OT and Low Vision and Community Mobility – Flashcards
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Ot input is necessary for most informed recommendations for assisstive devices and parameters for their use
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True
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Diabetic retinopathy
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-affects nearly 40% of individuals with diabetes -can affect all aspects of visual function -potential to cause profound vision loss by damaging the small blood vessels of the reitnal leading to scar tissue within the eye (can lead to retina detachment) -can develop scatomas -can develop decreased contrast and color discrimination, decreased night vision, and fluctuations in vision
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Scatomas
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partial loss of vision or a blind spot in an otherwise normal visual field
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Diabetic retinopathy treatment
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medical: surgery, laser, vitrectomy Ot: color/contrast, glare control, lighting, magnification, visual skill training
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Glaucoma
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-damage to optic nerve caused by increased intraocular pressure -results in decreased peripheral vision (tunnel vision) -extreme pain cuased by abnormal blood vessel growth -pressure due to buildup of fluid in eye
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Glaucoma functional complaint
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-difficulty with night vision -mobility impairment -end stages difficulty with central (reading and facial recognition)
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Glaucoma treatment
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meds, surgery typical OT
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Cataracts
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-progressive, painless clouding of the natural internal lens of the eye -block light making it diffficult to see -can cause blindness -glare outside or headlights makes it worse
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Cataracts functional complaint
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Decreased visual acuity Decreased contrast sensitivity Difficulty with night driving and diplopia
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Macular Degeneration
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age-related macular degeneration is disease associated with aging that gradually destroys macula (light sensitive cells for central vision of the retina) progressive and irreversable
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2 types of macular degeneration
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wet (fluid leaked into macula) and dry (thining of macula)
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Visual skills training
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scanning eccentric viewing training
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eccentric viewing training
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teaches to use peripheral vision more effectively and identify strongest area closest to fovea
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OT interventions for LV
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-enviornmental adaptations: lighting, contrast, filters -magnification -organizational strategies -sensory substitution (tactile or auditory) -client/family education
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All OTs should have the skills necessary to assess driving-related skills and to carefully assess the client's psychosocial skills related to driving and community mobility
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TRUE
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How OTs address community mobility
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-eval-occupational profile and analysis of occ performance -intervention -outcomes to determine success
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Algorithm of OT process for driving
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each pathway ensure client access to screening assessment, eval, comprehensive driving eval, intervention and exploration of community mobility options
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What can a generalist tell
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-when a person with low risk is fully able to drive -when a person with high risk is unable to drive
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Driver Eval process
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Occupational Profile Mobility Options & Transportation Needs Cognition Vision/Perception Physical Assessment On Road Assessment
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Cognition
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-Trailmaking -Short blessed test of memory and concentration -traffic sign recognition
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Vision/Perception tests
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Pelli-Robson Contrast Sensitivity Static Distance Visual Analyzer Near Visual Acuity Humphrey Visual Field Analyzer(flashing dots maps out visual field)
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Physical assessment
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-ROM -Strenght: MMT and handgrip -Rapid pace walk -coordination -transfer -observation of accessing vehicle controls
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Eval process
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-Closed course -Open road--- with more difficult environment
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Able to drive with Therapeutic intervention
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Adaptations to the vehicle or the driving environment Temporary alternative transportation Indicates capacity for improvement May refer to OT for additional treatment New driver
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Community Mobility: Developmental Disabilities
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Safety or stability while being transported Determining eligibility & application for paratransit services Use of public or private alternative modes of transport. Use of power equipment (e.g. electric scooters, power wheelchair) Driving a vehicle
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6 out of 10 teen crashes involve
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driver distraction
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What is a good measure of predriving skills?
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Adolescent skills checklist -Kitchen-- operates appliances safely -Family responsibilities--- plans activities with family or friends -Home-- cleans up after self in bathroom or kitchen
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What is a self-monitoring log
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-helps keep track of type of driving, behavior and successfulness of drive
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What is agrability
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a program that modifies farm equipment to make it accessable
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5 A's of senior friendly transport
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Availability Acceptability Accessibility Adaptability Affordability
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10 warning signs of demtia
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. Memory loss 2. Difficulty performing familiar tasks 3. Problems with language 4. Disorientation to time and place 5. Poor or decreased judgment 6. Problems with abstract thinking 7. Misplacing things 8. Changes in mood or behavior 9. Changes in personality 10. Loss of initiative
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Assessment of Readiness for mobility transition (ARMT)
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a tool for mobility counseling a measure of emotion and attitudinal readiness to cope with mobility change and loss associated with advancing age
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Driver Rehab certification
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certified driver rehab specialist/allied health professional with specialization or an OT/OTA with advanced training
