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Use of Telemedicine to Implement Remote Diagnosis and Treatment of Various Oculo-Motor and Perceptual Problems 利用远程医疗实现各种视觉运动和知觉问题的远程诊断和治疗
Pub Date : 2020-06-22 DOI: 10.31707/vdr2020.6.2.p93
The current pandemic has accentuated interest in alternative or adjunctive vision therapy evaluations and therapy. The BVA (Binocular Vision Analysis) Test and the PTS (Perceptual Therapy Suite) Test provide a useful baseline for the HTS/HTS2 and PTS2/PVT2 programs respectively. Computerized testing and therapy can serve as an effective complement to non-computerized testing and therapy procedures. Success in administering remote vision therapy evaluations and interventions through telemedicine platforms bodes well for the future of these technologies.
当前的大流行加剧了人们对替代或辅助视力治疗评估和治疗的兴趣。BVA(双目视觉分析)测试和PTS(知觉治疗套件)测试分别为HTS/HTS2和PTS2/PVT2项目提供了有用的基线。计算机化测试和治疗可以作为非计算机化测试和治疗程序的有效补充。通过远程医疗平台管理远程视力治疗评估和干预的成功预示着这些技术的未来。
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引用次数: 0
A Personal Perspective on Developing an Online Remote VT System 开发在线远程VT系统的个人观点
Pub Date : 2020-06-22 DOI: 10.31707/vdr2020.6.2.p121
Being nestled within interior British Columbia, Canada surrounded by lakes, mountains and wide open spaces has lifestyle benefits that are difficult to match anywhere in the world. Getting away from it all is easily achievable, allowing inhabitants of this beautiful areato separate from the hustle and bustle of daily life on a moment’s notice. Providing Vision Therapy in a region such as this however presents logistical challenges if your goal isto ensure that anyone who visits your clinic for evaluation has access to weekly training to better both their visual systems and lives.
加拿大坐落在不列颠哥伦比亚省的内陆,周围环绕着湖泊、山脉和广阔的空间,这种生活方式的好处是世界上任何地方都难以比拟的。远离这一切是很容易实现的,让这个美丽地区的居民瞬间从日常生活的喧嚣中分离出来。然而,如果你的目标是确保每个来你诊所接受评估的人都能每周接受培训,以改善他们的视觉系统和生活,那么在这样一个地区提供视力治疗就会带来后勤方面的挑战。
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引用次数: 0
Challenges in Telehealth Vision Therapy with a Hasidic Patient Population 哈西德患者群体远程医疗视力治疗的挑战
Pub Date : 2020-06-22 DOI: 10.31707/vdr2020.6.2.p188
The COVID-19 pandemic brought unprecedented change to health care delivery. Vision therapy services were temporarily forced to a telehealth platform. The Ezra Medical Center serves a predominately Hasidic patient population where there is limited access to computers, iPads and internet. This unique set of circumstances required innovative techniques to ensure that current therapy patients could continue their clinical treatment.
2019冠状病毒病大流行给卫生保健服务带来了前所未有的变化。视力治疗服务暂时被迫转移到远程医疗平台。以斯拉医疗中心主要为哈西德派患者服务,这些患者使用电脑、ipad和互联网的机会有限。这种独特的情况需要创新的技术来确保目前的治疗患者能够继续他们的临床治疗。
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引用次数: 0
Remote Vision Therapy at VCDC: Lessons Learned from Dr. Harry Wachs VCDC的远程视力治疗:从Harry Wachs博士那里学到的经验
Pub Date : 2020-06-22 DOI: 10.31707/vdr2020.6.2.p107
2020 has not turned out to be the year that optometrists were eagerly anticipating. The COVID-19 pandemic has changed nearly every aspect of our lives – both professionallyand personally. We are all looking for best practices and ways to come out of COVID-19 in the best shape possible. For many, providing vision therapy remotely is a foreign concept driven by necessity. For some, it is a temporary solution that will not be continued after stay-at-home orders relax. Others have found remote vision therapy to be a splendid addition to their mix of services, one that will further open their eyes to more creative and novel methods of providing vision care. As numbers of infections continue to rise and experts warn of a second wave, we are unsure what the future will bring. Since the founding of the Vision & Conceptual Development Center by Harry Wachs, the best technology available has been used to remotely observe patients in their home, school and therapeutic environments. These tools are used not simply because at times the office is inaccessible but because oftentimes these observations can be one of our most successful diagnostic tools. The authors share their experience with remote vision therapy at the Vision & Conceptual Development Center, its advantages and challenges for staff and patients, and how it can become a permanentservice offered at some practices.
