1. Visual impairment.

2. 2 Objectives  Leading causes of visual impairment and blindness in the U.S.  How to assess a patients vision and ability to identify and properly use medications  Identify strategies for assuring appropriate medication use in patients with visual impairment

3. 3 Leading Causes of Visual Impairment  Cataracts  Glaucoma  Age-related macular degeneration  Diabetic Retinopathy

4. 4 Cataracts  Clouding of the lens due to protein clumping.  Leading cause of blindness in the world and leading cause of low vision in U.S.

5. 5 Cataracts  Link to animation showing cataract formation  http://www.allaboutvision.com/con ditions/cataracts.htm http://www.allaboutvision.com/con ditions/cataracts.htm

6. 6 Example of what vision might be like for a person with cataracts

7. 7 Glaucoma  Disease of the optic nerve that is usually associated with (but not always) increased intraocular pressure and can lead to decreased vision, blindness  Two kinds Open-angle Angle-closure

8. This picture is recreated from "Understanding and Treating Glaucoma" a Human Anatomy Board Book by Tim Peters and Company, inc. Gladstone, NJ8 Glaucoma Link to animation showing flow of aqueous humor http://www.theschepens.org/eye_disease_fact_sheet.htm

9. 9 Example of what vision might be like for a person with glaucoma

10. 10 Age-Related Macular Degeneration (ARMD)  Associated with aging and gradually destroys sharp central vision  Slow breakdown of the light-sensing cells in the macula (central part of retina that helps for central vision)  Two kinds of ARMD Dry – 90% of patients Wet – 10% of patients but 90% of blindness due to ARMD is from wet ARMD  ARED study

11. 11 ARMD

12. 12 Example of what vision might be like for a person with ARMD

13. 13 Example of what vision might be like for a person with ARMD

14. 14 Diabetic Retinopathy  Damage occurs to the tiny blood vessels that nourish the retina.  Leading cause of blindness in the industrialized world in people ages 24 – 74

15. 15 Example of what vision might be like for a person with diabetic retinopathy

16. 16 Assessing a patients ability to identify and properly use medications  Ask  Introduce yourself and identify yourself  What are some counseling techniques and aids you could use to assist someone with low vision.

17. Statistics and pictures from National Eye Institute, National Institutes of Health References  Handbook of Nonprescription Drugs, 14 th Edition.  Applied Therapeutics, The Clinical Use of Drugs, 8 th edition.  National Eye Institute: http://www.nei.nih.gov/ http://www.nei.nih.gov/  MedicineNet.com http://www.medicinenet.com/glaucoma/a rticle.htm http://www.medicinenet.com/glaucoma/a rticle.htm  All About Vision http://www.allaboutvision.com http://www.allaboutvision.com