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Fall Prevention & Vision Aids
January 15, 2020 12:00 PM EST
Dr. Ana M. Juricic
THIS WEBINAR IS BEING RECORDED.THE SLIDE DECK AND RECORDING WILL BE
EMAILED AFTER THE WEBINAR.
STAY IN THE LOOP!WWW.FALLSLOOP.COM
WWW.JR.FALLSLOOP.COM
THIS WEBINAR IS BEING RECORDED.THE SLIDE DECK AND RECORDING WILL BE
EMAILED AFTER THE WEBINAR.
STAY IN THE LOOP!WWW.FALLSLOOP.COM
WWW.JR.FALLSLOOP.COM
Fall Prevention & Vision Aids
January 15, 2020 12:00 PM EST
Dr. Ana M. Juricic
Fall Prevention:
What you need to know
about visionDR. ANA M. JURICIC
LOW VISION OPTOMETRIST
LOOP FALL PREVENTION – JANUARY 15, 2020
TORONTO, ONTARIO
Poll Question
What field of health care are you in?
A. Occupational Therapy
B. Physiotherapy/Kinesiology
C. Nursing
D. Eye health care professional
E. Low Vision Therapist/Orientation and
Mobility
F. Government and/or Management
G. None of the above
www.DrLowVision.com
Poll Question
If you are in health care, how many hours
on average a week are you involved with
direct patient care?
A. 0-5 hours
B. 6-10 hours
C. 11-20 hours
D. 21-30 hours
E. 31 or more hours
www.DrLowVision.com
Canadian Patient Charter for Vision Care:
Estimated 5.5 million Canadians live with a vision threatening eye condition
Of whom nearly 500,000 already are blind or partially sighted
Patients have a right to: Receive a timely referral and access to the full spectrum of care in their journey through vision loss, from an ophthalmologist’s or optometrist’s initial assessment to the rehabilitation professional’s delivery of intensive therapy, including any required specialized training to allow them to live safely, independently and with dignity
The Canadian Patient Charter for Vision Care was signed on May 7, 2015 and was signed by all the leaders in Vision Health and CNIB
www.DrLowVision.com
Vision Loss Facts
BY AGE 65, 1 IN 3 CANADIANS WILL HAVE AN EYE DISEASE
LEADING TO CHANGES IN VISION
1 IN 9 SENIORS WILL HAVE IRREVERSIBLE VISION LOSS
WITH VISION LOSS IT IS COMMON TO LOSE INDEPENDENCE
www.DrLowVision.com
Vision Loss Can Lead to:
Declining health
Disability
Need for Assisted Living/Retirement
Facilities
Depression
Frequent Falls
www.DrLowVision.com
Statistics of Falls in
Canada
1 in 3 Canadians over the age of 65
are at risk of falling at least once
Having impaired vision more than
doubles the risk of falls
Unintentional falls resulted in almost
1,800 reported emergency
department (ED) visits and 417
hospital stays EVERY DAY in 2016-2017
in Canada
www.DrLowVision.com
How to avoid vision loss?
Vision loss is avoidable under regular care of an
optometrist
Comprehensive eye examinations will detect any eye
health or vision problems before they have a toll on
day to day life
For seniors, annual eye examinations are recommended
(more often if being monitored for an eye condition)
For 20-65 yrs old, eye examinations every 2 years or
sooner if any eye conditions
Children, eye examinations every year
www.DrLowVision.com
Poll Question:
How many clients/patients a month do you see who live
with vision loss?
A. 0-5
B. 6-20
C.21-50
D. 51 or more
www.DrLowVision.com
Vision Loss can lead to 6X increase risk of depression
www.DrLowVision.com
Poll Question:
Do you have a family member or friend who is living
with vision loss?
