Strab Mt3

Front 1

What is normal correspondence?

Back 1

When 2 foveas are connected to the same cortical visual direction

Front 2

What is anomalous correspondence?

Back 2

When 2 foveas are not connected to the same visual direction. The fovea of one eye is connected to a non-foveal point in the other eye.

Front 3

What is the difference between corresponding and noncorresponding retinal points?

Back 3

Corresponding retinal points are connected to the same visual direction but noncorresponding retinal points are not.

Front 4

What is an associated point? (Point A)

Back 4

The retinal point in the deviated eye that is connected to the fovea in the good eye.

Front 5

What is a zero measure point? (Point Z)

Back 5

The retinal point in the deviated eye the visual axis hits during binocular fixation.

Front 6

(T/F) In normal correspondence, point A is the fovea in the deviating eye.

Back 6

T - Otherwise, you have anomaous correspondence

Front 7

What is the objective angle? (Angle D)

Back 7

The angle between point Z (retinal point the visual axis hits during binocular fixation) and the fovea in the bad eye.

Front 8

What is the subjective angle? (Angle S)

Back 8

The angle between the associated point (retinal point connected to fovea in good eye) and the zero measure point (retinal point the visual axis hits during binocular fixation)

Front 9

What is the angle of anomaly? (Angle A)

Back 9

The angle between the fovea of the bad eye and Point A (the retinal point connected to the fovea in the good eye.)

Front 10

What is the relationship between angle D, S, A?

Back 10

Angle S + Angle A = Angle D

Front 11

When are angles positive for angle D and S?

Back 11

Eso

Front 12

When are angles positive for angle A?

Back 12

Crossed separation of foveal tags

Front 13

What is Harmonious Anomalous Correspondence in terms of angles?

Back 13

When Angle A = Angle D. Therefore Angle S = 0.

Front 14

What is Unharmonious Anomalous Correspondence?

Back 14

When associated point is between zero point and fovea.

Front 15

What is Harmonious Anomalous Correspondence in terms point retinal points?

Back 15

When associated point and zero point are the same.

Front 16

What is Unharmonious Anomalous Correspondence in terms of angles?

Back 16

When Angle D > Angle S > 0.

Front 17

What is paradoxical anomalous correspondence 1 in terms of retinal points?

Back 17

When point A is farther from point Z from the fovea

Front 18

What is an easy way to describe paradoxical anomalous correspondence 1?

Back 18

An eso who thinks they are subjectively exo or vice versa.

Front 19

What is paradoxical anomalous correspondence 2 in terms of retinal points?

Back 19

When point A is on the opposide size of point Z from the fovea.

Front 20

What is an easy way to describe paradoxical anomalous correspondence 2?

Back 20

An eso or exo who subjectively has a larger magnitude than measured.

Front 21

What is paradoxical anomalous correspondence 1 in terms of angle size?

Back 21

Angle A > Angle D

Front 22

What is paradoxical anomalous correspondence 2 in terms of angle size?

Back 22

Angle S > Angle D

Front 23

What is confusion?

Back 23

When each eye sees a different image so the brain makes the pt see both on top of each other

Front 24

What is diplopia?

Back 24

When each eye sees the same image but slightly shifted, so the pt sees 2 of the same image.

Front 25

Angle D is manifest in (strabismus/heterophoria)

Back 25

Strabismus

Front 26

Angle D is latent in (strabismus/heterophoria)

Back 26

Heterophoria

Front 27

In normal correspondence, what is the relationship between angle S and angle D?

Back 27

Angle S = Angle D

Front 28

What values does the angle of anomaly have when we have NC or AC?

Back 28

NC: Angle A=0. AC: Angle A <> 0.

Front 29

Nasal EF is (+/-)

Back 29

+

Front 30

What is the relationship between Angle Dtrue, Dmeasured, EF, Atrue, Ameasured

Back 30

Dtrue = Dmeasured + EF. Atrue = Ameasured + EF

Front 31

What is the relationship between angle A and D for PAC 1?

Back 31

Angle A > Angle D

Front 32

What is the relationship between angle S and D for PAC2?

Back 32

Angle S > Angle D

Front 33

Name 6 tests for testing correspondence? Which ones are for small angle strabs?

