Question 1

The main reason for a growing population of persons with low vision is a(n):&#10;A) Lack of access to vision insurance&#10;B) Increasing older adult population&#10;C) Lack of prioritization of vision care&#10;D) Shortage of vision professionals

Accepted Answer

In the United States, approximately 3.2 million people had low vision in 2015, and this number is expected to increase to 6.9 million by 2050 (Varma et al., 2016). One in every 28 persons in the United States age 40 and above have low vision, and the prevalence of visual impairment increases with age (Vision Council, 2015). In 2011, the oldest baby boomers turned 65, and by 2030, the baby boomers will make up 18% of the U.S. population (Heimlich, 2010). The most common eye diseases for those age 40 and over include cataract, glaucoma, diabetic retinopathy, and macular degeneration.

Question 2

The most common age group to experience low vision is:&#10;A) Premature infants&#10;B) Grade school-aged children&#10;C) Adolescents&#10;D) Adults over 40

Accepted Answer

In the United States, approximately 3.2 million people had low vision in 2015, and this number is expected to increase to 6.9 million by 2050 (Varma et al., 2016). One in every 28 persons in the United States age 40 and above have low vision, and the prevalence of visual impairment increases with age (Vision Council, 2015). In 2011, the oldest baby boomers turned 65, and by 2030, the baby boomers will make up 18% of the U.S. population (Heimlich, 2010). The most common eye diseases for those age 40 and over include cataract, glaucoma, diabetic retinopathy, and macular degeneration.

Question 3

Shelly is an 80-year-old woman who reports problems with vision and can only &#34;see things from the sides of her eyes.&#34; Shelly is experiencing which common eye disease?&#10;A) Cataract&#10;B) Glaucoma&#10;C) Diabetic retinopathy&#10;D) Macular degeneration

Accepted Answer

Etiology, prevalence, and medical treatment for the common eye diseases vary. Cataract, or clouding of the eye lens, is the most frequently reported condition in persons with low vision; the prevalence of this diagnosis ranges from 11.8% to 18.8% for African American, Caucasian, and Hispanic individuals (National Eye Institute [NEI], n.d.). Cataracts cause low vision, but there is a surgical procedure that can correct this problem. Cataract removal surgery has an estimated 90% chance of improving vision, with a rare incidence of issues occurring post-surgery (NEI, 2015b). Glaucoma, damage to the optic nerve, occurs when the normal fluid pressure inside the eyes rises, resulting in vision loss and blindness. Treatment to save remaining vision may include eye drops, laser trabeculoplasty, and/or conventional surgery (NEI, 2015d). Diabetic retinopathy develops secondary to diabetes and results from a change in the blood vessels of the retina. From 40% to 45% of persons diagnosed with diabetes have some stage of diabetic retinopathy, and many are unaware of this fact (NEI, 2015c). Diabetic retinopathy can occur as non-proliferative or proliferative retinopathy. Proliferative retinopathy is treated with laser surgery or with a vitrectomy (Johns Hopkins Medicine, n.d.). Lastly, age-related macular degeneration (AMD), damage to the central part of the retina, occurs in one of two forms, dry or wet. It is the leading cause of vision loss in the United States for persons age 50 and older (NEI, 2015a). There is no medical treatment for dry macular degeneration; however, some patients are advised to take formula eye vitamins (Age-Related Eye Disease Study Research Group, 2001; Age-Related Eye Disease Study 2 [AREDS2] Research Group, 2013). Treatment for wet macular degeneration includes laser surgery, photodynamic therapy, and eye injections (NEI, 2015a). Eye injections are used to stop the growth of excessive blood vessels, and there are three types of medicines used: Avastin, Eylea, and Lucentis (Mogk, n.d.).

