Visual Impairment

From Anvita Health Wiki

Contents 1 More Specific Terms 2 Introduction 3 Etiology 4 Epidemiology 5 Clinical-manifestations 6 Complications 7 Management 8 More General Terms 9 Additional Terms 10 References

More Specific Terms

• blindness
• blurry vision (decreased visual acuity, DVA)
• color vision impairment (includes chromatopsia)
• micropsia
• visual field loss

Introduction

• A decrease in visual function that is subjectively &/or objectively demonstrable. Any person may be considered visually impaired if the corrected distant visual acuity in the better eye is 20/80 or less or if visual fields are significantly restricted.

• See visual function.

Etiology

• Acute visual loss lasting > 1 hour

• keratitis* (+)
• endophthalmitis (+)
• retinal hemorrhage or vitreous hemorrhage
• retinal detachment
• retinal artery occlusion
• retinal vein occlusion
• optic neuritis (+)
• ischemic optic neuropathy
• occipital cortex infarction ( stroke)
  * associated with red eye (+) accompanied by ocular pain
  

• Major causes of impairment (USA)

• diabetic retinopathy
• glaucoma
• age-related macular degeneration
• cataracts
• presbyopia ( refractive error)*
  

• * Most common reversible cause of visual impairment

Epidemiology

• 50% of persons > 75 years of age (excluding presbyopia)

Clinical-manifestations

• (patterns)
• slow central loss

• nuclear cataracts
• macular degeneration

• peripheral loss: advanced open-angle glaucoma
• hemianopsia
• scotoma suggests lesions in the retinas or visual pathways
• blurry vision ( reduced visual acuity)
• micropsia

Complications

• depression

Management

• screening:

• comprehensive eye exam every 1-2 years adults >= 65 years ()
• evidence for visual screening in older adults is inconclusive ( US Preventive Services Task Force)

• sudden visual loss: refer to ophthalmologist
• progressive or permanent visual impairment

• address treatable causes with ophthalmologist
• refer to vision rehabilitation specialist as needed

More General Terms

• eye disease (ophthalmopathy)
• sign/symptom

Additional Terms

• age-associated changes in the eye
• eye
• eye disease (ophthalmopathy)
• vision
• vision rehabilitation
• visual function

References

1. nlmpubs.nlm.nih.gov/hstat/ahcpr/
2. Guide to Physical Examination & History Taking, 6th edition, Bates B, JB Lippincott, Philadelphia, 1995, pg 35
3. Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998
4. Mangione CM, In:UCLA Intensive Course in Geriatric Medicine & Board Review, Marina Del Ray, CA, Sept 12-15, 2001
5. Low Vision & Blindness: NIH Institute and Center Resources [1]
6. National Guideline Clearinghouse
   - Orbits, vision, and visual loss. (American College of Radiology) ngc-guideline: [2]
   - Screening for impaired visual acuity in older adults: U.S. Preventive Services Task Force recommendation statement ngc-guideline: [3]

visual impairment