Back 33

Bagolini Striated Lens, Hering Bielchowsky After Image Test, Red Lens/Maddox Rod test, Major Amblyoscope, Haidinger's Brushes & AIT, Cupper's Bifoveal Test. (Last 2 for small angle strabs.)

Front 34

What does the UCT differentiate in the Bagolini Striated Lens Test? How?

Back 34

No movement = NC. Movement = AC

Front 35

If the 2 lights are above the middle of the X in the BSLT, what's going on?

Back 35

Pt is eso, so BO needed

Front 36

If the 2 lights are to the right of the middle of the X in the BSLT, what's going on?

Back 36

LE perceives image to be lower (so it's hyper). RE perceives image to be higher (so it's hypo)

Front 37

If the pt sees a gap in the middle of a X in the BSLT, what's going on? What is this common in?

Back 37

Central suppression of an eye. Small angle strabismus (micro-ET and monofixation syndrome)

Front 38

What angle does the HBAIT get?

Back 38

Angle A

Front 39

What kind of pt often suppresses in the HBAIT?

Back 39

Constant alternating strab

Front 40

(T/F) A patient that can see both Ais in the HBAIT but not at the same time? (they alternate)? Is the test valid?

Back 40

Can't interpret test

Front 41

If the HABIT shows a cross, we have Angle Ameasured = 0 if we assume…

Back 41

No EF

Front 42

(T/F) The magnitude of a deviation is related to whether a pt has AC or NC

Back 42

F

Front 43

What kind of pt often sees the Ais changing from a cross to an uncrossed separation (vertical line is far from horizontal line)

Back 43

IXT

Front 44

How does covariation work in the HBAIT?

Back 44

If strab pt has HAC, as the angle D decreases, so does angle A. Once both are zero, pt has NC.

Front 45

What technique does the modified HBAIT use?

Back 45

Vernier alignment

Front 46

What assumption must we make when using the Brock-Givner AIT?

Back 46

No EF

Front 47

What is the optical correction, target distance for the Red Lens test for Correspondence?

Back 47

BCVA correction, 1 m

Front 48

What is the measurement error for the Red Lens Test for Correspondence?

Back 48

<= 3 prism diopters

Front 49

What angles do we compare in the Red Lens Test for Correspondence?

Back 49

Angle D and Angle S

Front 50

(T/F) The MA directly measures Angle A.

Back 50

F. It indirectly measures Angle A by getting Angle D and Angle S.

Front 51

(T/F) The MA does not require best optical correction

Back 51

F

Front 52

How do you ask for superimposition when doing the MA?

Back 52

Is the fish in the bowl?

Front 53

If superimposition is not achieved, what does that suggest? What do we do next?

Back 53

AC. Allow pt to adjust tube to get Angle S.

Front 54

(T/F) With the MA, angle D is different from angle S. Douse shows no movement. NC or AC?

Back 54

NC b/c douse is indicator.

Front 55

If a pt sees 2 targets in MA but can't get superimposition, what 2 things may be causing this?

Back 55

central suppression or horror fusionis (images are so different, can't fuse them.)

Front 56

(T/F) For the combination HB & Brock Givner AIT, the vertical AI is flashed in the normal eye.

Back 56

T

Front 57

For the HB & BGAIT combo test, what does it mean if AI, fixation point and HB are all at the same spot?

Back 57

NC

Front 58

For the HB & BGAIT combo test, what does it mean if only AI and HB are at the same spot but fixation is at a different spot?

Back 58

NC and EF

Front 59

For the HB & BGAIT combo test, what does it mean if AI and fixation point are all at the same spot?

Back 59

AC and EF

Front 60

For the HB & BGAIT combo test, what indicates NC?

Back 60

AI and HB superimposed

Front 61

For the HB & BGAIT combo test, what indicates AC?

Back 61

AI and HB not in same location

Front 62

For the HB & BGAIT combo test, what angle do we measure?

Back 62

Angle Atrue

Front 63

For Cupper's Bifoveal fixation, what indicates NC and AC?

Back 63

Visuoscope centered on image target. Visuoscope not centered on image target.

Front 64

What is more relatively stable: AC or NC?

Back 64

NC

Front 65

What is the sensory theory?

Back 65

AC is an adaptive process that happens slowly and gets deeper with time.

Front 66

(T/F) According to the Sensory theory, the AC can never become so deep that we can't get to NC

Back 66

F

Front 67

What is the test ranking for the sensory theory hierarchy of testing? Which ones are the most and least dissociatied? Which one wil most likely show AC?

