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Driving with Low Vision Bill Takeshita, O.D.,F.A.A.O., F.C.O.V.D.
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DMV 962 Form People with low vision are eligible to apply for drivers license Requires a special vision examination and the completion of the DMV 962 form by a low vision optometrist or ophthalmologist Written and road tests
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Low Vision Examination Determine the functional strengths and weaknesses of the patient Design optical aids to maximize the patient’s remaining vision Develop treatment program to address functional problems Work with allied professionals
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Eye Movement Testing Fixation: Ability to keep eyes steady on the target. Nystagmus is the uncontrollable shaking of the eyes. Versions or pursuits: Ability to follow a moving target (Parietal lobe of brain) Saccades: Ability to shift the eyes from one target to another, such as when reading. (Front lobe of brain). Eye-hand coordination testing
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Convergence Testing Convergence is the ability to cross or bring both eyes together when reading. Poor convergence is a leading cause of the inability to read Double vision Headaches Loss of place when reading
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Depth Perception Photograph of stereo test
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Color Vision Photo of color vision test
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Contrast Sensitivity Testing Photo of Pelly Robson Photo of Vis Tek
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Peripheral Vision Testing Photo of Humphrey Test of finger confrontation
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Amsler Grid Central Vision Test Photo of Amsler Grid test
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Distance Acuity Photo of ETDRS Photo of Feinbloom
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Refraction Illustration of perspective with e on macula
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Telescopic Refraction Specialized technique to determine best spectacle correction Focus light on the healthiest region of retina for eccentric viewing
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Visual Status World Health Organization and Social Security Administration Fully Sighted Partially Sighted Legally Blind Functionally Blind
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Legal Blindness Visual acuity of 20/200 or worse in the BETTER eye with glasses or contact lenses Widest field of vision 20 degrees or smaller in the better eye with corrective glasses or contact lenses May qualify for audio books, Social Security, transportation discounts, Medicare
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Bioptic Telescopes 4x Full Diameter TS Not focusable Spiral focusable TS Expanded field focus TS (note: length)
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Ocutech Bioptic Cosmetically more appealing Autofocus option Slightly dimmer than DVI BTS Smaller field of view than DVI BTS
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Special Lens Materials Eschenbach Novus Super Modular Hyper 1.67 Trivex
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Polarized Prescription Filters Provide the most features for the patient UV filtration Eliminate reflected glare from concrete, windshields, water Many colors to reduce glare but not cut out so much light that one cannot see Available in prescriptions, bifocals, and progressive addition lenses
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UV Shield and NoIR Filters UV shields Solar Shields NoIR Spectra Shields
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Cocoon Filters Photo of cocoon filters
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Grey Filters Work well for those patients who are bothered by direct sunlight Does not distort color vision May be too dark for some patients Helpful for mobility during sunny days Gradient gray tints are also helpful for many patients
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Green filters Bausch and Lomb G-15 Some patients may prefer this color over the grey lens Some patients with glaucoma and optic nerve problems appreciate this color lens G-15 color can be made in plastic Red/green color deficiency may appreciate the green filter
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Blue Free Filters Brown, orange, amber, and yellow filter the blue wavelengths of light Corning CPF (glass) Increase the contrast of images Some patients may report that things are brighter Macular degeneration, diabetic retinopathy, retinitis pigmentosa
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PRL Training Teach the patient to move his or her eyes to allow the image to focus on the healthier regions of the retina. Eccentric viewing training Takes a lot of time and patience
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Macular Scar Photo of macular scar Can you read this?
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