Low Vision Patient and Elderly People (5 cr)

Objective

The student are able to
tell the following about a person whose vision cannot be significantly improved by using conventional spectacles or contact lenses. The goal is that the person can utilize the remaining vision using magnifying aids and imaging techniques: (1) definitions of low vision and blindness; (5) light and lighting, (6) peripheral vision aids, (7) eccentric viewing and "steady eye strategy", (8) environmental adaptation (9) clinical procedures (10) studies in subjects with severe visual impairment (11) ) use of complicated aids, eg telescopes mounted on eyeglass lenses (12) filter glasses
The student are able to tell
(1) Effects of aging on vision and ability to work, (2) Age-related changes in perception (not related to vision), (3) Eyelid correction in cases of aphakia and pseudo-phakia, (4) Psychological effects of vision loss, (5) Clinical management of ageing patients with multisensory loss (6) Assessment of the need for referral and consultation with other disciplines

SKILLS
The student able to
evaluate the vision of the visually impaired and the elderly
recommend vision aids for the visually impaired and the elderly

Content

Defining low vision and blindness:
Disorder, impairment, disability and handicap
WHO definitions
Evaluation of handicap for legal purposes (haittaluokat)
Low vision: Incidence and causes, prevalence
Measuring visual performance:
Acuity and contrast sensitivity
Glare and its effect
Reading
Methods of magnification:
Increasing object size
Decreasing viewing distance
Real image magnification
Telescopic magnification
Non-optical aids
Illumination and lighting
Aids for peripheral field
Eccentric viewing and “steady eye strategy”
Environmental modification and accessibility
Electronic devices and applications to aid vision
Ageing effects on vision and functioning:
Physiological changes - general and ocular physiology and functioning
Changes in vision
Visual acuity
Contrast sensitivity
Refractive error
Colour vision
Spectral transmission of the ocular media
Light sensitivity
Glare (disability and discomfort)
Dark adaptation, glare recovery
Visual fields
Critical flicker fusion frequency
Accommodation and convergence
Oculomotor system
Changes in perceptual function (non-visual) associated with ageing
Hearing
Coordination
Cognition
Social status
Clinical procedures and tests identifying changes in vision function of the ageing patient
Psychological effects of vision loss and management of patients with poor visual prognosis
Clinical management of ageing patients with multisensory loss
Assessment of the need for referral and consultation with other disciplines

Location and time

Autumn Semester 2024

The practical exercises included in the study course are done in a controlled schedule and order in the campus training facilities. Tasks and exercises other than on-the-job training cannot be done under the supervision of working life.

Materials

The tasks and MATERIALS prepared by the teacher are covered by copyright law (Tekijänoikeuslaki 404/61), which guarantees the ownership of these materials to the teacher. Tasks and MATERIALS are not permitted to be used for purposes other than for individual studying. Dissemination of these materials is only allowed with the permission given by the teacher.

Lecture notes, articles
Web-source: Näkövammaisten liitto ry (Finnish Federation of the Visually Impaired): www.nkl.fi
Suggested literature:
Primary Care Optometry (5th Ed.) : Ch 17- Age-Related Vision Problems, pages 404-415, Ch 18- Age-Related Vision Loss pages 416-434, Ch 19- Care of the Vision-Impaired Patient pages 435-455.
Borish´s Clinical Refraction (2nd Ed. or newer) : Ch 35- The Elderly, pages 1571-1590, Ch 36- Patients with Low Vision pages 1591-1618.
Jane Macnaughton (2005): Low Vision Assessment. Ch 3- Adapting the eye examination for the visually impaired, pages 32-76. Ch 4 Determining and prescribing magnification, pages 77-98. Ch 7- Additional strategies and non-optical methods for improving visual performance, pages 154-170.
Riitta Lahtinen, Russ Palmer & Merja Lahtinen (2009) Aisti kuvailu (in English the same book: Environmental description for visually and dual sensory impaired people, 2010).
K M Saari (Ed.) (2011) : Silmätautioppi Ophthalmology (11th Ed.), Ch 24- Näkövammaisten kuntoutus, apuvälineet ja sosiaaliturva, pages 486-510. Appendix: Näkövammasta johtuva haittaluokitus pages 514-520.
Käppi, Anni; Laitala, Jenna (2009). Heikkonäköisen kuntoutuspolku Helsingin ja Uudenmaan Sairaanhoitopiirin alueella. Opinnäytetyö. http://urn.fi/URN:NBN:fi:amk-200912178230
Frigård, Katri; Dromberg, Elisa; Ojala, Maria (2016). Kun lasit eivät riitä : Opas heikkonäköisten apuvälinesovitukseen. Opinnäytetyö. http://urn.fi/URN:NBN:fi:amk-201604214732
https://www.theseus.fi/handle/10024/107133
Aaltonen, Laura; Itkonen, Jenni; Kemppinen, Emma (2015). Väliinputoajat : opas alentuneen näöntarkkuuden huomioimiseen optikkoliikkeessä. Opinnäytetyö. http://urn.fi/URN:NBN:fi:amk-201504234872
Practical Low Vision. Essilor Academy Europe 2013. http://www.essiloracademy.eu/en/publications/ophthalmic-optics-files
Ageing-review Optometry Today CET (2003) parts 1 ageing, definition; 2 examining, 3 visual function, 4 ant segm; 5 contact lenses, 7-17 ocular and general disorders in the aged population (cataract, post segm, amd, syst diseases causing ophthalmic manifestations 1&2)

Teaching methods

Interactive lectures
Guided practicals and assignments
Individual or group assignment

Exam schedules

Written examination: 25.11.2024. Retake 1: x.x.2024. Retake 2: x.x. 2025.

