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2017 CAO CONGRESS POSTER ABSTRACTS

Parag Majmudar has received research funding from Shire and has been a consultant for Allergan, Rapid Pathogen
Screening, TearScience, and Valeant.

Aparna Raychaudhuri was an employee of Shire PLC at the time of this work and owns stock in Shire PLC.

Monica Roy and Amir Shojaei are employees of Shire PLC and own stock/stock options in Shire.

The addition of Orientation and Mobility (O&M) training improves movement detection in the
blind hemi-field when using Peli prisms for hemianopia: A Case Study

Terry Gallant, OD 1, 2, 3; Annie Deschênes, DESS O&M specialist 1, 2; Frederique Poncet, PhD 2, 4;
Walter Wittich, Ph.D CLVT FAAO 2, 3, 4
1 - CISSS Laurentides, St-Jerôme Rehabilitation Center, St-Jerôme, Quebec
2 - Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Quebec
3 - School of Optometry, University of Montreal, Montreal, Quebec
4 - Department of Psychology, Concordia University, Montreal, Quebec

INTRODUCTION
Previous research has indicated that Peli prisms improve mobility, primarily as evaluated by questionnaires. We de-
signed an interdisciplinary protocol to quantify this gain in mobility objectively in order to allow comparison with
and without training by an O&M specialist.

METHODS
We developed a protocol similar to the in-office training originally suggested by Peli and colleagues. However, our clini-
cal impression indicated better adaptation to the prisms by the patients once the O&M intervention was introduced. We
designed an interdisciplinary protocol to maximise the adaptation to the device, which includes the patient selection,
prism adjustment by the optometrist and short in-office training. Then, two quantitative reference tests are performed
(Time 0) to evaluate the detection (static) and mobility (dynamic) abilities of the patient. The patient is asked to wear
the prism as much as possible and to return two weeks later and the static and dynamic tests are repeated with the Peli
prisms (Time 1). Thereafter, the O&M specialist takes charge of the training with specific exercises developed to help the
patient overcome the confusion caused by sudden and moving images, and to use the peripheral image efficiently. After
two weeks of O&M training, the patient repeats the static and dynamic tests (Time 2).

R E S U LT S
By fitting a regression line from a birds-eye perspective to the detection points in the blind hemi-field of Patient MF,
we observed a flattening in the slope of this line when measuring detection with a parallel moving target (from -2.37
to -1.33) as well as with a perpendicularly moving target (from -3.18 to -2.19), indicating an increase in the size of the
perceived visual field from T1 to T2.

CONCLUSION
The data indicate that adding O&M training improved movement detection in the blind hemi-field using the Peli
prisms. Next steps will focus on a patient-centered evaluation of the subjectively perceived benefits.

CANADIAN JOURNAL of OPTOMETRY | REVUE CANADIENNE D’OPTOMÉTRIE VOL. 79 NO. 2 31