Question 4

Of the four most common eye disorders, intervention for most involves:&#10;A) Surgery&#10;B) Occupational therapy&#10;C) Eye drops&#10;D) Pharmaceuticals

Accepted Answer

Etiology, prevalence, and medical treatment for the common eye diseases vary. Cataract, or clouding of the eye lens, is the most frequently reported condition in persons with low vision; the prevalence of this diagnosis ranges from 11.8% to 18.8% for African American, Caucasian, and Hispanic individuals (National Eye Institute [NEI], n.d.). Cataracts cause low vision, but there is a surgical procedure that can correct this problem. Cataract removal surgery has an estimated 90% chance of improving vision, with a rare incidence of issues occurring post-surgery (NEI, 2015b). Glaucoma, damage to the optic nerve, occurs when the normal fluid pressure inside the eyes rises, resulting in vision loss and blindness. Treatment to save remaining vision may include eye drops, laser trabeculoplasty, and/or conventional surgery (NEI, 2015d). Diabetic retinopathy develops secondary to diabetes and results from a change in the blood vessels of the retina. From 40% to 45% of persons diagnosed with diabetes have some stage of diabetic retinopathy, and many are unaware of this fact (NEI, 2015c). Diabetic retinopathy can occur as non-proliferative or proliferative retinopathy. Proliferative retinopathy is treated with laser surgery or with a vitrectomy (Johns Hopkins Medicine, n.d.). Lastly, age-related macular degeneration (AMD), damage to the central part of the retina, occurs in one of two forms, dry or wet. It is the leading cause of vision loss in the United States for persons age 50 and older (NEI, 2015a). There is no medical treatment for dry macular degeneration; however, some patients are advised to take formula eye vitamins (Age-Related Eye Disease Study Research Group, 2001; Age-Related Eye Disease Study 2 [AREDS2] Research Group, 2013). Treatment for wet macular degeneration includes laser surgery, photodynamic therapy, and eye injections (NEI, 2015a). Eye injections are used to stop the growth of excessive blood vessels, and there are three types of medicines used: Avastin, Eylea, and Lucentis (Mogk, n.d.).

Question 5

Low vision is considered:&#10;A) Reversible&#10;B) Developmental&#10;C) Irreversible&#10;D) Functional

Accepted Answer

Vision provides approximately 80% of what individuals perceive through their senses (Protect-your-sight.com, 2008). Using the ICD-10-CM threshold criteria, people are considered as having low vision if they have an impairment of visual functioning even after treatment and refractive correction, and have visual acuity of less than 20/70, or a visual field of less than 10 degrees (World Health Organization [WHO], 2016). Levels of visual impairment are allocated to categories (see Table 14-1). Low vision is irreversible and may be hereditary, congenital, or acquired.

Question 6

The amount of assistance with activities of daily living that people with low vision need is estimated at:&#10;A) 15-30%&#10;B) 20-40%&#10;C) 50-60%&#10;D) 35-50%

Accepted Answer

Low vision adversely affects an individual's ability to perform everyday activities (American Academy of Ophthalmology Vision Rehabilitation Committee, 2001). Compared to individuals without disabilities (Burmedi, Becker, Heyl, Wahl, & Himmelsbach, 2002), individuals with low vision demonstrate a 15-30% higher dependence on others to perform activities of daily living (ADLs). Despite their decreased ability to perform ADLs and instrumental activities of daily living (IADLs), persons with low vision still have the need and desire to perform everyday activities that support their life roles (Crews & Campbell, 2001; Horowitz, 2004; Raina, Wong, & Massfeller, 2004; Travis, Boerner, Reinhardt, & Horowitz, 2004).

Question 7

Ed is a 75-year-old who is complaining about not recognizing people he knows when he goes grocery shopping. Ed is experiencing challenges with activities of daily living due to which common low-vision disorder?

