Talk:Low Vision Rehabilitation/Lionel Messina

Questions relating to Lionel.

1. You tested Lionel's contrast using the Pelli Robson test. Why is contrast sensitivity an important factor for Lionel?

CS is a significant predictor of reading and mobility performance.

2. What is the difference between discomfort glare and disability glare?

Discomfort glare - discomfort when person is suddenly exposed to higher level of light than to which they are adapted.

Disability glare - when loss of contrast occurs due to something like a reflection from a shiny page or light source.

3. Lionel complains of problems with glare and light/dark adaptation. How can you assist him with this problem?

Dark filters/glasses with side shields. Patient chooses which colour/shade is most comfortable across a variety of lighting situations.

4. Apart from the scanning techniques described in the lectorial, what else can you suggest for Lionel to enhance his visual field?

"Reversed telescopes" i.e. minifiers

5. Paying particular attention to the article by Herse, what multi-disciplinary/external services would be useful for Lionel? Describe these in detail.

O&M training

Assistance with ADLs

Adaptive technology

Employment assistance

Disability support and blind pension

6. Can Lionel drive? Justify your answer and what tests you need to conduct to reach a conclusion.

He legally cannot drive, his visual fields are too severely constricted. A binocular Esterman is needed to determine this and he must have a binocular field no less than 120 degrees horizontally and 10 degrees supriorly and inferiorly.