Lva case study

Low vision aids case presentation

1. LOW VISION AIDS CASE PRESENTATION BY Aswin . J III rd year

2. CASE A 30-year old male Farmer by occupation Diagnosed with choroiditis 13 years back. Referred to Low V ision Care clinic for further management. Difficulty with visual tasks for 1 year. No signs of systemic abnormalities.

3. Present complaints Onset: 13 years Distance vision : difficulty in seeing faces beyond 2m, viewing steps Near vision: difficulty in managing accounts, phone numbers ADL: The activities of daily living was independent and had no light sensitivity problems Visual problems: spotting bills/ receipts, currency recognition, writing tasks

4. EXAMINATION DISTANCE VISION(unaided) OD: 1/30 (6/180) OS : 3/24 (6/48) BE : 3/24 (6/48) NEAR VISION (UNAIDED) OD :N64 @ 38 cm OS: N32 @ 38 cm

5. REFRACTION ( Retinoscopy) OD: + 0.50 DS/-3.50 DC x180 OS: -0.50/-2.00DC x180 SUBJECTIVE REFRACTION OD : Plano / -3.50 DC x 180( 1/24,6/144) OS: -1.00 DS / -1.50 DC x 180 (3/15,6/30) NEAR: ADD: OD : +4.00 DS (N50 – reads partially only) @25cm OS: +4.00 DS (N32) @ 25 cm

6. COLOUR VISION : The patient was unable to match any colors on the D 15 test. AMSLER : OD :DEFFERED OS: Does not report scotoma CONFRONTATION :OU: No S cotoma detected TRIAL FOR NEAR : Required near visual acuity: Need: : N16(currency Spotting ) Calculated magnification: EVP = 32/12 x 100/38 =approx. 7.0 D or 1.75 x Need Spotting :N6 Calculated magnification: EVP =32/12 x 100/38 = 21.0 D OR 5.26 x

7. TRIAL:1 +7.00 ADD: N16 : ABLE TO SEE SELF WRITTEN TEXT, RECOGNIZE CURRENCY, MOBILE NUMBERS.(working distance of 14 cm HALF EYES : +8.00D (N12) not comfortable TRIAL 2: 5x pocket magnifier :N6; Able to spot bills and receipts. DISCUSSIONS: 1 in 140 people in urban aged above 40 years have uveitis or past uveitis treatment 35% people with uveitis have moderate or profound visual impairment in spite of treatment.

8. The Patient in this case have moderate visual impairment secondary to uveitis The patient did not complain about glare or photophobia which is a part of the classic triad of uveitis FINAL Rx: New distance single vision Rx separate near Rx with +6.00DS ADD for writing 5x pocket magnifier

9. OTHER ADVICE Patient was reassured about his closer working distance. They explained to him that the Rx would help him to view mobile font To see faces he was asked to use magnifiers He was asked to get a 75% disability certificate from local district government hospital.

10. REFERENCES Dandona .L .Et al. population based assessment of uveitis in an urban population in southern India

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