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68 Cards in this Set
- Front
- Back
Name 2 direct Accomodative Tests
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Acc. Amplitude
Monocular Acc. Facility |
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Visual therapy uses feedback mechanisms to provide patient info on whether or not they are doing thetests correctly, these mechanisms include
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Diplopia
Blur Suppression Kinesthetic awareness Small In, Large out |
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What is a Quit Vectogram
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Polairzed R an L images
Tells you if patient is suppression an eye |
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T/F Using a BASE OUT prism, a target appears SMALLER and moves CLOSER in
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T
Fused objects looks smaller and move closer in order to maintain size constancy CONVERGE=Close and SMALL |
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T/F Using BASE OUT prism, a target appears LARGER and moves FARTHER away
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FALSE
BASE IN DIVERGE=LARGE, AWAY |
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using a base _________ makes a target look smaller and closer
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out
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using a base _______ makes a target look farther away and larger
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in
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As we converge out eyes, a target's Relative Image size increases, so in oder to perceive the target correctly, we
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shrink the size of the image in order to maintain size constancy
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Who are more likely to respond with Small OUT and Large IN rather than SILO?
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Adults, they rely more on previous experiences inviewing oj move away
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Why don't pencil push ups work?
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This works both accomodation and convergence rather than working one or the other
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BIM=
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Base IN demand, MINUS lenses
Makes eyes turn in and must use negative fusual vergence, or BI to keep target single |
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BOP=
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Base OUT demand, PLUS lenses
Makes eyes diverge so that you have to use positive fusional vergence. |
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T/F in order to increase positive fusional demand, you would use minus lenses in front of patient
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FALSE
PLUS lenses increases BO demand on patient |
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When you converge, you move the plane of vergence ___ patient
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towards
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The _______ the separation between the plane of accomodation and plane of vergence, the GREATER the demand on fusional vergence
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GREATER
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PLus lenses/BO prism makes it harder for a patient to
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keep convergence, keep an ojbect single
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If you have trouble fusing BO prism make it easier by using
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MINUS Lenses OR give patient EXTRA BI
(its like your patient is an Exophore and cannot do the BO vergence facility test, give them minus lenses in front of eye and they can do it) Makes patient more esophoric so you do not have to use as much BO to fuse object |
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If you have trouble fusing BI prism, make it easier by using
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Plus lenses/ BO prism
Plus lenses will decrease accomodative demand. MAkes patient less eso so they don't have to use as much BI. |
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How do you make BO therapy harder?
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ADD MORE BO or PLUS lenses to the patient
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How do you make BI therapy harder?
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Add MORE BI or Minus lenses to the patient
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When using BO prism the plane of convergence is always __ of the target
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in front of
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When using BI prism the plane of convergene is always _______ the target
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beyond,no vergence demand
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If the patient is trying to fuse BO prism and sees one image BUT its blurry, the patients plane of accomodation must be _______ to the plane of convergence then it should be
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CLOSER
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definition of prism diopter=
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1 cm seperation at a distance of 1 m
if HTS took place 1 m away targets are seperated by 1 cm= 1pd demand Or working distance, however is 40 cm so when you separate targets by 4mm you create a 1 pd demand |
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When using the Vectogram, if your Right eye sees the R, the prism you are using must be
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BI
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When using a vectogram, if your Right eye see the L, the prism you are using must be
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BO
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Decreasing the working distance ALWAYS ____ the prismatic demand regardless of direction of therapy, BO or BI
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increases
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T/F Increasing the working distance always DECREASES the prismatic demand regardless of direction of therapy, BO or BI
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T
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Brock String is used for what condition?
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BI
a cord with 2 wooden beads, one end tied to the door nknow, other to the brdige of nose. When looking at one bead, will see diplopia of other bead. |
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If patient cannot accomplish CI tasks, give them _____ lenses to help
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minus lenses, help with convergence
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What other CI task is used after patient accomplishes Brock String?
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Barrel Card
Helps patient normalize near point convergence. Card on drige of nose, fixate on barrle fartherst away and fuse other barrel will be seen as double |
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What is the most effective use of prism in optometry?
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Vertical relieving prism
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If an esophore uses negative fusional vergence and has low BI vergence ability _____ prism would relieve patient
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BO
puts image where eye likes it |
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What is the compensating vergence for an exphore?
