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Providing Rehabilitation to People Who Have Restored Vision Through a Retinal Implant

Providing Rehabilitation to People Who Have Restored Vision Through a Retinal Implant. Duane R. Geruschat Ph.D. CLVT, COMS. Disclosure. The presenter is a collaborator with Second Sight Medical Products Supported by: R01 EY021220 to Gislin Dagnelie , Ph.D

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Providing Rehabilitation to People Who Have Restored Vision Through a Retinal Implant

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  1. Providing Rehabilitation to People Who Have Restored Vision Through a Retinal Implant Duane R. Geruschat Ph.D. CLVT, COMS

  2. Disclosure The presenter is a collaborator with Second Sight Medical Products Supported by: R01 EY021220 to GislinDagnelie, Ph.D University of Pennsylvania/CHOP

  3. Background Information I am an EXPERT!!

  4. What is an Expert? An expert is a person who has made all the mistakes, which can be made, in a very narrow field. Niels Henrik David Bohr (1885-1962)

  5. This Is Real • FDA approved the Argus II for commercial use in the US in February 2013 • Medicare approved payment (inpatient and outpatient settings) effective October 1, 2013

  6. Clinical Sites 2013 Ann Arbor, MI Atlanta, GA Baltimore, MD Chicago, IL Cleveland, OH Dallas, TX Durham, NC Los Angeles, CA Miami, FL Nashville, TN Philadelphia, PA San Francisco, CA Toronto On

  7. You Will Be Involved Clients will hear/read and contact you for information

  8. Goals For This Presentation • What type of functional vision and activities • Patient profile • Providing rehabilitation instruction • Best Candidates • Challenges using prosthetic vision

  9. What type of functional vision?

  10. Simulation of Argus II Filter simulation video

  11. Counting bowls

  12. Walking A Line

  13. Counting white parking lines

  14. What These Videos Mean? The Blind Can See • Low Visual Acuity • 20 Degrees of Visual Field • Takes time to process the image Ultra Low Vision

  15. Patient Profile • RP – severe visual impairment • Average years since blind = 15 • Lived as person who is blind • Re-introduction of vision • Sequence of vision loss • Sighted • Low vision • Blind • Ultra low vision

  16. Patient Profile • Psychological dynamic • Approach is different • Technology is unique – ultra low vision • Sequence of life events

  17. Principles of Patient Care • Patients have varying levels of skills with non-visual strategies • Many tasks can be completed with non-visual alternatives • More successful patients seem to have good blindness skills • Technology which enhances good blindness skills

  18. Rehabilitation In Clinic rehabilitation Community based rehabilitation

  19. In Clinic Rehabilitation Goal is to Teach 1 Components of system 2 Manipulation of controls 3 Basic visual skills

  20. Argus II System

  21. In Clinic Rehabilitation Goal is to Teach 1 Components of system 2 Manipulation of controls 3 Basic visual skills

  22. Video Processing Unit (VPU)

  23. Filter video if it can work

  24. In Clinic Rehabilitation Goal is to Teach 1 Components of system 2 Manipulation of controls 3 Basic visual skills

  25. Eye - Head - Camera Maintaining Alignment and RF Link

  26. Argus II Instructional Kit

  27. What is the Best We Can Expect?

  28. What is the Best We Can Expect?

  29. Community Rehabilitation Goal is to Reinforce and Teach • Components of system • Manipulation of controls • Basic visual skills • Teach INTEGRATION OF VISUAL SKILLS

  30. Community Rehabilitation What to do on day one? • You know how to do rehabilitation • Do what you always do • This is a new and unique technology but it’s still blind rehabilitation

  31. Community Rehabilitation What to do on day one? • Good assessment of functional abilities without Argus II • Functional vision assessment • Set goals

  32. Community Rehabilitation Apply good low vision rehabilitation techniques

  33. The Visual Environment is Important

  34. The Visual Environment is Important

  35. The Visual Environment is Important

  36. Contrast is Important

  37. Community Rehabilitation • Good assessment of blindness skills • Environmental considerations • Argus II is a supplement, an enhancement to good blindness skills

  38. Visual Integration ADL • Sorting Laundry • Setting Table

  39. White Plate Black Background

  40. Black Plate Black Background

  41. Black Plate Black Background

  42. Visual Integration Orientation and Mobility • Crossing Street • Midblock bus stop • Turning house lights off

  43. Crossing the Street

  44. Midblock Crossing

  45. Lights and Windows

  46. Visual Integration Quality of Life • Fireplace • Television • Just feeling sighted again

  47. Visual Integration Development of visual memory

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