Abv 2 Test 1

Front 1

What are the 3 major areas of visual system?

Back 1

Motor, sensory, perceptual

Front 2

Definition of strabismus

Back 2

Manifest deviation of the primary lines of sight of 1 pd or more. Lines of sight are not directed toward the same fixation point either constantly or intermittently.

Front 3

Definition of amblyopia

Back 3

Unilateral or (infreq) bilateral condition in which the BCVA is poorer than 20/20 in the absence of any obvious structural anomalies or ocular dx. Reduced VA (<20/20), not correctable by refractive means, not attributed to structural or pathological anomalies, and is associated with form deprevation, strabismus, anisometropia, or other amblyogenic ref errors.

Front 4

What is most common visual abnormality found in children age 6-17?

Back 4

strabismus

Front 5

In the under-20 age group, what causes more vision loss than trauma and all other ocular disease?

Back 5

amblyopia

Front 6

T/F Strabismus/amblyopia are treatable conditions, however only within a certain age limit

Back 6

False, no age limit! But have fairly good prognosis.

Front 7

Which normal binocular vision component (anatomical, motor, sensory, or integration)do each of the following correspond to? Accommodative dysfunction, Amblyopia, Aniseikonia, Anomalous correspondence, Central fusion disruption syndrome, Disease, Eccentric fixation, Horror fusionis, Nystagmus, Refractive error, Strabismus, Suppression, Vergence Dysfunction?

Back 7

Anatomical: Disease.
Motor: Nystagmus, strabismus, vergence dysfunction.
Sensory: Accommodative dysfunction, amblyopia, effectric fixation, refractive error.
Integration: Aniseikonia, anomalous correspondence, central fusion disruption syndrome, horror fusionis, and suppression.

Front 8

What is one specific section of case history that is required only for strabismus/amblyopia cases?

Back 8

Goals

Front 9

The S/S of asthenopia is common with which disorders?

Back 9

intermittent strab or large phorias.

Front 10

The greater the frequency of strabismus, the _______ (higher/lower) probability of sensory anomalies. The more sensory anomalies, the ________ (greater/fewer) the symptoms

Back 10

higher; fewer

Front 11

In a pt with long-standing strabismus, in order to reduce symptoms, the pt has developed sensory adaptations such as?

Back 11

suppression or anomalous correspondence.

Front 12

What 5 causes must you differentiate between when coming across reduced VA?

Back 12

Organic, congenital, acute or chronic ocular or systemic disease.

Front 13

Functional amblyopia when bilateral is extremely rare and you must rule out ________ or __________ causes.

Back 13

congenital; pathological

Front 14

Determining the time and type of onset, such as congenital vs acquired, is critical when finding what?

Back 14

prognosis

Front 15

any __ after 6 months or ___ after 2 months is considered abnormal.

Back 15

XT; ET

Front 16

Whats the age for acquired onset?

Back 16

Greater than 1 year. Early acquired is <5 yrs; Late acquired is >5yrs

Front 17

Early onset think about what? tendency for ______ prognosis

Back 17

Sensory adaptations; poor prognosis.

Front 18

_____ onset think neurological/pathological etiology first

Back 18

acute

Front 19

What are 4 family histories that could promt to an early exam?

Back 19

Fhx of low vergence systems, significant hyperopia (>1.5D), high AC/A ratio, eso/exophoric tendency.

Front 20

What amount of refractive error is asssociated with esotropia and amblyopia?

Back 20

+2.00 d hyperopia and >1.00 anisometropia, any meridian.

Front 21

refractive status is an important baseline for what?

Back 21

management plan

Front 22

when scoping, as you go off axis astigmatism ______ and spherical power ______.

Back 22

Increases; decreases

Front 23

When would you consider out of phoropter refractions on children?

Back 23

deviations >15 pd

Front 24

when scoping strabismus (ETs and verticals) pts you place correcting prism in front of which eye?

Back 24

fixating eye aka normal eye

Front 25

when scoping strabismus (XTs) what must you do?

Back 25

align purkinje images or use prism

Front 26

For the near retinoscopy test (Mohindra), what working distance do you use and subtract ___ from the sphere value? how does it change for children > 2yrs?

Back 26

50 cm; lights out; 1.25; 1.00D for chidren > 2

Front 27

think of near retinoscopy as a ---------- method. When poor confidence in NRM, perform what?

Back 27

supplemental; cyclopledgic refraction.

Front 28

What are the 2 drugs used for cyclopledgic retinoscopy?

Back 28

0.5%, 1% Cyclopentolate and 0.5% 1% Atropine

Front 29

What are the 7 ways to assess visual acuity? which do we use at NSU?

Back 29

Standard snellen chart, S-Chart psychometric visual acuity test (Flom), Psychometric visul acuity cards, Contrast sensitiviity function, Multiple pinhole, Grading acuity assessment (interferometer, retinometer), Overall strategies; PVA cards

Front 30

What two types of amblyopia can be determined from the CSF? what are the results?

Back 30

Strabismus and anisometropia. S - decreased across HIGH frequiencies; A - decreased across ALL frequencies

Front 31

The interferometer is good at detecting what? However, what is a fault of it?

