Geriatric Optometry MT II - Non-trad + driving

Older patients prefer appointments at what time of the day?

Mid-morning

What is a retinomax?

Handheld autorefractor

What is the portable lensometer range?

+/- 15.00D

The perkins tonometer is basically a handheld Goldmann tonometer, so you definitely need a bottle of...

fluorescein

What is the iCare?

IOP device, uses "rebound" (not applanation) technology. No anesthetic req'd, but probe actually touches cornea

What are the components of the minimum database?

Review "Examination" slide on pg 5

T/F - If using a medical facility in treating a patient, the charts of your patients are your property.

False - property of the facility

T/F - There is a billable code for home bound visits.

True

T/F - You can use your office as the billing address.

False - can't do this!

Medicare Part A?

Hospital insurance - pays for nursing home

Medicare Part B?

Medical insurance

Medicare Part C?

Medical advantage plan - private health insurance vs A/B

Medicare Part D?

Prescription drug plan

What is the trend of traffic accidents since 1961?

- Incr 1961-1966
- Dropped 1974 since fuel crisis and 55 mph speed limit
- 1970s-80s = stable rate
- Late 80s = decline

T/F - Accident rates with age decline but least with older population.

True

T/F - Older drivers drive the fewest miles and have the lowest rate of crashes per mile driven.

False - have highest rate of crashes per mile driven

Fatality risk of older pts at 70 yo is __x more than age 20.

3

Peak of age specific traffic accident deaths at what age?

18 yo

Total driver fatalities has (decr/incr), and drivers 65+ fatalities (decr/incr).

decr, incr

T/F - Younger drivers are more involved in fatal accidents than older.

False - older drivers involved in more fatal crashes

T/F - Older drivers are more responsible for crashes they are involved in.

True

T/F - Older drivers are involved in about the same number of multivehicle crashes as younger drivers.

False - more multivehicle crashes in older

__% of all motor vehicle crashes related to poor vision.

50

Vision accounts for __% of information drivers use to operate a car.

90

What is UFOV?

Useful Field Of View - size of VF in which useful information can be acquired in a single glance.

Older adults have __% reduction in UFOV.

40

Older adults with reduction of UFOV are __x more likely to get in a crash vs those with no reduction.

6

T/F - No states have laws that have UFOV requirements at this time.

True

T/F - Most older adult traffic fatalities with other cars are in the evening.

False - straight roads, daylight hrs, at intersections

Males have __x more risk of crash than females.

2

T/F - More crashes for older people occur at night, with bad weather and poor road conditions.

False - few crashes in these conditions (maybe b/c elderly decide not to drive in these cond)

T/F - Largest elderly populations tend to be more lax with driving regulations.

True

*What is the vision standard in CA for driving?

- 20/40 OU with or without correction, AND
- 20/40 in one eye AND
- 20/70 in the other eye

- Worse than 20/200 will not be licensed to drive

*T/F - In CA, drivers 60 and over cannot renew by mail.

False - 70 and over

*T/F - In CA, must renew in person every 5 years.

True

What happens if you fail the vision standard?

You get handed form DL-62, Report of Vision Examination

T/F - The DMV has the final say of the driver's license, regardless of the exam results.

True

T/F - If you make a mistake on the DL-62 form, you must use a fresh new form.

True - cannot make corrections

Dr L. said if the patient has good vision, what should you check off for when the pt needs a new DMV exam form?

Check off "5 years", but if worse then put less

What is the key number in the visual field test for DL-62?

120 degrees; if CF=FTFC, then 60 degrees per eye, 60 x 2 = 120 degrees

T/F - Dr. L recommends that you put no more than 3 diagnoses on form DL-62.

False - unless you must, put only one diagnosis because >1 will result in restriction

What happens if your pt gets 20/40 with correction? If not?

- Better than 20/40 w/ correction = restriction on license
- If not = scheduled a driving test (Supplemental Driving Performance Evaluation, Area Driving Performance Evaluation)

What are the two evaluations used if a patient gets worse than 20/40 with correction?

- Supplemental Driving Performance Evaluation
- Area Driving Performance Evaluation (if SDPE not passed)

What is the SDPE?

Supplemental Driving Performance Evaluation; evals multiple directions, add'l lane changes, concentration, freeway/hwy driving, destination trip.

What is the ADPE?

Area Driving Performance Evaluation; if SDPE not passed. Determines if person able to drive safely within restricted area, i.e. home to grocery/dept store

Passing ADPE results in...

- Restricted license ("ADPE")
- Limited driving to specific area
- No freeways

T/F - For monovision, an SDPE will determine the driving safety.

True

T/F - Bioptic telescopes can be used during driving tests to improve VA.

False - cannot be used during tests, but it does improve VA

If a driver has less than 20 degrees visual field in each eye, then what action must take place?

Requires an SDPE

What conditions require an SDPE with no exception?

Decreased periph vision <20 degrees, diplopia, hemianopsia, post capsule opacification, retinal damage, any VF loss