Aston University

Elizabeth Bartlam BSc (Hons) FBDO (Hons) LVA

History, symptoms
& requirements
Is it an initial assessment or
follow-up?
If follow-up, when was the
patient last seen?
Who referred them?
Status:
Married, live lone, family,
job, retired?
Condition:
When diagnosed, where
diagnosed, does patient
understand condition?
History, symptoms
& requirements.
Establish patients needs:
Find out what patient
wishes help with. (can use
a quality of life
questionaire (QoL)).
Questions that can be asked:
Do you have difficulty with
reading?
Do you have difficulty
getting ready and carrying
out your day to day tasks?
Do you have difficulty
getting around safely?
Do you have difficulty
watching T.V?
Do you have difficulty with
bus numbers, street signs
and names of shops?
History, symptoms
& requirements.
Do you have difficulty with
your work?
Do you have any hobbies?
Do you have difficulty with
these?
How does your vision
make you feel?
Do you feel motivated to
try new things?
History, symptoms & requirements.
Patients description of vision, in their own words.
Make a note of patients expectations.
What are the three most important items that the
patient requires help with, in order of priority.
Last Eye
Examination.
Date of last
examination.
Where was
this?
Previous Ocular Health.
Is the patient registered?
When and where?
Is the patient under HES?
Which one, name of consultant? Last appointment?
Next appointment?
Has the patient had any treatment?
Has the patient has any other ocular problems?
Are there any ocular health problems in the family?
General Health.
Name and address of G.P.
Any other health problems?
Are there any health problems in the family?
Does the patient smoke?
Medications? Including any supplements?
Contact.
Social services? How do
they help?
Organisations or self-
help groups?
Current spectacles/contact lenses.
Record Rx.
Monocular VA.
Binocular VA.
What type? Description.
usage?
Refraction check
details.
Ret details.
Subjective details.
Any significant difference?
Referral to optometrist?
Any further tests you have
performed?
Do ensure their is
justification on what
further tests you have
performed. What
information will it give you
to help the patient?
Starting magnification.
Calculate and state.
Do consider the duration of the task the patient wishes
to achieve as well as the size.

Achieved VA/required VA = Starting mag.
Current Aids.
Make?
Model?
Type?
Mag?
VA achieved with?
Fluency?
Lighting used?
Working distance.
Eye used?
What it is used for?
How does the patient cope
with the aid?
Aids tried.
Record the same as current
aids.
Did you issue/order/loan
aid?
Can you justify your
choice?
Non-optical aids
and advice.
Any non-optical aids used?
Do you advise any?
What advice have you given?
Use of aid?
Contrast?
Supplements?
Lighting?
Etc. Do ensure you can
justify youy choice of
noa & advice.
Reports.
Social services?
G.P?
Patients optometrist?
Hospital consultant?
Counselling?
Any other services?organisations?
Do ensure you can justify why you have sent a
report/referred to where you have.
Follow-up.
When you wish this to occur?
Do ensure you can justify why you have chosen this time
scale.
Anything specific you would like covered in the follow-
up?
Further tests, training, etc.
General health
Low vision patients can be elderly and will therefore
suffer from the conditions that affect the elderly.
You may one day come across a patient who is
suffering from dementia.
To understand this condition please visit:
www.alzheimersresearchuk.org

