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Providing Rehabilitation to People Who Have Restored Vision Through a Retinal Implant. Duane R. Geruschat Ph.D. CLVT, COMS. Disclosure. The presenter is a collaborator with Second Sight Medical Products Supported by: R01 EY021220 to Gislin Dagnelie , Ph.D
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Providing Rehabilitation to People Who Have Restored Vision Through a Retinal Implant Duane R. Geruschat Ph.D. CLVT, COMS
Disclosure The presenter is a collaborator with Second Sight Medical Products Supported by: R01 EY021220 to GislinDagnelie, Ph.D University of Pennsylvania/CHOP
Background Information I am an EXPERT!!
What is an Expert? An expert is a person who has made all the mistakes, which can be made, in a very narrow field. Niels Henrik David Bohr (1885-1962)
This Is Real • FDA approved the Argus II for commercial use in the US in February 2013 • Medicare approved payment (inpatient and outpatient settings) effective October 1, 2013
Clinical Sites 2013 Ann Arbor, MI Atlanta, GA Baltimore, MD Chicago, IL Cleveland, OH Dallas, TX Durham, NC Los Angeles, CA Miami, FL Nashville, TN Philadelphia, PA San Francisco, CA Toronto On
You Will Be Involved Clients will hear/read and contact you for information
Goals For This Presentation • What type of functional vision and activities • Patient profile • Providing rehabilitation instruction • Best Candidates • Challenges using prosthetic vision
Simulation of Argus II Filter simulation video
What These Videos Mean? The Blind Can See • Low Visual Acuity • 20 Degrees of Visual Field • Takes time to process the image Ultra Low Vision
Patient Profile • RP – severe visual impairment • Average years since blind = 15 • Lived as person who is blind • Re-introduction of vision • Sequence of vision loss • Sighted • Low vision • Blind • Ultra low vision
Patient Profile • Psychological dynamic • Approach is different • Technology is unique – ultra low vision • Sequence of life events
Principles of Patient Care • Patients have varying levels of skills with non-visual strategies • Many tasks can be completed with non-visual alternatives • More successful patients seem to have good blindness skills • Technology which enhances good blindness skills
Rehabilitation In Clinic rehabilitation Community based rehabilitation
In Clinic Rehabilitation Goal is to Teach 1 Components of system 2 Manipulation of controls 3 Basic visual skills
In Clinic Rehabilitation Goal is to Teach 1 Components of system 2 Manipulation of controls 3 Basic visual skills
In Clinic Rehabilitation Goal is to Teach 1 Components of system 2 Manipulation of controls 3 Basic visual skills
Community Rehabilitation Goal is to Reinforce and Teach • Components of system • Manipulation of controls • Basic visual skills • Teach INTEGRATION OF VISUAL SKILLS
Community Rehabilitation What to do on day one? • You know how to do rehabilitation • Do what you always do • This is a new and unique technology but it’s still blind rehabilitation
Community Rehabilitation What to do on day one? • Good assessment of functional abilities without Argus II • Functional vision assessment • Set goals
Community Rehabilitation Apply good low vision rehabilitation techniques
Community Rehabilitation • Good assessment of blindness skills • Environmental considerations • Argus II is a supplement, an enhancement to good blindness skills
Visual Integration ADL • Sorting Laundry • Setting Table
Visual Integration Orientation and Mobility • Crossing Street • Midblock bus stop • Turning house lights off
Visual Integration Quality of Life • Fireplace • Television • Just feeling sighted again
Visual Integration Development of visual memory