2020年并不是验光师们热切期待的一年。COVID-19大流行几乎改变了我们生活的方方面面——无论是职业还是个人。我们都在寻找最佳做法和方法,以尽可能以最佳状态走出COVID-19。对许多人来说,远程提供视力治疗是一个陌生的概念。对一些人来说,这是一种临时解决方案,在居家令放松后不会继续下去。其他人发现远程视力治疗是他们综合服务的一个极好的补充,它将进一步开阔他们的眼界,让他们看到更有创意和新颖的视力护理方法。随着感染人数继续上升,专家警告可能出现第二波,我们不确定未来会发生什么。自从Harry Wachs建立视力和概念发展中心以来,最好的技术已经被用于远程观察患者在他们的家里,学校和治疗环境。使用这些工具不仅仅是因为有时无法进入办公室,还因为这些观察结果通常是我们最成功的诊断工具之一。作者分享了他们在视力与概念发展中心进行远程视力治疗的经验,它对工作人员和患者的优势和挑战,以及它如何在一些实践中成为一项永久性服务。
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引用次数: 0
Perceived Importance of and Equipment Used for Home Vision Therapy Activities 家庭视力治疗活动的重要性和使用的设备
Pub Date : 2020-06-22 DOI: 10.31707/vdr2020.6.2.p166
Home vision therapy activities can be prescribed as part of an in-office optometric vision therapy treatment program. Home training between in-office sessions can be prescribed anywhere from intensive activities to sporadic assignments during a week. Anteo and Emergent ran independent surveys, prior to their partnership and previous to the COVID-19 lockdown, to gather information from vision therapy providers in 2019 and 2015 respectively. Emergent is a vision therapy equipment company whose services also include online vision therapy training and practice management consulting. Anteo is a vision therapy platform for in-office and remote vision therapy.The Anteo survey aimed to (1) identify the perceived importance of vision therapy homeactivities during a weekly in-office vision therapy regimen (2) assess home activity compliance. The Emergent survey aimed to (1) determine what equipment providers were using when assigning home vision therapy (2) the cost and price charged for that equipment.
家庭视力治疗活动可以作为办公室验光视力治疗计划的一部分。在办公室课程之间的家庭培训可以安排在任何地方,从密集的活动到每周一次的零星任务。在合作之前和COVID-19封锁之前,Anteo和Emergent分别在2019年和2015年进行了独立调查,以收集视力治疗提供者的信息。Emergent是一家视力治疗设备公司,其服务还包括在线视力治疗培训和实践管理咨询。Anteo是一个用于办公室和远程视力治疗的视力治疗平台。Anteo调查的目的是(1)确定每周视力治疗方案中视力治疗家庭活动的重要性(2)评估家庭活动的依从性。紧急调查的目的是:(1)确定供应商在分配家庭视力治疗时使用的设备;(2)该设备的成本和价格。
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引用次数: 0
Finding the “Eye” Amid a Pandemic Storm: A Holistic Guide Toward Visual and Autonomic Balance 在大流行风暴中寻找“眼睛”:视觉和自主平衡的整体指南
Pub Date : 2020-06-22 DOI: 10.31707/vdr2020.6.2.p150
In March, 2020, the world was confronted with the COVID-19 pandemic and worldwide governmental orders to “shelter in place.” Within days of this externally imposed hardship, threatening plans for gathering in every community, behavioral optometry organized a platform for virtual education which united the vision therapy community in mutual self-education, shared over 55 countries around the globe. The following article is distilled from a 4-part series of lectures presented by the author, Dr. Samantha Slotnick, on “Making Remote Vision Therapy Valuable.” These lectures constitute a guide for acting in a supportive capacity for our patients, with attention to the reciprocal roles of a balanced, open and available visual process, and a balanced autonomic nervous system. It addresses the impact of the sympathetic response on the visual system, and offers guidance to help patients selfmodulate the state of their nervous systems, with both bottom-up and top-down direction. In particular it elucidates the role of the peripheral visual field in both stress modulation and binocular visual skill development. It offers recommendations on conducting optometric assessments through the telehealth interface, as well as providing vision therapy through a video-based portal. Through the hardship the pandemic has created, and the wonder of technology, this isolating experience may in fact serve as an opportunity to hone our single most valuable tool in our practice: Ourselves, and our ability to facilitate change for others.