A. YES
B. NO
www.DrLowVision.com
DID YOU
KNOW…
1 in 3 Canadians will suffer from vision loss by the age of 75
1 in 3 will have difficulty:
Reading the paper
Driving
Watching TV
Identifying peoples faces
Increased Risk of Falls
www.DrLowVision.com
Main causes of Vision Loss:
Macular Degeneration
Glaucoma
Cataracts
Diabetic Retinopathy
Hereditary conditions
Ocular injury
www.DrLowVision.com
How does the eye work?
www.DrLowVision.com
MACULAR
DEGENERATION
www.DrLowVision.com
▪ LEADING CAUSE OF VISION LOSS IN
WESTERN WORLD
▪ APPROX 2 MILLION CANADIANS AND 13 MILLION AMERICANS ARE AFFECTED
WHAT IS MACULAR DEGENERATION?
MACULA RESPONSIBLE FOR FINE
DETAIL AT THE BACK OF THE EYE
WITH MACULAR DEGENERATION
THERE IS DISRUPTION OF THE
RETINAL LAYERS AT THE MACULA
LEADING TO DISTORTED VISION
www.DrLowVision.com
TWO TYPES OF AMD
www.DrLowVision.com
Macular Degeneration
DRYMacular
Degeneration(~85%)
WETMacular
Degeneration(~15%)
10 – 20 % of Severe Vision Loss 80 – 90 % of severe vision loss
AMD and Stargardt’s
– central vision loss
www.DrLowVision.com
Glaucoma
Statistics
www.DrLowVision.com
Over 4 million Americans and 350,000 Canadians have glaucoma, but only half of them know they have it.
Glaucoma is second leading cause of blindness according to World Health Organization
Glaucoma
–
peripheral
vision loss
www.DrLowVision.com
Cataracts
Cloudiness of the
natural lens of the eye
located behind the iris
More than 2.5 million
Canadians have
cataracts
www.DrLowVision.com
Cataracts-overall blurriness
www.DrLowVision.com
Diabetic
Retinopathy
Approx. 2 million Canadians are diabetic
500,000 have diabetic retinopathy of which
100,000 have severe vision threatening forms
Leading cause of new cases of blindness
among adults aged 20-64 yrs old
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Diabetic
Retinopathy
– vision loss
www.DrLowVision.com
Retinitis Pigmentosa – tunnel vision
Approx. 1 in 3500 Canadians are
affected
100, 000 in the US
20-30% of RP individuals also
have other conditions such as
Usher’s syndrome which has
hearing loss
www.DrLowVision.com
Albinism
Individuals with albinism have
little or no pigment in their eyes
and possibly with their skin and
hair
Do not produce usual amounts
of a pigment called melanin
1 in 17,000 in USA
have some degree
of albinism
www.DrLowVision.com
Stroke and Ischemic Optic Neuropathy
Often can cause visual field loss which will
increase risk of
bumping into things and people
Missing steps
Walking into doors/glass walls
www.DrLowVision.com
What Is
Legally Blind
vs Low
Vision?
www.DrLowVision.com
Legally Blind = central acuity is 20/200 or less in the better eye, even with corrective lenses OR if the peripheral field is restricted to a diameter of 20 degrees or less
Low Vision = central acuity is 20/70 or less in the better eye even with correction
FACT:
Approx. 80-90% of legally blind individuals have some degree of
usable vision
www.DrLowVision.com
Only 2% of legally blind people
use a guide dog and 35% use a
white cane according to the
Braille Institute.
There are many faces to vision loss…
www.DrLowVision.com
…and many solutions.
What may help some may not help others even if they have the same condition.
www.DrLowVision.com
WHAT SOLUTIONS ARE AVAILABLE?