A) Cataract
B) Glaucoma
C) Diabetic retinopathy
D) Macular degeneration

Accepted Answer

The eye diseases that result in low vision affect different areas of occupational performance. Clients with cataracts may have difficulty with taking care of themselves, recognizing faces, reading or watching television, doing their job, or leaving their home (Nordqvist, 2017). Ramulu (2009) found that the most frequent complaints of those with glaucoma were difficulties with extremes in lighting, such as walking out of a darkened theater to a sunlit parking lot, and those with bilateral glaucoma reported difficultly with reading, walking, and driving. Diabetic retinopathy at all levels of severity results in difficulty in reading and driving (Coyne et al., 2004). Persons more severely affected have difficulty with diabetic care routines, more mobility issues, and have an increased fear of accidents, leading to decreased social participation. AMD adversely affects the individual's ability to read standard print and can limit independence in preparing meals, using a telephone, taking care of finances, traveling, shopping, taking medications, and washing laundry (Ryan, Anas, Beamer, & Bajorek, 2003).

Question 8

As an occupational therapist, you notice Mike, a 66-year-old from your faith community, is having difficulty with his vision when participating in the community garden. He asks you who could help him figure out what is going on with his vision. You recommend which of the following vision professionals?

A) Optometrist
B) Ophthalmologist
C) Vision rehabilitation therapist
D) Mental health service provider

Accepted Answer

A number of team members, in addition to occupational therapy practitioners, work with clients with low vision (see Table 14-2). Ophthalmologists are medical doctors (MDs) who diagnose and treat eye diseases, prescribe medications, and perform surgery. Optometrists are doctors of optometry (ODs) who treat refractive errors with glasses, contacts, and magnifiers. Vision rehabilitation therapists receive referrals from state or non-profit agencies to provide training in the home for adaptive techniques to perform everyday activities and modify the environment. Orientation and mobility (O&M) specialists are consulted for difficulties in mobility and provide training for people to travel safely using devices such as canes, guide dogs, and/or electronic devices. They teach people to take public transportation on their own and also receive referrals through the state or a nonprofit agency. Mental health service providers such as psychiatrists, psychologists, and/or social workers may be consulted to assist with psychosocial difficulties in coping and adjusting to low vision. They may address such issues as anxiety, frustration, fear, anger, and depression. Finally, family members often transport the client to appointments, may perform home modifications for the client, and assist in follow-through with home programs. Family members of the visually impaired are often more involved than are family members of other populations with functional deficits.

Question 9

After getting his diagnosis, it is recommended that Mike stop driving until his vision can be addressed through surgery. Mike reports to you he has never taken public transportation and has no idea where to begin. You recommend he connect with which of the following vision professionals?

A) Optometrist
B) Ophthalmologist
C) Vision rehabilitation therapist
D) Orientation and mobility specialist

Accepted Answer

A number of team members, in addition to occupational therapy practitioners, work with clients with low vision (see Table 14-2). Ophthalmologists are medical doctors (MDs) who diagnose and treat eye diseases, prescribe medications, and perform surgery. Optometrists are doctors of optometry (ODs) who treat refractive errors with glasses, contacts, and magnifiers. Vision rehabilitation therapists receive referrals from state or non-profit agencies to provide training in the home for adaptive techniques to perform everyday activities and modify the environment. Orientation and mobility (O&M) specialists are consulted for difficulties in mobility and provide training for people to travel safely using devices such as canes, guide dogs, and/or electronic devices. They teach people to take public transportation on their own and also receive referrals through the state or a nonprofit agency. Mental health service providers such as psychiatrists, psychologists, and/or social workers may be consulted to assist with psychosocial difficulties in coping and adjusting to low vision. They may address such issues as anxiety, frustration, fear, anger, and depression. Finally, family members often transport the client to appointments, may perform home modifications for the client, and assist in follow-through with home programs. Family members of the visually impaired are often more involved than are family members of other populations with functional deficits.