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Exophore uses Positive fusional vergence to see.
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To compensate for an exophore _____ prism would releive patient
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BI
puts image where eye likes it |
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Why is prism effective for Divergence insufficiency?
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Patient is ESO at distance and has a LOW AC/A ratio. Patient will not do well will Plus lenses so you use BO prism to help patient
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T/F Research has shown that BI prism is a good way to relieve CI in kids
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FALSE
may only be effective if CI is aquired after brain injury |
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Fixation disparity is the difference between vergence stimulus and _____________
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vergence RESPONSE
how much we SHOULD converge versus how much we ACTUALLY converge |
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How can we measure fixation disparity in clinic?
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Wesson card --> measure associated phoria
The amount of prism required to achieve alignment of the arrow and center line is the associaed phoria. Use polarized glasses, one eye sees arrow and other sees colored lines, add in prism until arrow points to middle line. |
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Whe we measure for prism through a phoropter we are using ______ phoria because patient is not fusing the target
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dissociated phoria
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Sheard's criterion is better for _______ determination of prism
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EXOPHORIAS
Compensating Fusional Vergence should be twice the phoria in order to be comfortable. prism= 2/3phoria- 1/3compensating fusional vergence |
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prism= 2/3phoria- 1/3compensating fusional vergence
is what formulae? |
Sheards
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Percival's Criterion is better for _______ determination of prism
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Esophoria
Paitnet should be operating withing the middle third of their vergence range to be comfortable, INDEPENDANT of phoria prism= 1/3 Greater vergence- 2/3lesser vergence |
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T/F Perceival's criterion is DEPENDANT on patient's phoria
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FALSE
only wants patient to be in the middle of vergence powers, regardless of what the patients phoria is |
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prism= 1/3 Greater vergence- 2/3lesser vergence
is what formula? |
percival's
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Prism is neither necessary nor desirable unless the phoria is _______ and then it is the FIRST choice treatment
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VERTICAL
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PAtient is 6 eso, what prism/lens will help patient?
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BASE OUT
PLUS lens |
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What is the effect of using a minus lens on an esophore?
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causes more ESO, even more demand on already low BI vergence
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X-BIM=
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eXophores do BEST with BASE IN prism and MINUS lenses
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BOP-S=
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Base OUT or Plus lenses work best for eSophores
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T/F Base out prism would minimize an esophores problem
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FALSE
BASE OUTS |
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How many accomodative/binocular problems can be treated without the use of therapy as the primary treatment?
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5 out of 12
Acc. insuffisciency Ill sustained accom Divergence insufficiency Convergence Excess vertical phoria |
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How much + should be Rx from a cycloplegic refraction?
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subtract .50D from the findings because that is from tonic accomodation
Example: find +2.50, Rx +2 to patient |
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How much plus do you put in an ADD power?
It depends on what findings? |
NRA/PRA
Take the difference and divide by 2 Example= +2.50 NRA -1.00 PRA Amount of + needed is +.75D NRA-x=PRA+x |
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For patients with LOW AC/A ratios, what therapy is most effective?
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Vision Therapy
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For HIGH AC/A ratios, what therapy will be most effective?
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Lenses
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Typical CI presents with
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exo at near
low BO low positive fusional vergence receped NPC Low AC/A |
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Which has higher sucess for CI patients, Home or Office VT?
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OFFICE
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When should you followup with a patient who has CI?
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4-6 weeks after home bsed VT used.
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I with Accomodative Excess patients tend to have what type of astigmatism?
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ATR!!
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Only difference between accomodative facility versus fusional vergence disparity
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accomodative facilitiy patients will fail MAF
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BO prism is used to treat and diagnose
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Esophoria
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T/F BO prism is used to treat and diagnose Esophoria
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T
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BI prism is used to treat and diagnose
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Exophoria
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T/F BI prism is used to treat and diagnose Exophoria
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T
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A sudden onset of divergence insufficiency must make you suspecious of
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6th nerve palsy
test for comittancy |
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The Covergence Insufficienc Treatment Trial showed tat the only effective treatment for CI is
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VT
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Test Psuedo-CI by
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using +1.00 and doing NPC.
A real CI patient will have a more receeded NPC with +1 (makes them use even more BO). Psuedo CI patients will have nroam l NPC |