A LOW VISION APPROACH TO A COMMON OCULAR CONDITION

Title A LOW VISION APPROACH TO A COMMON OCULAR CONDITION
Author, Co-Author Richard Zimbalist, Olga Whitman, Lindsey Lear
Topic
Year
2008
Day
Thursday
Program Number
85208
Room
Affiliation
Pennsylvania College of Optometry at Salus University
Abstract BACKGROUND: Vision loss occurs from a variety of etiologies, all of which impact a patient’s quality of life. One such cause is uveitis associated cystoid macular edema (CME) where decreased acuity or metamorphopsia may be noted. If medical treatment of CME is unsuccessful, focus should be directed on improving sight through low vision devices. Magnification allows for better vision by enlarging an image size and subsequently minimizing areas of distortion or scotoma in the retina.

CASE REPORT(S): A 19 year old black female with history of JRA and CME presented with a primary goal of being able to safely drive in the state of New Jersey, which requires 20/50 acuity in the better seeing eye and has no visual field restrictions. BCVA's were Hand Motion OD and 20/60 OS. Retinoscopic reflex was absent in OS secondary to an infero-temporally positioned PCIOL and subjective refraction with loose lenses revealed insignificant refractive error. A 3x Wide Field non-focusable telescope was compared to an Ocutech of the same magnification. The 3x Ocutech was accepted with much greater success because of an adjustable focus that allowed for correction of undetected refractive error. The combination of magnification and focus enabled the patient to see 20/20 at the time of exam and also provides a buffer for visual fluctuations due to CME. This device is optimal for driving since it is mounted superiorly on a frame which allows for peripheral viewing.

CONCLUSIONS: Medical intervention is the mainstay treatment for various ocular conditions. If treatment fails additional support must be considered to maintain quality of life and visual potential. Magnification with focusing capability is an ideal choice for individuals with macular swelling since increased metamorphopsia and hyperopic fluctuations are common with increasing disease severity. This case demonstrates the use of a telescopic device as an alternative approach to visual management of uveitis associated CME after failed medical treatment.
Affiliation of Co-Authors Pennsylvania College of Optometry at Salus University, Pennsylvania College of Optometry at Salus University
Outline