination
B/O with +5.00DS BI-PRISM Spectacle magnifier (B-H) able to read N8/1M print size with English newspaper (good speed).
Prefer to read the footnotes (N6/0.8M) with 6x-stand magnifier at
4-5cm from the lens
Prefer to write using felt tip pen (black ink)
REHABILITATION PLAN
Counseling done
To continue with distance vision habitual glasses
Spectacle magnifier (half –eyes +5.00D) for regular reading
Stand magnifier (6x) for reading footnotes
Need felt tip pen (black ink) for writing task.
To stop driving two wheeler and car
REHABLITATION SERVICES
Training instruction in using spectacle magnifier and stand magnifier given
Environmental modification: close working distance adviced
1st follow up 29/3/2004
OCULAR STATUS: Stable
VISUAL OOBJECTIVES:
Came to get information about Ocutech telescope
Difficulty in reading small preint in news paper , documents,text books even after using the magnifiers
Difficulty in recognizing faces bus numbers beyond 3m.
CURRENTLY USED OPTICAL DEVICES
DISTANCE: Has binocular (2.8x)-uses rarely for spot use
(did not bring)
NEAR: +5.00D Base-in prism half eyes (B&H)-uses occationally
6x stand magnifier –uses mostly for reading news paper at home and office
2.5x Dome magnifier-uses often at home and office for text and map reading
PGP: (OD)-2.50D/-1.00X90
(OS)-2.50D
Single vision glasses
Photogrey lenses
VISUAL ACUITY(CC)Under fl.room illumination
DISTANCE:
HCVA
(OD): 3/30p,6/60p,20/200p
(OS): 3/30p,6/60p,20/200p
LCVA
(OD):2/38,6/114,20/380
(OS):2/38,6/114,20/380
NEAR(SC):Able to read N12/1.6M with 25cm with Baile-Lovie reading chart with good speed
REFRACTION
OBJECTIVE:
(OD): -2.50D/-1.50X70
(OS):-2.50D/-1.50X130
SUBJECTIVE:
(OD): -2.50D/-1.50X70(3/30p,6/60p,20/200p)
(OS): -2.50D/-1.50x130(3/30p,6/60p,20/200p)
Feels the same with PG and new Rx
Telescope trial
(OD)with 4xLVPEI telescope (3/7.5,6/15,20/50)
(OD)with4xSpecwell telescope(3/6,6/12,20/40)
Prefers 4x Specwell
Ocutech telescope :
Demonstrated showing the computer screen –finds comfortable at reading distance
Demonstrated outside for the distant use – finds useful
Dome magnifier: Megabite(4x) &Coil(4.42x)shown-prefers
Megabite (4x)
Focusable Bioptic telescope trialed-comfortable with the adjustable reading distance
Microsoft inbuilt magnification in computer demonstrated
ADVICE:
To continue with the prescribed devices
Assistive devices and additional devices were tried and demonstrated and addresses provided.
REHABILITATION SERVICES
Demonstration of (Magic magnification 8.0, Jaws, Kursweil) given
2nd follow-up 4/05/2005
Accop.by: wife
OCULAR STATUS:Stable
VISUAL OBJECTIVES:
Came to get information about Ocutech telescope and devices for intermediate distances
Not using +5.00D base in prism spectacle magnifier as he doesn’t have prolonged reading tasks.
CURRENTLY USED OPTICAL DEVICES
DISTANCE:Has a binoculars but never uses them.
NEAR: Hand held magnifier (4x,10x) for spot reading
+5.00D half eyed base in prisms spectacle magnifier ,uses occationally for reading
6x stand magnifier ,uses regularly for reading newspaper at home and at office
4x Dome magnifier ,uses often at home and at office
Uses a incandescent table lamp for reading at home
Uses black gel pens to write.
PGP:(OD)-2.50D/-1.00X90
(OS)-2.25D
photo grey
single vision glasses
ARC coated
VISUAL ACUITY(CC):under fl.room illumination
DISTANCE
HCVA
(OD):3/30,6/60,20/200
(OS):3/30p,6/60p,20/200p
LCVA
(OD):2/38,6/114,20/380
(OS):2/38,6/114,20/380
NEAR(SC):
B/O Able to read N12/1.6M at 20cm with Baile Lovie reading chart with good speed
REFRACTION
OBJECTIVE:
(OD): -2.50D/-1.00X90
(OS):-2.50D
SUBJECTIVE
(OD):-2.50D/-1.00x90(3/30,6/60,2/200)
(OS):-2.50D(3/30p,6/60p,20/200p)
pt.feels the same with the PG and the new Rx
Ocutech telescope (OD)3/9.5,6/19,20/63.3
Prefers ocutech telescope ,could read at 40cm for near
With 4xDome magnifier (his own) –N8/1Mwith english newspaper with good speed. Same with 4x(65mm)Dome magnifier (HK)
Prefers HK 4x Dome magnifier
With (OD) 4x,10x foldable magnifier –N8/1M with english newspaper
With (OD) 6x stand magnifier(L112)-N8/1mM with english news paper with good speed
Demonstratd PICO pocket video magnifier ,prefers It
Using papermate black ink pen for writing
ADVICE
To continue his habitual glasses.
4xDome magnifier (HK) for reading office documents.
Address given about PICO pocket video magnifier
Continue with the foldable pocket magnifier (4x,10x)for spot reading
Needs demonstration of computer magnification software.
REHABLITATION SERVICES
Instructional training provided in using computer software Magic 8.0
Pt prefers to use the same and purchased the same .
posted by anandopt at 11:03 AM
0 comments
