- •Geriatric Ophthalmology
- •Foreword
- •Preface
- •Contents
- •Contributors
- •Medical Knowledge
- •Case Vignette
- •Practice-Based Learning and Improvement
- •Patient Care
- •Medical Knowledge
- •Interpersonal and Communication Skills
- •Professionalism
- •Systems-Based Practice
- •Case Resolution
- •References
- •Refractive Error in the Geriatric Population
- •Case Vignette
- •Patient Care
- •Medical Knowledge
- •Interpersonal and Communication Skills
- •Professionalism
- •Systems-Based Practice
- •Scenario Resolution
- •References
- •Cataracts and Cataract Surgery
- •Case Vignette
- •Patient Care
- •Medical Knowledge
- •Interpersonal and Communication Skills
- •Professionalism
- •Practice-Based Learning and Improvement
- •Systems-Based Practice
- •Case Resolution
- •References
- •Glaucoma in the Elderly
- •Case Vignette
- •Patient Care
- •Medical Knowledge
- •Interpersonal and Communication Skills
- •Professionalism
- •Practice-Based Learning and Improvement
- •Systems-Based Practice
- •Case Resolution
- •References
- •Diabetic Retinopathy and Its Management
- •Case Vignette
- •Systems-Based Competency
- •Communication Skills and Professionalism
- •Management of Diabetic Retinopathy in Older People: Medical Knowledge and Patient Care
- •Management of Diabetic Macular Edema
- •Practice-Based Learning
- •Management of the Level of Diabetic Retinopathy
- •Case Resolution
- •References
- •Case Vignette
- •Patient Care
- •Management of AMD in Older People
- •Management of Intermediate and Often Large Drusen
- •Management of the Neovascular Stage
- •Impact on Patient’s Perception of Quality of Life Because of Vision
- •Case Resolution
- •References
- •Low Vision: When Vision Fails
- •Case Report
- •Practice-Based Learning and Improvement
- •Medical Knowledge
- •Patient Care
- •Interpersonal and Communication Skills
- •Professionalism
- •Systems-Based Practice
- •Case Resolution
- •References
- •Visual Loss and Depression
- •Case Vignette
- •Introduction
- •Practice-Based Learning
- •Communication Skills
- •Systems-Based Learning
- •Professionalism
- •Patient Care Summary
- •References
- •Visual Loss and Dementia
- •Case Vignette
- •Introduction
- •Perimetry
- •Neuroimaging
- •Practice-Based Learning
- •Communication Skills and Professionalism
- •Systems-Based Practice
- •Patient Resolution
- •References
- •Visual Loss and Hearing Loss
- •Case Vignette
- •Introduction
- •Practice-Based Learning
- •Communication Skills
- •Professionalism
- •Systems-Based Care
- •Summary
- •References
- •Visual Loss and Falls
- •Case Vignette
- •Introduction
- •Practice-Based Learning
- •Practice-Based Improvement
- •Systems-Based Learning
- •Communication Skills
- •Patient Care Summary
- •References
- •Elder Abuse
- •Case Vignette
- •Patient care
- •Five Common Manifestations of Adult Maltreatment (Adapted from. Lachs et al.3)
- •Medical Knowledge
- •Eight Red Flags for Elder Abuse (Adapted from Purdy10)
- •Interpersonal Skills and Communication
- •Nine Questions to Ask a Suspected Victim of Adult Mistreatment2
- •Professionalism
- •Practice-Based Learning and Improvement
- •Systems-Based Practice
- •Elder Abuse Resources (Adapted from Aravanis2 and Kleinschmidt 7)
- •Case Resolution
- •References
- •Functional Impairment and Visual Loss
- •Case Vignette
- •Practice-Based Learning and Improvement
- •Patient Care
- •Medical Knowledge
- •Interpersonal and Communication Skills
- •Professionalism
- •Approach to the Visually Impaired Patient
- •Systems Based Practice
- •Case Resolution: System-Based Practice
- •References
- •The Research Agenda-Setting Project (RASP)
- •Screening for Comorbidities
- •Case Vignette
- •Introduction
- •Practice-Based Learning
- •Communication Skills
- •System-Based Learning
- •Professionalism
- •Patient Care Summary
- •References
- •Refer Comorbidities
- •Case Vignette
- •Introduction
- •Practice-Based Learning
- •Communication Skills
- •System-Based Learning
- •Professionalism
- •Patient Care Summary
- •References
- •Index
Functional Impairment and Visual Loss |
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Systems Based Practice
The effect of eye disease on the functional vision loss needs to be recognized. Most persons with irreversible, subnormal vision can be assisted with properly selected optical aids.
It is the role of the doctors caring for these patients to make sure they receive low-vision care either on site or by referral to a low-vision specialist. We need to treat the vision loss as a medical problem and relate the diagnosis to a functional vision loss. Our history should include a functional history as well as the goals and expectations of the patient and family. Only then can we begin to treat and provide needed low-vision care.
Case Resolution: System-Based Practice
The ophthalmologist took care of the patient by making appropriate referrals to treat the whole patient and not just the eye pathology. He understood the relationship of vision loss to loss of independence and depression. He understood the functional vision loss of the patient and immediately could understand her difficulty with the oven and microwave. Being able to see the whole picture enabled him to provide the best care.
The patient visited the low-vision clinic where she was able to have her lowvision aids adjusted for her new environment. She also was put in touch with a group of contemporary folks with vision loss so she might be able to share her experiences. A vision-rehabilitation teacher visited the home and marked the dials on the kitchen appliances enabling the mother to see them. A largenumbered telephone was purchased as well so she did not have to try to see the portable phone located around the house with ‘‘tiny’’ numbers. Additionally, a new remote control device for the TV was purchased for her to enable her to see what she needed to. Both daughter and mother learned to share their fears and concerns and agreed to keep each other informed so they could have open communication.
References
1.Brody BL, Garnst AC, Williams RA, et al. Depression, visual acuity, comorbidity, and disability associated with age-related macular degeneration. Ophthalmology. 2001; 108:1893–1901.
2.Faye EE. A Functional classification of eye disease. In: Faye EE, ed. Clinical Low Vision. Boston: Little, Brown and Company; 1976:203–252.
3.Faye EE. Factors in visual function. In: Faye EE, ed. Clinical Low Vision. 2nd ed. Boston/ Toronto: Little, Brown and Company; 1984:171–196.