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VISION of ORTHOPTICS

VISION of ORTHOPTICS. For the stroke team. Eye Team. Ophthalmologist Orthoptist Optometrist Optician Ophthalmic technician. Small part of the MDT in stroke pathway. AIMS for each stroke patient Vision Acuity / Field Normal eye movements No Diplopia (Double vision -prism, patch etc).

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VISION of ORTHOPTICS

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  1. VISION of ORTHOPTICS For the stroke team

  2. Eye Team • Ophthalmologist • Orthoptist • Optometrist • Optician • Ophthalmic technician

  3. Small part of the MDT in stroke pathway • AIMS for each stroke patient • Vision Acuity / Field • Normal eye movements • No Diplopia • (Double vision -prism, patch etc)

  4. Acuity Matching, Pictures etc OPTOMETRIST POH Amblyopia Glaucoma macular disease Colours Contrast Fields Vision

  5. The field of vision can be plotted by: • Confrontation • Goldmann kinetic (and static) threshold perimetry • Humphrey static threshold perimetry computer 30 degrees

  6. Left Eye

  7. InattentionPartial Hemianopia • Macular Sparing

  8. Complete Hemianopia(Reading Techniques and positioning)

  9. What is new to the stroke • What is old disease (old VA VF) • Glaucoma • Cataract • Macular degeneration • River blindness

  10. Glaucoma progression

  11. Glaucoma progression

  12. Glaucoma progression

  13. Glaucoma progression

  14. Glaucoma progression

  15. Glaucoma progression

  16. Glaucoma progression

  17. Glaucoma progression

  18. Glaucoma progression

  19. Glaucoma progression

  20. Humphrey Visual FieldsGlaucomaDrivingComputer

  21. DRIVING VF - DVLA • VISION • Read number plate at 25 yards = 6/10 (BEO) • VISUAL FIELD • ESTERMAN or opt for Goldmann • 120 degrees of visual field • No more than 3 missed in central 30 degrees

  22. Orthoptist is a small part of the MDT in stroke pathway • AIMS for each patient • Vision • Eye movements assessed • Diplopia Treated (prism, patch etc) • Visual field defect mapped • Help with rehab etc • Driving

  23. Small part of the MDT in stroke pathway • AIMS for each patient • Vision • Eye movements assessed • Diplopia Treated

  24. IIIn IVn VIn Palsy • Vertical gaze Palsy • Horizontal gaze palsy • Skew deviation • INO • Gaze Palsy • One and a half (INO + Horiz GP) • Parinauds • Nystagmus

  25. Orthoptists help Diagnostically • IIIn IVn VIn Palsy • Vertical gaze Palsy riMLF • Horizontal gaze palsy PPRF • Skew deviation • INO MLF • Gaze Palsy • One and a half (INO + Horiz GP) • Parinauds Dorsal Midbrain • Nystagmus

  26. Orthoptists help therapeuticallyOcclusion, prisms, exercises AHP, BoTox Surgery • IIIn IVn VIn Palsy • Vertical gaze Palsy • Horizontal gaze palsy • Skew deviation • INO • Gaze Palsy • One and a half (INO + Horiz GP) • Parinauds • Nystagmus

  27. Nystagmus

  28. Horizontal problems • VI • INO • Gaze palsy (complete seen as VF defect)

  29. Vertical problem • IIIn • IVn • Skew deviation • Gaze palsy

  30. Small part of the MDT in stroke pathway • AIMS for each stroke patient • Vision Acuity / Field • Assess eye movements • Treat any Diplopia • (Double vision -prism, patch etc) Orthoptists should be a small amount of help Diagnostically & Therapeutically for the stroke patients

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