Back 67

(Most dissociated) HBAIT, Red Lens Test, MA, Bagolini striated lenses (Least dissociated and most likely to show AC)

Front 68

(T/F) the Sensory Theory explains UAC well.

Back 68

F - Explains HAC well

Front 69

How does the sensory theory account for the UAC?

Back 69

UAC occurs initially but Angle A increases until HAC. UAC occurs after change in Angle D. Is testing artifact. There is a point to large area of correspondence.

Front 70

What did Flom & Kerr say about the sensory theory and disagreement between different tests?

Back 70

1) Measurement error 2) Unstead EF 3) Changes in relative eye position

Front 71

What type of pt does the motor theory best explain?

Back 71

IXT

Front 72

What is the motor theory?

Back 72

When a strab has AC, both anomalies have a common neurological cause that is not the same as the neurological cause of strabismus with NC?

Front 73

What are the 2 types of eye movements according to the motor theory?

Back 73

Accommodative vergence (non-registered). Fusional vergence (registered)

Front 74

What is the difference between registered and non-registered eye movement according to the motor theory?

Back 74

Neural impulses only communicate with EOMs. Neural impulses communicate with EOMs and perceptual apparatus in brain.

Front 75

What is the prevalance of AC in comitant strabismus? (Accommodative cases vs non-accommodative cases.

Back 75

8%. 82%.

Front 76

(T/F) Greater dissociation has an greater probability of AC for sensory theory?

Back 76

F. Greater probability of NC.

Front 77

Why does the prevalence of AC vary so much ? (1-95%) (3 reasons)

Back 77

Different tests used to determine AC. Different types of patients in each study. Associated conditions present.

Front 78

(T/F) There is a relationship between angle D (ET) magnitude and AC

Back 78

F. Katsumi determined this.

Front 79

(T/F) Prevalence of NC onset decreases with age.

Back 79

F. NC increases with age. AC decreases with age.

Front 80

(T/F) Duration of ET is inversely correlated with AC.

Back 80

T. The longer a pt has ET, the more likely they are to have AC.

Front 81

What is the innate theory of AC?

Back 81

Pts are born with AC

Front 82

(T/F) A ET child <= 2 y/o is unlikely to have AC.

Back 82

T. Because AC is correlated with having an ET for a long time.

Front 83

What is sensory fusion?

Back 83

The process by which stimulus from 2 eyes is integrated into a single percept

Front 84

What is motor fusion?

Back 84

Relative movement of eyes in response to disparate retinal stimuli so sensory fusion can occur.

Front 85

What is the difference between physiological and pathological diplopia?

Back 85

When stimulating disparate retinal points outside of panums area. Caused by strab.

Front 86

Suppression is attributed to ____ inhibition

Back 86

corticol

Front 87

(T/F) Suppression occurs in monocular viewing conditions

Back 87

F - Binocular

Front 88

What is Jampolsky's Classical View of suppression?

Back 88

The fovea is suppressed all the way to point Z in a D shape.

Front 89

(T/F) The suppression zone "D" of Jampolsky's Classical View of suppression is half of a perfect circle.

Back 89

F. The horizontal > vertical

Front 90

Ets suppress the (nasal/temporal) hemiretinal

Back 90

Nasal

Front 91

Explain how suppression works in Pratt Johnson's theory of suppression

Back 91

The suppressing eye suppreses the whole area that is covered by the good eye. Temporal crescents are not suppressed, however.

Front 92

Pratt Johnson's binocular field of vision is (smaller/larger) for XTs

Back 92

Larger

Front 93

Describe what Pratt Johnson found about heretinal suppression and triggers?

Back 93

There is none except for small Ets (<10 prismD). But, it can be trigger to make it happen.

Front 94

How is hemiretinal suppression triggered in Pratt Johnson's theory?

Back 94

Overcorrect (add prism or do surgery) so image falls on other side of fovea.

Front 95

Describe the diplopic area when it's triggered according to Pratt Johnson's?

Back 95

The area where both eye vision overlaps

Front 96

Suppression size: Fovea ____, Central ____, Peripheral _____

Back 96

< 1 degree, 1-5 degrees, > 5 degrees

Front 97

(T/F) Depth of strabismus is correlated with the frequency of strabismus

Back 97

T

Front 98

(T/F) Intensity of supression is correlated with greater angle D of strabismus

Back 98

F

Front 99

Name 5 different ways to get most natural to less natural dissociation.