2020年3月,全球面临新冠肺炎大流行,各国政府纷纷下令“就地避难”。在这种外部强加的困难,威胁每个社区聚会计划的几天内,行为视光组织了一个虚拟教育平台,将视力治疗社区联合起来进行相互自我教育,共享全球55个国家。下面这篇文章是从作者Samantha Slotnick博士关于“使远程视力治疗有价值”的四部分系列讲座中摘录出来的。这些讲座为我们的患者提供了一个支持能力的指导,关注平衡、开放和可用的视觉过程和平衡的自主神经系统的相互作用。它解决了交感反应对视觉系统的影响,并提供指导,帮助患者自我调节他们的神经系统的状态,自下而上和自上而下的方向。特别地,它阐明了周边视野在压力调节和双目视觉技能发展中的作用。它就通过远程保健界面进行验光评估以及通过基于视频的门户网站提供视力治疗提出了建议。通过大流行病造成的困难和技术的奇迹,这种孤立的经历实际上可以成为一个机会,磨练我们在实践中唯一最宝贵的工具:我们自己,以及我们促进他人变革的能力。
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引用次数: 0
Use of Remote Optometric Vision Therapy in a Primary Eye Care Practice 远程验光视力治疗在初级眼保健实践中的应用
Pub Date : 2020-06-22 DOI: 10.31707/vdr2020.6.2.p99
Many optometrists supplement office-based vision therapy with home-based vision therapy procedures. Others prescribe primarily home-based vision therapy activities with in-office instruction. With recent development of telehealth online platforms, it is possible to enhance home-based vision therapy with one-on-one doctor-guided and vision therapist-guided remote optometric vision therapy (ROVT). This may increase access for times when the patient is not able to present to the office.Procedures for implementing ROVT are discussed including patient selection, casemanagement, and technical requirements. 35 patients received ROVT, with the vast majority responding positively. Three cases of ROVT are presented. While there are significant limitations to ROVT, this experience shows that it is possible to conduct ROVT when there is need. We found that case selection and parental support at home are important factors for success.
许多验光师以家庭视力治疗程序作为办公室视力治疗的补充。其他一些医生主要在办公室指导下进行家庭视力治疗活动。随着远程医疗在线平台的发展,有可能通过一对一医生指导和视力治疗师指导的远程验光视力治疗(ROVT)来加强家庭视力治疗。这可能会增加访问的时间,当病人不能出席到办公室。讨论了实施ROVT的程序,包括患者选择、病例管理和技术要求。35例患者接受ROVT治疗,绝大多数患者反应积极。本文介绍了三例ROVT病例。虽然ROVT有很大的局限性,但这一经验表明,在需要时进行ROVT是可能的。我们发现个案选择和家长在家的支持是成功的重要因素。
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引用次数: 0
Implementation of Vision Therapy Using Telehealth Services in an Academic Practice 在学术实践中使用远程医疗服务实施视力治疗
Pub Date : 2020-06-22 DOI: 10.31707/vdr2020.6.2.p182
Background: In telehealth, care is delivered through a virtual platform with the provider and the patient using a real-time audio and video telecommunication system. Interest in telemedicine services has grown considerably since the clinic closures enforced by the COVID-19 pandemic. In this paper, we outline the implementation of telehealth services for delivering vision therapy at our academic clinical practice.Methods: A secure, Health Insurance Portability and Accountability Act (HIPAA) compliant service with synchronous audio-video capability was chosen as the platform for delivery of care. The office staff and the providers underwent training on how to use the platform for patient enrollment and conducting visits respectively. To ensure continuity of care, patients who were previously receiving vision therapy were offered and enrolled in telehealth if interested. Components of a virtual visit and documentationof the visit are discussed.Conclusions: Since its implementation, our telehealth-based vision therapy service has been welcomed both by the providers and patients. Given the current state of the pandemic, interest in implementing telehealth services is likely to grow. The relaxed policies and regulations for telehealth in response to COVID-19 are temporary. Sustainable and successful implementation depends on feasibility, user satisfaction,improvement in clinical outcomes and cost effectiveness. Evaluation of these telehealthattributes for vision therapy is warranted for informed-decision making.
