VISION of ORTHOPTICS

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VISION of ORTHOPTICS

• For the stroke team

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Eye Team

• Ophthalmologist
• Orthoptist
• Optometrist
• Optician
• Ophthalmic technician

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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

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

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The field of vision can be plotted by

• Confrontation
• Goldmann kinetic (and static) threshold
  perimetry
• Humphrey static threshold perimetry computer 30
  degrees

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Left Eye
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InattentionPartial Hemianopia

• Macular Sparing

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Complete Hemianopia(Reading Techniques and
positioning)
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• What is new to the stroke
• What is old disease (old VA VF)
• Glaucoma
• Cataract
• Macular degeneration
• River blindness

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Glaucoma progression
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Glaucoma progression
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Glaucoma progression
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Glaucoma progression
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Glaucoma progression
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Glaucoma progression
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Glaucoma progression
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Glaucoma progression
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Glaucoma progression
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Glaucoma progression
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Humphrey Visual FieldsGlaucomaDrivingComputer
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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

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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

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Small part of the MDT in stroke pathway

• AIMS for each patient
• Vision
• Eye movements assessed
• Diplopia Treated

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

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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

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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

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Nystagmus
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Horizontal problems

• VI
• INO
• Gaze palsy
• (complete seen as VF defect)

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Vertical problem

• IIIn
• IVn
• Skew deviation
• Gaze palsy

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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