www.DrLowVision.com
Low Vision Exams can
help provide solutions to
maximize the intact vision
www.DrLowVision.com
Low Vision Exams are different than routine
exams
www.DrLowVision.com
Low Vision Exams are customized to each specific patient
www.DrLowVision.com
• Vision Goals will be addressed
• Updated refraction
• Glare and photosensitivity will be addressed
• Distance and Near aids will be shown
• Will show NEW electronic aids
Exam will take 1-1.5 hrs
• Many provinces there may be a fee for Low Vision Rehab Assessments
Specialized exam
Vision Goals Need to Be Addressed
Near
• Read
newspaper/books/mail
• Read medication bottles
• See price tags, labels
Distance• See faces of loved
ones
• TV watching
• Theatre and live events
Glare
• Sunlight
• Indoor glare
• Glare from screens
(computer etc)www.DrLowVision.com
Medication Side Effects Can Affect Vision causing:
Dizziness, dryness of eyes and muscle weakness
Increased risk of medication error
Double the risk of falls
Triple the risk of depression
Quadruple the risk of hip fractures
www.DrLowVision.com
“CAN’T YOU JUST
MAKE THE GLASSES STRONGER?”
www.DrLowVision.com
A GOOD REFRACTION IS IMPORTANT
Stronger glasses for near may be prescribed in the form of reading glasses or bifocals/progressives
Very important to educate patient that the focal
point in the reading area is much closer and if
they look in this area while looking at floor – RISK
OF FALLING
If a patient has COGNITIVE issues this may not be
the best option if does not have a caregiver or
family member who can supervise
www.DrLowVision.com
Glare cutting
lens tints
www.DrLowVision.com
• Corning lenses
• Noir tints
• Fitovers
• Polarized Sunglasses
• Blue Blocking Lenses
U2 lead singer Bono wears glare blocking sunglasses due to his glaucoma
www.DrLowVision.com
Goal of Low Vision Exams
Address the patient’s goals
Increase a sense of independence
Decrease risk of depression by providing vision solutions to be able to
accomplish important daily living tasks
Address any safety issues especially if at higher risk of falls
www.DrLowVision.com
Evaluate Near Viewing Devices:
www.DrLowVision.com
Magnifiers: dome, hand held, stand , illuminated and non-illuminated
Prismatics
Near Focus Binoculars
Digital
Reading
Devices
www.DrLowVision.com
High Tech Reading Aids
*CCTVs
*OCR readers*ZoomText*Jaws*Kurzwell
www.DrLowVision.com
Distance Viewing Aids
Helpful aids for distance viewing
Not to be used while walking and looking through telescopic lens
Will magnify floor too much
HIGH RISK OF FALLING OR TRIPPING
Headborne Telescopes and
Binoculars
www.DrLowVision.com
Binocular clip for TV viewing, looking at faces, watching live events including theatre
www.DrLowVision.com
New High Tech Devices
www.DrLowVision.com
eSight 3 - Electronic Eyewear
eSight 3 eyewear
Electronic Digital Eyewear
allow user to see DISTANCE,
INTERMEDIATE AND NEAR!
CAUTION: user needs to flip device up in bioptic mode when walking to avoid falls
www.DrLowVision.com
IrisVision – using a Samsung smartphone
CAUTION: NOTE TO BE USED WHEN WALKINGwww.DrLowVision.com
OrCam 2.0 -OCR technology
Converts TEXT to
SPEECH, identifies
known faces and
currency, tells you the
time, has auditory
commands
www.DrLowVision.com
Coming in spring 2020, voice activated guiding
You can ask:
“What’s in front of me?”
It may respond: “It’s a door”
You can ask it to guide you to the door
www.DrLowVision.com
OrCam at Vision Quest Conference
www.DrLowVision.com
Aira (EYE-rah)
Augmented Reality smartglassescombined with trained professional
AIRA IS ON A MISSION TO PROVIDE
INSTANT ACCESS TO VISUAL
INFORMATION FOR ANYONE, ANYTIME,
ANYWHERE.
www.DrLowVision.com
The smartphone is the biggest
revolutionary invention for the visually
impaired and blind since Braille.
www.DrLowVision.com
ADVANCEMENTS WITH SMARTPHONES
•Zoom magnification
•Contrast adjustments
•Voice Over
•Talking virtual assistant
•Endless Apps available
Be My Eyes – Free app
Over 1.5 Million
volunteers
available to assist
over 93,000
registered partially
sighted and blind
individuals in over
150 countries
www.DrLowVision.com
Seeing AI –free app from Microsoft
Narrates the world around you
Designed for the blind and low
vision community, harnessing the
power of AI to open up the visual
world and describe nearby
people, text and objects.