Elizabeth Ann Bartlam BSc (Hons) LVA (Hons) FBDO
Bar magnifier
Comes in low powers of
approminately 2 x
Use by placing on the print.
Magnifies in one direction
which avoids distortion of
the image.
Useful for patients who
require a magnified image
such as those with a central
field defect.
Hand magnifiers
These are easily portable
devices.
If held at its focal length
then distance vision glasses
are to be used.
If the magnifier is held closer
than its focal length then
near vision spectacles are to
be used.
They are useful for central
field defects by magnifying
the image.
If used incorrectly then the
image will suffer from
aberrations.
Hand magnifiers can come
with internal illumination.
Hand magnifiers have a good
range of powers (up to
approx 12.5 x) and are
economical in comparison to
stand or spec mounted aids.
To train the patient to use a
hand magnifier.
Ask them to firstly raise the
magnifier away from the
object until it appears clear.
Then with the magnifier to
object distance set, ask them
to bring the magnifier and
object towards .
This helps increase field of
view.
Stand magnifier.
This is placed on the print
and is therefore useful for
patients who are unable to
hold a hand magnifier.
Stand magnifiers magnify
the image and therefore are
useful for patients with a
central field defect.
Stand magnifiers can come
with internal illumination.
Stand magnifiers can be
illuminated with either a
battery handle or a mains
supply handle.
Low power magnifiers will
have a longer working
distance and enable both
eyes to be used.
Higher power magnifiers will
mean a shorter working
distance and only one eye to
be used.
Stand magnifier.
The focal length of a stand
magnifier is usually longer
than the stand.
Therefore divergent rays
leave the magnifier meaning
an addition is required to be
worn if the patient does not
have sufficient amplitude of
accommodation.
Stand magnifier
with cantilever
head.
This allows patients better
posture as tilts the magnifier
towards the patient to
prevent them leaning over it.
Stand magnifier
with guideline.
The guideline will assist with
tracking.
Neckchain
This rests on the chest and is
therefore hands free.
Neck chain
It is suitable for hands free
tasks such as sewing.
It comes in relatively low
powers.
However it can have a small
button within its aperture
that provides a higher power
for tasks that require it. E.g
threading a needle.
Telescopic fitting
set.
Here there are galilean
distance vision telescopes
that can be spec mounted.
There are a series of reading
caps to convert to near vision.
There are also higher power
hand-held terrestrial
telescopes
(astronomical/Keplerian).
The rays of a telescope for a
distance object will enter
parallel & emerge parallel.
To view a near object, the
telescope will require
adaption.
One way to do this is to fit a
reading cap to neutralise the
divergent vergence arising
from a near object.

Terrestrial
telescope.
A terrestrial telescope literally
means used for land. As
opposed to astronomical which
is for use during astronomy.
The difference is that an
astronomical telescope will
produce an inverted image. A
terrestrial telescope will utilise
a prism system to make the
image upright.
The use of prism also shortens
the optical system.
Galilean telescopes go up to
2-3x magnification.
Beyond this a terrestrial
(astonomical/Keplerian) is
used.
Galilean distance
telescope with
reading cap.
A distance vision telescope
with a reading cap. The
telescope is Galilean. The
reading cap allows it to
become a near vision
telescope.
Telescope with
finger ring.
Telescopes can be used for
distance tasks. Such as
spotting bus numbers or
viewing train timetables.

The patient must be trained
to focus a telescope.
Some telescopes have a slide
for focussing instead of a
wheel/twist system. This is
generally easier to use and
can be done with one finger.
A finger ring attachment
helps make the appliance
easier to hold.
Spec mounted
distance vision
telescope.
Useful for watching
television or stationary
distance tasks.
Telescopes cannot be used
for mobility.
They have a restricted field of
view.
Near vision
telescope.
These can be spec mounted.
These provide a longer
working distance than an
simple magnifier.
This device consists of
Fresnel prisms.
This creates magnification
but also helps maintain a
lightweight lens.
Filters.
Filters can help improve
patients contrast sensitivity.
Filters help reduce glare.
Different pathologies may
require a different coloured
filter or a different LTF.
Non-Optical Aids
Liquid level indicator.
This device allows patients to make drinks without
overspilling.
It consists of 3 prongs that when hung over the edge of
a cup will make an audible sound when liquid reaches
the lower two of the prongs.
The first audible sound will allow enough room for
milk to then be filled into the cup.
Once the milk is filled, the fluid rises to the third
prong and the second audible sound is emitted. This
instructs the patient to stop.

They have a magnetic back.
This allows the first
The following is a whole power point. Click on it
to scroll down to all the slides.
Elizabeth Bartlam BSc (Hons) FBDO (Hons) LVA SMC
(Tech)
Aston University. Optometry Department.