This presentation will cover:
- Identifying common visual changes post-stroke
- Identifying common age-related visual changes
- Identifying adaptive vision strategies
Mary Warren’s Visual Hierarchy
- Visual Acuity — How well you can see with your eyes
- Visual Fields — The space we can see with our eyes
- Oculomotor Skills — Moving our eyes in various directions
- Visual Attention — Maintaining focus on a fixed spot
- Visual Scanning — Moving your eyes in a coordinated fashion
- Pattern Recognition — Understanding and following patterns
- Visual Memory — Recognition of shapes and forms
- Visual Cognition — Functional use of visual skills
Visual Changes
Common visual changes post-stroke
- Approximately 65% of stroke survivors experience vision changes/problems (American Stroke Association, n.d.)
- Neglect — Don’t visually respond to and aren’t aware of things on their affected side
- Field cuts — Loss of some of the area we see with our eyes
- Eye movement disorders
- Eye turning (strabismus)
- Eye tracking control issues (oculomotor dysfunction)
- Rapid eye jiggling (nystagmus)
Common age-related visual changes
- Losing the ability to see items close to you
- Increased time needed to adjust to lighting changes
- Difficulty distinguishing colors
- Age related macular degeneration — Loss of central vision
- Diabetic retinopathy
- Cataracts — Cloudy areas in vision
- Glaucoma — Can lead to vision loss
- Dry eye
These can result in “low vision”
What is “low vision”?
- Eyesight that cannot be fixed with glasses, contact lenses, medication, or surgery
- Examples of having low vision may include…
- Trouble reading
- Can’t see well enough to do daily tasks such as cooking
- Difficulty recognizing faces of familiar people
Things to do to help keep our eyes healthy
- Get your eyes checked regularly
- Protect your eyes from sunlight—wear sunglasses and/or a hat when outside
- Follow a healthy, nutritious diet
- Monitor blood pressure
- Stop smoking
- Control Diabetes as well as possible (if you have it)
LOW VISION ADAPTATIONS AND STRATEGIES
Dressing:
- Hang/organize clothes by color
- Use small boxes within drawers as dividers to help organize items
- Place high contrast tape on back of only one shoe in each pair to tell right from left
Bathing/hygiene:
- Use high contrast items such as a dark bathmat to distinguish from the tub
- Add large print labels to your shower items
- Use a magnified mirror for shaving or makeup
Cooking:
- Use a high contrast cutting board (i.e. light cutting board on dark counters, vice versa)
- Keep items in fridge and cabinet in an order that feels natural to you
- Use utensils/plates/cups with high contrast
- Mark appliance dials with “bump dots” to identify commonly used buttons easier
- Mark oven dials with high contrast tape to help see them easier
- Use the microwave if you feel unsafe using the stove
Reading & Writing:
- Line isolator—’Magna Typoscope’
- Bright tape at the edge of page to help you scan to the edge of the page
- E-readers to adjust font size
- Magnifying glass for reading
- Use paper with bold lines when writing
- Use bold pens when writing
- Use large print address books, calendars, checks, etc.
Managing Money:
- Organize important papers in different colored trays or folders with labels
- Pay bills online to allow for enlarged font
- Use large-print checks, magnifiers, etc.
- Find a system to fold paper money in different ways to help identify them
- Ask cashiers to verbally tell you what value of coin/paper money they are giving back to you
Managing Medications:
- Label prescription bottles with large-print labels or different colored tape
- Mark bottle caps in large print with identifiers (i.e. write ‘BP’ on blood pressure meds)
Other Strategies:
- Scanning (head turns)
- Dark colored light switches and electrical outlets to increase contrast against walls, or add tape around them
- Motion lights that turn on when you enter a room
- Nightlights
- Clocks with large numbers and phones with large font
- Colored tape on edge of stairs to identify where they start
- Make grocery list according to where items are found in the store to consolidate
- Remove clutter from home
Who is there to help with visual changes?
- Doctor
- Optometrist
- OT can provide adaptive strategies
- Proper diagnosis and rehabilitation can help recover and improve performance in daily activities (American Stroke Association, n.d.)