Back 99

Free space, in-instrument, polarized filters, red filter, R/G filters

Front 100

How is shallow different from deep suppression?

Back 100

Present only in natural conditions-- get diplopia in less natural testing conditions. Present under most/all conditions

Front 101

What kind of strab pts should get out of instrument evaluations?

Back 101

Constant and intermittant tropias

Front 102

What kind of strab pts should get in instrument evaluations?

Back 102

Constant tropias

Front 103

(T/F) If a pt sees 4 balls with the worth 4 dot test, they have NC

Back 103

F. Could be NC or HAC. Do UCT to check.

Front 104

What do you tell a pt to look at when doing the worth 4 dot test?

Back 104

White ball

Front 105

How can we tell if a pt is getting diplopia from insufficient motor fusion or bad sensory fusion?

Back 105

Do prism bar to reduce/eliminate vergence demand.

Front 106

(T/F) High motor problems are the most difficult to treat.

Back 106

F. Easiest!

Front 107

What type of strab pt will align their eyes in presence of disparity but can appear to have poor second degree fusion

Back 107

IXT

Front 108

Name 2 Lateral Disparity Stereopsis tests. Monocular cues?

Back 108

Titmus StereoFly, Circle part of Randot test. Yes.

Front 109

(T/F) Bifixation is not required when doing the random dot stereopsis tests.

Back 109

F

Front 110

Name 5 random dot stereopsis tests

Back 110

Random Dot E, Figure portion of randot, Lang, Randot preschool, Randot distanct tests

Front 111

(T/F) Small angle constant strabs can have bifixation.

Back 111

F. All constant strabs don't have bifixation

Front 112

Which random dot stereopsis test doesn't need glasses?

Back 112

Lang

Front 113

What is the best In-Instrument-Evaluation tool for looking at strabs?

Back 113

Major amblyoscope

Front 114

What other tool can be used for an in-instrument-evaluation of strabs.

Back 114

Wheatstone

Front 115

If we get stable peripheral fusion (single vision w/ no suppression) what does this tell us?

Back 115

Good prognosis

Front 116

What slides do we use in a MA to look at lateral disparity?

Back 116

3rd degree synoptophore slides

Front 117

What slides do we use in a MA to look at RDS?

Back 117

RDS/Braddick Random -Dot graded Stereo slides

Front 118

Do we check motor fusion and stereopsis in a MA with unstable second degree fusion?

Back 118

No

Front 119

What are 4 things we need to rule out when a pt has unstable fusion (unable to fuse 2 targets or suppresses) in a MA

Back 119

primary vertical, noncomitant deviation, aniseikonia, unequal image quality, head trauma (sensory fusion disruption syndrome)

Front 120

What kind of pt often shows high amounts of prism adaptation?

Back 120

ETs

Front 121

What causes prism adaptation?

Back 121

Anomalous motor fusion (AMF) response that tries to maintain initial anomalous sensory status.

Front 122

How does the prism adaptation test work? (PAT)

Back 122

Put prism on to neutralized. Wait 30-45 mins. Check eye.

Front 123

What does a negative PAT result indicate?

Back 123

There is no prism adaptation

Front 124

How does the progressive prism adaptation test work (PPAT)

Back 124

Put prism on to neutralized. Wait 30-45 mins. Check eye. Add prism. Repeat until no more prism adaptation.

Front 125

(T/F) Surgery is not successful for pts that have high amounts of prism adaptation.

Back 125

T

Front 126

Name 4 tests to evaluate central sensory fusion

Back 126

Worth Dot at 3 meters, polarized distance acuity chart, bagolini striated lenses, 4BO prism test.

Front 127

(T/F) The 4 BO prism test evaluates microtropia

Back 127

F. Checks for central suppression.

Front 128

What are the 2 indicators of central suppression in the 4BO Prism test?

Back 128

With prism over good eye, version only in bad eye. With prism over bad eye, no movement of good eye.

Front 129

(T/F) The presence of diplopia in the 4BO Prism test is diagnostic for central suppression

Back 129

F

Front 130

(T/F) The 4BO prism test is not well repeatable

Back 130

T