FUNCTIONAL ASSESSMENT OF VISION: ADULTS

Name client: Julius Cesar Tan Age: 24

Area /Village: Punta, Sta. Ana, Manila Date: 2011-03-30
Eye problem and history: Acquired Optic Atrophy. He had a high fever for
one week and was rushed to the hospital.(sept.12, 1998) He was 12 years old
at that time. His vision blacked out after recovering from his fever. He was
referred to an ophthalmologist and was prescribed with polynerve and after
three months notorphyl was added to his prescription, his vision improved
to light perception but there was no further improvement after that.

Needs: Braille, cane, JAWS and TALKS software for gadgets

Best visual acuity RIGHT LEFT BOTH

DISTANCE NLP LP With glasses Yes / No
Prescription:
NONE

NEAR (Both eyes) ........... At distance of .......... cm

Test used:
With distance glasses Yes / No
With magnification Yes / No Kind: …… Power: …….

Contrast Needs good contrast (E.g. dark on light background) 

Can work with little contrast (E.g. white on white) 
We ask him to identify what is the color of our uniform (white) and we
presented a black, rectangular case and asked him to identify its color. We have
to move it at a very close distance for him to be able to distinguish its color.
Comments:
Better with good contrast, can also work with little contrast if place is
familiarized
Light client prefers /dislikes:
Indoors: Outdoors:
Comments:
Preferred normal lighting indoors, they use typical incandescent and fluorescent
light in their house.
Visual field Complete  Limited 
Comments: OD: Peripheral vision OS: Good central and peripheral vision
at close distance.
We move our fingers in all around his sides and he was able to identify it in
specific places.
Colour vision Any problems: Yes  No 
 Comments: problem with colour discrimination, this was tested by presenting
different sizes and colours of objects. We presented a black rectangular case, a
blue and violet candy. He recognized the black rectangular case at 8 inches from
him and was able to distinguish the colour and shape of the object. He failed to
recognize the difference between the blue and violet targets.

Visual skills: Record: 1 (= no problem), 2 (some difficulties /closer distance)

or 3 unable to do /very difficult) and any observations
3 – Patient found it very difficult to view objects even by moving it closer to
him. He cannot recognize faces of people, he uses his functional vision to
move around familiar places independently. (ex. RBI)

4 c. Mobility: (Avoid objects - route with obstacles) look at tracking / scanning

skills
1 - Good scanning and tracking skills here at RBI and other familiar places to
him, in these places he can independently move around even without the use of
cane. He has difficulty moving outdoors and in unfamiliar places, he lacks
orientation and landmarks to the place.
We observed that he can move around to RBI

8. Reading text: (fill in local language)…………..:  English: 

*. Circle Print or Print with magnification or Braille

Best size: Distance:
Material used: Braille

Comments:
Reading Text: with maximum effort in viewing, patient found it very difficult to
read even with visual aids, he reads letter by letter and slow to pick-up, therefore
preferred to use Braille. He is adept in using the Braille both in reading and
writing, he primarily used Braille for his studies and other writings.

9. Writing:

Speed: Size: Distance:….. cm

Readability:

Comments:
When writing, patient uses bold lines as guide, but he cannot read his own
writing anymore. When writing in Braille, he can write 1 ½ sentence per minute.
10 Non optical devices:
Prescribed: Stand Typoscope  Black pen  Writing guide Cap
Sunglasses Other:…..

Which are used? Cane, Braille, JAWS and TALKS software.

Comments:
He uses cane for travelling and moving in unfamiliar places.
11. Use of optical device for near tasks:
Used at… cm Correct distance: Yes / No

Used for:  Reading  Writing  Both Correct? Yes/ No

Comments: He don’t use any optical device, he uses Braille. He tried several
optical devices to improve his functional vision, but there was no improvement.

15. Comments on vocational skills, daily living skills:

With the best optical correction in aid, he still had a great difficulty in using his
vision for reading and writing, he reads letter by letter with maximum effort at a
very close distance. His writing skills are very poor, even with a bold writing
paper, he writes very slow and cannot even read his own writing. He decided
that using Braille and other non-optical devices are more beneficial to him.

He adapted easily, by being sensitive to his movements, by familiarizing himself

to places. he is well oriented to his house, he is notified if there will be any
change in the arrangements of households. Their house has good contrast,
they use white paint for their walls.

Recommendations

When in an unfamiliar place, a sighted guide is very helpful by guiding him to

specific places and helping him in familiarizing other places. At his age, he is
required to acquire advance mobility training to move independently, this is very
essential if he will have to work.
A GPS system is also beneficial in locating different places, since he is an IT
specialist, he can easily use softwares like JAWS and TALKS for a GPS system.
In travelling, giving landmarks to the patient is very essential for orientation. In
a mall, orienting him first to a map before touring him to the different places is
useful.
Making a visual map is very functional for low vision patients, it gives them
confidence in roaming around the place. Orienting him to the places is good, but
giving him a visual map first is better. In that way, he will easily memorize
places when actual orientation starts.

It is also important to train the sighted guide that will help him, it is not enough
to have a person who will guide him. That person should also know the proper
techniques and approach in handling low vision patients. He should also be
observant in the possible obstructions that can hamper the improvement of the
patient.

Since he is already a graduating IT student, We highly recommend an aid of an

occupational therapist. Having an occupational therapist can help him in being
more independent that will be applicable in seeking for his job. Occupational
therapists are also helpful in arranging the environmental settings of a patient to
maximize his remaining functional vision. In his case, light perception can be
maximized by adding contrast to the environment.

Better Contrast for indoors by changing colours of curtains and certain

household appliances, to improve awareness and mobility.
Since they have white walls, strong yellow coloured curtains are useful for more
awareness, placing distinct coloured mats over appliances, and highly
contrasting colours for his properties for better awareness and orientation.

Date /month to come for follow-up:

Name person who did assessment / report:
BAGASINA, EMMANUEL
DE LEON, RALPH LORENZ
DEAN, JOHN SHERWIN
GONZALES, MARK ANDREW
VALINA, JOSE MARI VIDAL