OCR/Facial Recognition
www.DrLowVision.com
Navigation
Apps
Parapan athlete Tiana Knight navigating using BlindSquare
• Blindsquare
• iBeacon (indoor
App)
www.DrLowVision.com
Sensing your surrounding USING ECHOLOCATION AND ULTRASONIC DETECTION
Sunu Band $410 CDN Buzz Clip approx. $350 CDN
www.DrLowVision.com
Voice Activated Assistants
Siri on Iphone
Alexa on
Amazon Echo
Google home
Can be used to tell time, weather, recipes, sport scores etc from within your house
www.DrLowVision.com
Sometimes the solutions may look different...if it allows a person to live more independently and minimize depression, Is it worth it?
Helping
People
See
Again
www.DrLowVision.com
Three C’s for Living with Low Vision
Colour
Contrast
Cues
www.DrLowVision.com
High contrast
coloured tape
on stairs
www.DrLowVision.com
PAINT DOOR FRAME HIGH CONTRASTING COLOURCOMPARED TO WALL COLOUR
*OPAQUE CUPS, DISHES BETTER THAN
CLEAR GLASSES
www.DrLowVision.com
Extra lighting
*sconces, task lights, night lights* if difficulty seeing in night, use a flashlight
www.DrLowVision.com
In Bathroom:
*Good lighting
*Use high contrasting towels, floor mats that are non slip
www.DrLowVision.com
With cross collaboration we can let people know
“Help is Available”
www.DrLowVision.com
Resources for
those living with
vision loss…
Low Vision Eye Care Professionals
CNIB /Vision Loss Rehab of Ontario
Balance For Blind Adults (Etobicoke)
Vision Institute
OCAD Vision Tech Services
Fighting Blindness Canada, Canadian Council for the Blind,
Toronto Visionaries and more.
www.DrLowVision.com
Resources
for those
living with
vision loss…
Auxilliary Health Care Professionals
Certified Low Vision Therapists (CLVT)
Certified Orientation & Mobility
Specialists
Occupational Therapists (OT)
Physiotherapists
www.DrLowVision.com
What can you do to protect your eyes?
Wear 100% UV blocking sunglasses/hat
Eat green leafy vegetables and colourful fruits
Use multivitamins with carotenoids
Yearly eye examinations, or sooner
Stop smoking
www.DrLowVision.com
New Pilot Project – In home training
Objective: Increase
success with
prescribed vision aids
Decrease frustration
associated with the
learning curve of using
a new device
Free of charge service
for eligible patients +
www.DrLowVision.com
COMMUNITYLET YOUR PATIENTS/CLIENTS KNOW THAT THEY ARE NOT ALONE
Local Resources Toronto has many organizations focusing on the visually impaired and blind
Find out which support groups are in your area like:
Canadian Council for the Blind’s Toronto Visionaries
www.DrLowVision.com
Challenge to you:
Find out
Find out who in your area provides low vision rehab services
Find out
Find out what local organizations/health care professionals are available that you can refer clients/patient to
Educate
Educate individuals you meet that there is HELP THAT IS AVAILABLE
www.DrLowVision.com
With cross collaboration WE CAN make a difference
www.DrLowVision.com
www.DrLowVision.com
EVERYONE DESERVES
TO “SEE” THE BEAUTIFUL
THINGS IN LIFE!
Email: [email protected]
Questions?
Type your questions into the Q&A box.
THIS WEBINAR IS BEING RECORDED.THE SLIDE DECK AND RECORDING WILL BE
EMAILED AFTER THE WEBINAR.
STAY IN THE LOOP!WWW.FALLSLOOP.COM
WWW.JR.FALLSLOOP.COM
