VISION of ORTHOPTICS For the stroke team. Eye Team Ophthalmologist Orthoptist Optometrist Optician Ophthalmic technician.

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Presentation transcript:

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)

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

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

Left Eye

Inattention Partial Hemianopia Macular Sparing

Complete Hemianopia (Reading Techniques and positioning)

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

Glaucoma progression

Humphrey Visual Fields Glaucoma Driving Computer

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

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

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

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

Orthoptists help Diagnostically IIIn IVn VIn Palsy Vertical gaze Palsy riMLF Horizontal gaze palsyPPRF Skew deviation INOMLF Gaze Palsy One and a half (INO + Horiz GP) ParinaudsDorsal Midbrain Nystagmus

Orthoptists help therapeutically Occlusion, 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

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

Vertical problem IIIn IVn Skew deviation Gaze palsy

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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