背景:在远程医疗中,护理是通过虚拟平台提供的,提供者和患者使用实时音频和视频通信系统。自COVID-19大流行迫使诊所关闭以来,人们对远程医疗服务的兴趣大大增加。在本文中,我们概述了在我们的学术临床实践中提供视力治疗的远程医疗服务的实施。方法:选择一个安全的、符合HIPAA(健康保险流通与责任法案)的、具有同步音视频功能的服务作为提供护理的平台。办公室工作人员和提供者分别接受了如何使用该平台进行患者登记和访问的培训。为了确保护理的连续性,向以前接受视力治疗的患者提供服务,并在有兴趣的情况下登记远程保健。讨论了虚拟访问的组成部分和访问的文件。结论:远程医疗视力治疗服务自实施以来,受到了医患双方的欢迎。鉴于疫情的现状,实施远程保健服务的兴趣可能会增加。为应对COVID-19而放松的远程医疗政策和法规是暂时的。可持续和成功的实施取决于可行性、用户满意度、临床结果的改善和成本效益。评估这些远程医疗属性的视力治疗是必要的知情决策。
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引用次数: 1
Telehealth During COVID-19 for Remote Vision Rehabilitation of a Patient with mTBI COVID-19期间远程医疗对mTBI患者远程视力康复的影响
Pub Date : 2020-06-22 DOI: 10.31707/vdr2020.6.2.p191
Background: Binocular and accommodative vision problems are common after mild traumatic brain injury (mTBI). Traditionally, the management of visual dysfunctions following mTBI included in-office vision rehabilitation with a trained eye care provider. The concept of providing telehealth for remote vision rehabilitation in mTBI patients is a relatively novel practice that has not been widely utilized until the recent outbreak of the 2019 novel coronavirus (COVID-19) pandemic.Case Report: We describe the implementation of telehealth for remote vision rehabilitation during COVID-19 within the Veterans’ Health Administration (VHA) system in an adult patient with multiple confirmed histories of mTBI.Conclusion: Our telehealth remote vision rehabilitation was successfully implemented utilizing established VHA’s web-based videoconferencing tools. Therapeutic goals identified prior to COVID 19 were addressed without any challenges. The delivery of vision rehabilitation intervention via telehealth allowed for the continuance of services within the home setting that led to improvements in functional vision, decreased perception of performance challenges, and improved quality of life.
背景:双眼和适应性视力问题在轻度创伤性脑损伤(mTBI)后很常见。传统上,mTBI后视觉功能障碍的处理包括由训练有素的眼科保健提供者进行的办公室视力康复。为mTBI患者的远程视力康复提供远程医疗的概念是一种相对较新的做法,直到最近2019年新型冠状病毒(COVID-19)大流行爆发才得到广泛应用。病例报告:我们描述了在退伍军人健康管理局(VHA)系统中实施的远程医疗在COVID-19期间进行远程视力康复,该患者有多次确认的mTBI病史。结论:利用VHA建立的基于网络的视频会议工具,我们成功地实现了远程医疗远程视力康复。在COVID - 19之前确定的治疗目标没有遇到任何挑战。通过远程保健提供视力康复干预,可以在家庭环境中继续提供服务,从而改善功能性视力,减少对行为挑战的感知,提高生活质量。
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引用次数: 0
COVID-19 and Vision Therapy: An Academic Experience 2019冠状病毒病与视力治疗:学术经验
Pub Date : 2020-06-22 DOI: 10.31707/vdr2020.6.2.p95
Background: The COVID-19 pandemic required unprecedented changes to health care delivery. The University Eye Center (UEC) at the State University of New York College of Optometry has a robust vision rehabilitation practice. However, during the pandemic via state mandate, it could no longer provide in-office care. Development of novel approaches to manage patients with binocular vision disorders, especially to care for the vulnerable traumatic brain injury and pediatric patient populations, was essential and required rapid response. This included a combination of launching telehealth visits and a home-based vision therapy app, as well as innovative programs developed internally. While telehealth is not a substitute for in-office vision therapy, the combination of multiple platforms enabled the UEC to continue patient care despite a stay-at-home order during the pandemic.
背景:COVID-19大流行要求对卫生保健服务进行前所未有的变革。纽约州立大学视光学院的大学眼科中心(UEC)拥有强大的视力康复实践。然而,在大流行期间,通过国家授权,它无法再提供办公室护理。开发新的方法来管理双眼视力障碍患者,特别是照顾易受创伤的脑损伤和儿科患者群体,是必不可少的,需要快速反应。这包括推出远程医疗访问和基于家庭的视力治疗应用程序,以及内部开发的创新项目。虽然远程医疗不能替代办公室视力治疗,但多种平台的结合使UEC能够在疫情期间继续为患者提供护理。
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引用次数: 0
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Vision development and rehabilitation
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