Functional Vision
Vision is our most far-reaching sensory ability, involved in nearly everything we do. The visual changes associated with PSP can prove disabling. The visual challenges that people with PSP may face include difficulties in downgaze, blurred or double vision, reduced blink rate( leading to painful, dry eyes), photosensitivity( especially outdoors in bright sunlight), interrupted smooth tracking and steady gaze, and a reduced ability of the eyes to converge while watching objects move closer.
OTs collaborate with other vision professionals to support improved functional vision. Those who have begun to experience vision difficulties will want to meet with each of the vision specialists, since they address different visual challenges. Physicians known as neuro-ophthalmologists specialize in identifying and treating eye problems caused by neurological processes. Neuro-optometrists, also called behavioral optometrists, can provide glasses with adaptive lenses for combatting double vision, photosensitivity, or visual tracking difficulties. These professionals work closely with OTs to address neurologically-based vision problems.
The OT’ s role in vision care may include recommendations for home modification, task adaptation, and assistive devices intended to help you optimize visual performance during everyday tasks. For instance, it is important to make sure that the lighting at home is bright but without glare, especially in the areas used for reading, cooking, grooming, or working. Clearing clutter from floors, cabinets, and work surfaces allows overtaxed eyes to find things more easily and helps minimize pathway obstacles.
Wherever possible, one should improve visual contrasts in the home. For example, wall switch faceplates and doorknobs may be replaced with contrasting colors to make better visual targets. Florid wallpaper can play havoc with already-challenged eyesight. Flat colors and clearly marked surfaces work better. An OT can visit the home to recommend changes tailor-made for the individual.
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For those with downgaze difficulty, a downward-tilted mirror at the bathroom sink or over the kitchen stove may help in seeing items that fall below the visual range. You can purchase mirrored prism glasses( see Resources below) that work in the same way as downward tilted mirrors, allowing one to read as always— by holding a book in the lap. Bookstands and tablet holders can be adjusted to keep reading material at eye level. Magnifying glasses, as well as increased print size and contrast on a tablet or computer screen, can help compensate for blurred vision. Tablets and computers also have the capability to read aloud any onscreen printed material. The OT can help you incorporate these tools and strategies.
Visual difficulties can make community outings a chore. Gray-tinted wrap-around glasses are a good choice for reducing photosensitivity in bright daylight. While walking, use of a cane can help identify surface changes and obstacles on the street. Allowing extra time for any activity in the community is advisable, as is seeking quieter outings at less busy times, so as not to overtax the visual abilities. The OT can teach a systematic head-bobbing technique to allow scanning the visual environment during walking.
Fall Safety and Mobility
If there have been falls or a feeling of weakness in the legs, a talk with an OT can provide ways to make everyday tasks safe. The OT may recommend a physical therapist for ambulatory challenges as well. A tub bench or shower seat may be very useful here. These sturdy, waterproof furniture items are available at medical equipment houses and pharmacies. They allow one to get in and out of the tub safely, sitting down first, then swinging the legs in. Taking a shower sitting down conserves energy while reducing the risk of falling. Adding a shower mat, a grab rail, and a shower hose may help as well. For those who prefer baths to showers, some newer hydraulically-driven bath chairs raise and lower one safely into and out of the tub. The OT can recommend exactly the right combination for the individual’ s needs and bathroom size.