Back 31

Pts who are not going to improve; overestimate potential acuity.

Front 32

Definition of functional amblyopia? is visual acuity recoverable?

Back 32

visual pathway is intact and normal, but fails to develop or operate normally; yes with treament

Front 33

What are the 3 types of functional amblyopia?

Back 33

Form Vision deprivation amblyiopia, refracive amblyopia, and strabismic amblyopia

Front 34

What are the conditions that could cause each type of amblyopia?

Back 34

Form vision deprivation: physical obstruction. Refractive amblyopia: high be equal (isoametropic) or clinically sig unequal (anisometropic) uncorrected refractive errors. Strabismic: early onset constant unilateral strab.

Front 35

What amounts of uncorrected refractive error have been associated with isoametropic amblyopia?

Back 35

Astig: 2.5; Hyperope: 5; Myope: 8

Front 36

What amounts of uncorrected refractive error have been associated with anisometropic amblyopia?

Back 36

astig: 1.5; hyperope: 1.0; Myope: 3.

Front 37

What are the 2 major amblyogenic mechanisms involved in functional amblyopia?

Back 37

form deprivation and suppression

Front 38

How is organic vision loss different from vision loss due to functional amblyopia?

Back 38

Organic - due to components of the visual pathway failing to develop, either bc of structural defects, metabolic, or toxic disturbances; Functional - visual pathway is intact and normal at birth.

Front 39

What are the 4 types of organic vision loss?

Back 39

congenital, nutritional, toxic, and pathological

Front 40

What VA range is considered shallow amblyopia? Moderate? Deep?

Back 40

Shallow: 20/25-20/60
Moderate 20/70 - 20/100
Deep: 20/200

Front 41

What are some clinical features of psychogenic vision loss?

Back 41

Bilateral reduced VA, normal ocular health, minor symmetric refractive error (either emmetrope or hyper), normal bv, ortho or small heterophoria, ABNORMAL visual fields.

Front 42

What is the relationship between the amount of Eccentric Fixation (EF) and reduced VA in amblyopia?

Back 42

As EF increases, VA decreases.

Front 43

If EF is nasal (+), it will give a ________-estimation of ET, and _______-estimation of XT

Back 43

under; overestimation

Front 44

Definition of eccentric fixation

Back 44

use of an off-foveal site during monocular viewing

Front 45

Is eccentric fixation more common in strabismic ablyopes or anisometropic amblyopes?

Back 45

Strabismic

Front 46

During visuoscopy, what are you assessing?

Back 46

Location of the RETINA being used to fixate target's center (thus you judge EF from the center of reticle, ex. reticle in btwn macula and ONH = nasal EF)

Front 47

During Haidinger's brushes, the pt locates the brush in relationship to fixation target, so the brush will mark the position of what?

Back 47

fovea (is a direct relation). Thus normal light falls on specific retina = the EF (Ex. RE sees brush to the right of the center = light falling on nasal retina = Nasal EF)

Front 48

Which assessment of monocular fixation is subjective?

Back 48

Haidinger's brushes

Front 49

If the pt cannot see the brush while doing Haidinger's, what 4 things can they try and do?

Back 49

use +10 lens, use extra blue gelatin filter, decrease room illumination, or change test distance.

Front 50

Which assessment of monocular fixation is based on the assumption that pt has NORMAL CORRESPONDENCE?

Back 50

Brock-givner after image transfer test

Front 51

What is the average <K and why?

Back 51

~+0.5 mm nasal since the fovea is temporal to the pupillary axis

Front 52

In <K, nasal displacement relative to pupil center = ____ EF; while temporal displacement relative to pupil center = ___ EF

Back 52

(+) Temporal (To the nose); (-) nasal.

Front 53

A large positive <K may hide a ________ or cause pseudo-________. A large negative <K may hide _________ or cause pseudo-_________.

Back 53

small esotropia; exotropia; exotropia; esotropia

Front 54

<Kappa is better for determining ___________ than ________.

Back 54

unsteadiness of fixation; detecting EF (is a gross method).

Front 55

How can you predict VA from magnitude of EF?

Back 55

MAR = [EF in prism diopters] + 1 -->
20/VA = 1/MAR

Front 56

What is Dr. Tea's suggested order to assess monocular fixation?

Back 56

1) Angle kappa/Hirschberg, 2) visuoscopy, 3) Haidinger's brushes or brock-givner after image transfer test.

Front 57

What are the 7 characteristics of an ocular motor deviation that should be identified during a strabismus eval?

Back 57

1) Direction, 2)Frequency, 3)magnitude, 4) laterality, 5)AC/A ratio, 6) cosmesis, 7) concomitancy [DFMLACC]

Front 58

What are 5 factors that might affect cosmesis of eso/exotropias?

Back 58

<K, bridge of nose, epicanthus, IPD, size of face. (BEKIS)

Front 59

Which objective test is especially useful for infants and patients with deep amblyopia?

Back 59

Krimsky Test (placing correcting prism in front of fixating eye, EYES move toward APEX)

Front 60

Which objective test provides a way to identify small angle strabismus in infants and uncooperative patients?

Back 60

Bruckner test (deviated eye will be brighter and whiter)