VR Clinical Pearls

The AOA's Vision Rehabilitation Committee provides information on common clinical scenarios in vision rehabilitation. If you are interested in drafting a clinical pearl, or need additional information, please contact Kara Webb at Kcwebb@aoa.org

Demystifying dizziness

In recent years, it is apparent that both the medical community and the public have become increasingly concerned with traumatic brain injury, including sports-related injuries or concussions. As a result, optometrists have seen a significant number of patients who suspect their injury has resulted in their many visual symptoms, including blurred vision, double vision, difficulty reading or viewing their electronic device, problems with balance and movement, disorientation in busy environments, and dizziness. Read more. Improving scanning efficiency of individuals with homonymous hemianopia Individuals with homonymous hemianopia (HH) sometimes report being told to simply move their heads more to improve their efficiency with reading or mobility tasks. With such instruction alone, individuals who are aware of their deficit tend to adapt disorganized scan paths, often scanning excessively into their blind field and putting themselves at risk for missing obstacles in their intact field, and those who are unaware of their deficit are not inclined to scan at all. Read more.

Optometry and social work

There is growing emphasis in health care on the importance of holistic, collaborative care for optimum, patient-centered outcomes. To practice as patient-centric and integrated health care providers, optometry must continue to increase relationships among all health care professions. One of the professions that can be a fruitful partner to optometry, especially throughout the vision rehabilitation process, is social work. Read more.

Strategies to help reading for the AMD patient with central scotomas

Patients with low vision caused by macular diseases frequently have distortion, blur or scotomas in their central visual field that interfere with reading activities and result in slow or inaccurate reading performance. Scotomas can cause parts of letters or words to be missing or blurry such that patients lose their place or have difficulty finding the beginning or end of a line of text. Read more.

Tips on Prescribing and Fitting a Bioptic Telescope System (BTS) for Driving. Part I.

Doctor of Optometry must often be like journalists, documenting the who, what and when before determining the how. This holds true when prescribing and fitting a bioptic telescope systems (BTS) for driving. I consider the following questions before starting the fitting process. Read more.

Tips on Prescribing and Fitting a Bioptic Telescope System (BTS) for Driving Part II: The How

In part I of this article, I presented thoughts to consider prior to fitting a patient with a bioptic telescope system (BTS) for driving. Once I determine the patient to be a good candidate to drive with a BTS, I design and order the system as follows. Read more.

Lens Rx prescribing for the patient with traumatic brain injury

When treating a patient with traumatic brain injury (TBI), my first step in vision rehabilitation treatment is to write a prescription that allows the visual system to maximize comfort and vision. Simple is better with this population. Most patients will be very successful with single-vision lenses that are specific for the given task (i.e., reading or distance). Generally, I avoid prescribing progressive lenses, as these lenses come with unwanted base down prism and can be very disturbing for patients with vestibular dysfunction and abnormal vestibular ocular reflex. I also find that progressives can adversely affect balance and gait in TBI patients. Be sure to discuss and explain the lens options to your patients, as the treatment choice is ultimately up to them. Read more.

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