Monday, 4 June 2007
Vision
I write this blog to highlight the importance of vision and what role physios play with eyes. I have a stroke pt whose only impairment is a "lazy" eye, no limb involvment or cognitive aspects. This has marked effects on the pts balance which is making the pt feel unsafe. My treatment has consisted of active movments of the "lazy" eye and getting the pt to focus on something far away then close. The pt is also instructed to wear an eye patch for an hour in the am and 1 hour in the pm. This has had great results with the pts balance and makes the pt feel safe. Therefore it is important to tell the pt that they can't wear it all day because the unaffected eye will then become "lazy". This was an issue with my pt so i needed to supply extra education. I have treated the eye muscle just like any other muscle in the body, and followed the same principles of retraining. If you have a stroke pt in the future whose balance is not crash hot take a closer look at the eye and see if thats the impairment.
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2 comments:
i agree. Vision is so important for balance especially in older people! i recently had a patient with a similar problem- his sight defecit following a stroke, was impairing his balance and making him a falls risk. We actually referred this patient onto an optomotrist in leederville who specicalizes in visiual problems in patients following stroke. Although there were some strategies that us as physios were able to implement, in this situation it was felt that further help was required. so i think that it is good to keep these types of places in mind when dealing with patients whose impairments may by treated better by a specialist in the field (but what you did for treatment dickie sounds pretty good).
Good on you dickie,your case is really interesting and i've never seen such a case before.I just wonder when you retrain the eye's muscles,do you ask patient to stare at the tip of a pencil and then you move the pencil around? Do you retrain diagonal eye movement as well?From my understanding, both eyes always look at the same direction,is that possible to use the eye on the unaffected side to facilitate the affected eye?Sorry for asking so many questions but i am relly interested.
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