International connections

Implementation is offered to the incoming exchange students.

Student workload

Theory 2 ECTS:
Lectures and presentation 24-28 h and written exam 2 h. Individual study 30 h.

Independent tasks 2 ECTS:
Presentation preparation 10 h
Accessibility survey and 2 other written tasks 44 h

Clinical skills development 1 ECTS:
Practicals 14 h, 2x2h "grand rounds" at the clinic, independent preparation 9h

Total 135 h

Further information

If a student has a decision on special support arrangements affecting the course the student needs to contact the teacher in charge right after enrollment period.
Those enrolling through Open UAS: a completed optician or optometrist degree is required for entering the realization.

Instructions on the use of artificial intelligence during the course are given separately. Students should familiarise themselves with Metropolia's AI guidelines and follow them in their study attainments.

Part of the teaching may be conducted in English.

DETAILED CONTENT
Defining low vision and blindness:
Disorder, impairment, disability and handicap
WHO definitions
Evaluation of handicap for legal purposes (haittaluokat)
Low vision: Incidence and causes, prevalence
Measuring visual performance:
Acuity and contrast sensitivity
Glare and its effects
Reading
Methods of magnification:
Increasing object size
Decreasing viewing distance
Real image magnification
Telescopic magnification
Non-optical aids
Illumination and lighting
Aids for peripheral visual field
Eccentric viewing and steady eye strategy
Environmental modification and accessibility
Electronic devices and applications to aid vision

Ageing effects on vision and functioning:
Physiological changes - general and ocular physiology and functioning
Changes in vision
Visual acuity
Contrast sensitivity
Refractive error
Colour vision
Spectral transmission of the ocular media
Light sensitivity
Glare (disability and discomfort)
Dark adaptation, glare recovery
Visual fields
Critical flicker fusion frequency
Accommodation and convergence
Oculomotor system
Changes in perceptual function (non-visual) associated with ageing
Hearing
Coordination
Cognition
Social status
Clinical procedures and tests identifying changes in vision function of the ageing patient
Psychological effects of vision loss and management of patients with poor visual prognosis
Clinical management of ageing patients with multisensory loss
Assessment of the need for referral and consultation with other disciplines

Evaluation scale

0-5

Assessment criteria, satisfactory (1)

The student is able to:

- apply professional knowledge in the field appropriately
- use concepts and information in his field systematically
- argue a course of action on the basis of research information and findings
- find information and argue the use of his sources
- work in various duties depending on the assignment
- define the principles of and requirements for his actions
- show that he has achieved the targets for core competence
- find out the safety instructions concerning a word assignments and to act accordingly
- act according to the relevant professional ethical principles
- plan and guide the operation of multidisciplinary groups
- communicate about professional issues

Assessment criteria, good (3)

The student is able to:

- use concepts and knowledge in his field fluently and comprehensively
- assess and use information sources and research information with a critical eye
- apply research information to professional assignments
- operate in a range of work situations, also in international contexts
- act in a client- and customer-oriented way and as an entrepreneur
- act responsibly in work duties, taking safety issues into consideration
- evaluate actions from the viewpoint of professional ethics
- represent his professional field in multidisciplinary and international groups and projects

Assessment criteria, excellent (5)

The student is able to:

- display a good understanding of professional information
- use theoretical and professional concepts and knowledge like an expert and combine them into larger entities
- create and communicate new information
- develop innovative and alternative solutions to professional assignments and problems
- apply professional expertise in new situations - take responsibility for a professional process in its entirety
- develop the community's safety and responsibility
- apply professional ethics in various situations
- manage the professional development of individuals/groups
- act purposefully and to develop himself and working life

Assessment criteria, approved/failed

The student is able to:

- apply professional knowledge in the field appropriately
- use concepts and information in his field systematically
- argue a course of action on the basis of research information and findings
- find information and argue the use of his sources
- work in various duties depending on the assignment
- define the principles of and requirements for his actions
- show that he has achieved the targets for core competence
- find out the safety instructions concerning a word assignments and to act accordingly
- act according to the relevant professional ethical principles
- plan and guide the operation of multidisciplinary groups
- communicate about professional issues

Assessment methods and criteria

Attending lectures, experience expert sessions and investigative techniques practicals and the lecture on Psychological aspects of visual impairment.
Learning assignments (30% of the final mark and three written tasks pass/redo)
Written tasks: Outline for low vision examination, Two case studies and Accessibility task.
Written examination (70% of the final mark)
Assignments at the practicals finished and evaluated (verbal feedback at the practicals)

Qualifications

Binocular Vision