Question 10

Compared to other functional deficits, family involvement for a person with low vision is likely to be:&#10;A) Less than other diagnoses&#10;B) Same as other diagnoses&#10;C) More than other diagnoses&#10;D) No studies demonstrate the need for family involvement

Accepted Answer

A number of team members, in addition to occupational therapy practitioners, work with clients with low vision (see Table 14-2). Ophthalmologists are medical doctors (MDs) who diagnose and treat eye diseases, prescribe medications, and perform surgery. Optometrists are doctors of optometry (ODs) who treat refractive errors with glasses, contacts, and magnifiers. Vision rehabilitation therapists receive referrals from state or non-profit agencies to provide training in the home for adaptive techniques to perform everyday activities and modify the environment. Orientation and mobility (O&M) specialists are consulted for difficulties in mobility and provide training for people to travel safely using devices such as canes, guide dogs, and/or electronic devices. They teach people to take public transportation on their own and also receive referrals through the state or a nonprofit agency. Mental health service providers such as psychiatrists, psychologists, and/or social workers may be consulted to assist with psychosocial difficulties in coping and adjusting to low vision. They may address such issues as anxiety, frustration, fear, anger, and depression. Finally, family members often transport the client to appointments, may perform home modifications for the client, and assist in follow-through with home programs. Family members of the visually impaired are often more involved than are family members of other populations with functional deficits.

Question 11

The ideal setting to access comprehensive services for those with low vision is:&#10;A) Outpatient rehabilitation&#10;B) Community agency&#10;C) Inpatient services&#10;D) No setting is comprehensive

Accepted Answer

The answer of The ideal setting to access comprehensive services...

Question 12

In order to garner referrals to occupational therapy low-vision services, the OT should connect with:&#10;A) Medicare&#10;B) A community agency&#10;C) An existing low-vision provider&#10;D) Veterans Administration

Accepted Answer

The answer of In order to garner referrals to occupational...

Question 13

Which of the following assessment tools focuses on specific competencies related to vision?&#10;A) Occupational profile&#10;B) Smith's Low Vision Independence Measure&#10;C) Self-Report Assessment of Functional Vision Performance&#10;D) Pepper Visual Skills for Reading Test

Accepted Answer

The answer of Which of the following assessment tools focuses...

Question 14

As a low-vision intervention for those with macular degeneration, which of the following is recommended to support reading and writing?&#10;A) Eccentric viewing&#10;B) Visual scanning&#10;C) Adopt the use of an optical device&#10;D) Closed-circuit televisions

Accepted Answer

The answer of As a low-vision intervention for those with...

Question 15

Preventing glare is an important consideration in environmental modification for low vision. Which of the following strategies can help reduce glare?&#10;A) Sheer drapes on windows&#10;B) Gooseneck lamp&#10;C) Full-spectrum lighting&#10;D) Tactile markings

Accepted Answer

The answer of Preventing glare is an important consideration in...

Question 16

A common secondary condition to low vision that occupational therapists should screen for is:&#10;A) Diabetes&#10;B) Dementia&#10;C) Depression&#10;D) Obesity

Accepted Answer

The answer of A common secondary condition to low vision...

Question 17

Emotional adjustment to low vision is facilitated by:&#10;A) Experimentation with assistive devices&#10;B) Training on how to use public transportation&#10;C) Access to a support group&#10;D) Maintaining engagement in previously valued activities

Accepted Answer

The answer of Emotional adjustment to low vision is facilitated...

Question 18

A community resource that assists persons with low vision is:&#10;A) Medicare&#10;B) A support group&#10;C) An optometrist&#10;D) The Veterans Administration

Accepted Answer

The answer of A community resource that assists persons with...

Question 19

Unless seen in a home health-care setting, the most common reimbursement source for low vision is:&#10;A) Medicare Part B&#10;B) Private insurance&#10;C) Community agencies&#10;D) The Veterans Administration

Accepted Answer

The answer of Unless seen in a home health-care setting,...

Question 20

When garnering funding for assistive devices for low vision, the best place to access financial support is:&#10;A) Medicare Part B&#10;B) Private insurance&#10;C) Community agencies&#10;D) The Veterans Administration

Accepted Answer

The answer of When garnering funding for assistive devices for...

Deck 14: Low Vision Services in the Community Introduction