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Visual Ana FINALS > AC/A RATIO & TESTS CONSIDERED IN NON-STRABISMIC HETEROPHORIA > Flashcards

AC/A RATIO & TESTS CONSIDERED IN NON-STRABISMIC HETEROPHORIA Flashcards

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1
Q

The measurement of convergence induced by accommodation per diopter of accommodation 1D.

A

AC/A RATIO

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2
Q

Ratio of 1D of accommodation every time the eye converges.

A

AC/A Ratio

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3
Q

Normal AC/A

A

4:1, 5:1, 6:1

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4
Q

Optical systems of accommodation

A
  • Crystalline lens
  • ciliary muscles
  • zonules of zinn
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5
Q

What type of accommodation cannot be measured?

A

Physiological accommodation

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6
Q

Unit for physiological accommodation

A

myodiopters

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7
Q

Type of accommodation

when ciliary muscles contract → Zonules of Zinn also contracts → 1.00D equivalent to accommodation of CL , and everytime the muscle converge, there is 1D equivalent to accommdation

A

Physiological accommodation

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8
Q

Type of accommodation

Actual contraction/deformation of crystalline lens

A

Physical accommodation

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9
Q

unit of measurement of physical accommodation

A

Diopters

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10
Q

How is physical accommodation measured?

A

VT 4, 5, 6, 7

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11
Q

Purpose of AC/A is to determine the change in ________________ that occurs when px ___________ or ________

A

accommodative convergence; accommodates; relaxes

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12
Q

Significance of AC/A is to determine the ___________ of the visual axes of the eyes at near when accommodative stimulus is changed without changing near convergence

A

relative horizontal position

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13
Q

Ways to determine ACA ratio

A
  1. Gradient test
  2. Calculated method
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14
Q

What method has: Lens in place: +/-1.00D over Vt # 7 findings

A

Gradient method

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15
Q

If the result of phoria test is within the NORMAL limits (0.5exo, ortho to 6 exo), what is placed over the VT7?

A

+1.00

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16
Q

What is placed over VT7 for px with high exophoria at near (result of VT 13B is beyond or higher than 6EXO)?

A

-1.00

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17
Q

After putting +/-1.00D, what is the next step?

A

perform 13B, then compare with 13 B result

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18
Q

If the result of 13B and gradient result has the same phoria, what is the next step?

EX:
13B = EXO, Gradient = EXO
13B = ESO, Gradient = ESO

A

SUBTRACT

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19
Q

If the result of 13B and gradient result is opposite from each other, what is the next step?

EX:
13B = EXO, Gradient = ESO
13B = ESO, Gradient = EXO

A

ADD

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20
Q

Perform gradient aca
Vt 7: -3.50Ds ; Phoria 13b: 7 exo
Gradient result: 4exo

A

Since higher than normal, place -1.00 on -3.50

  1. LIP becomes -4.50D
  2. Do phoria test
  3. Result: 4 exo
  4. Since same phoria, subtract
  5. 7-4 = 3

AC/A = 3:1

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21
Q

3:1 and below interpretation

A

LOW AC/A
In general, can mean any insufficiency.

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22
Q

4:1 - 6:1 INTERPRETATION

A

Normal
Can be normal eye, or has basic exo or basic eso.

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23
Q

7:1 INTERPRETATION

A

High AC/A
In general, can mean any excess.

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24
Q

FORMULA OF AC/A RATIO BY CALCULATION

A

AC/A = IPD + N (D’ - D)

or

AC/A = distance pd in cm + 0.40 (VT13B - VT8)

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25
In AC/A ratio by calculation method, if VT13B or VT8 is EXO, what sign should be used?
negative
26
In AC/A ratio by calculation method, if VT13B or VT8 is ESO, what sign should be used?
positive
27
Calculate the AC/A ratio if IPD is 60mm, VT8: 2exo, VT13B: 10exo
AC/A = 6.0 + 0.4 [-10-(-2)] = 6 + 0.4 (-8) = 6 + (-3.2) = 2.8:1 LOW ACA
28
Calculate the AC/A ratio if IPD is 56 mm, VT8: 3 exo , VT13B: 7 eso
ACA = 5.6 + 0.4 [7-(-3)] = 9.6:1 HIGH ACA
29
ACA INTERPRETATION LOW ACA
INSUFFICIENCY OR WEAKNESS
30
ACA INTERPRETATION LOW ACA WITH EXO FINDINGS
Convergence weakness exo or convergence insufficiency
31
ACA INTERPRETATION LOW ACA WITH ESO FINDINGS
Divergence weakness eso or divergence insufficiency
32
ACA INTERPRETATION NORMAL ACA
Basic exophoria Basic esophoria Equal amount of phoria at far and near
33
ACA INTERPRETATION HIGH ACA WITH EXO FINDINGS
Divergence excess
34
ACA INTERPRETATION HIGH ACA WITH ESO FINDINGS
Convergence excess
35
TESTS CONSIDERED IN NON-STRABISMIC HETEROPHORIA
NPC MEM BO TEST BI TEST PHORIA PR NRA ACA
36
INSTEAD OF GRAPHING Higher than normal expected = Lower than normal expected = Normal =
check high check LOW no recording
37
ANOMALIES OF NON-STRABISMIC ANOMALIES OF HETEROPHORIAS Anything to do with exo
1. Convergence insufficiency 2. Basic Exophoria 3. Divergence Excess
38
ANOMALIES OF NON-STRABISMIC ANOMALIES OF HETEROPHORIAS Anything to do with eso
1. Divergence insufficiency 2. Basic esophoria 3. Convergence excess
39
High near exophoria, low far exophoria
Convergence insufficiency
40
Equal near and far exophoria
basic exophoria
41
Low near exophoria, High far exophoria
divergence excess
42
Treatment for convergence insufficiency
Refraction modification Myp: Full correct with BI prism Hyp: Under correct with BI prism Primary: Vision therapy Pencil to nose Decentration of PD Secondary: Prism
43
TX for basic exo
over-minus at distance and near
44
TX for div excess
Over-minus at distance, maybe bifocals Hyp - undercorrection
45
TX for DIV INSUFF
Max plus at distance
46
tx for BASIC ESOPHORIA
max plus, bifocals may help at near
47
tx for conv excess
bifocals
48
In hyp, Least/weakest plus with BCVA
Absolute Hyperopia
49
IN hyp Strongest plus with BCVA
Manifest hyperopia
50
Facultative hyperopia =
manifest - absolute
51
hyperopia that can be overcome by accommodation
facultative
52
hyperopia cannot be overcome by accommodation
Absolute
53
What anomaly Symptom: Occasional near point asthenopia
Divergence excess
54
What anomalies Symptom: asthenopia & headache
Convergence insuff/excess
55
What anomalies Symptom: asthenopia associated with distacnce and near task
basic exo/eso
56
What anomaly Symptom: asthenopia associated with distacnce task
div insuff
57
What anomaly Symptom: Intermittent blur
All except div excess
58
What anomaly Symptom: Parents compain of eye turning out
div excess
59
What anomalies Symptom: Intermittent diplopia
all except div excess
60
What anomaly Symptom: child close one eye in bright light
div excess
61
What anomaly Symptom: symptom worse at the end of the day
all except div excess
62
What anomaly Symptoms: Burning and tearing inability to sustin concentration words moves on the page sleepiness when reading decreased reading comprehension over time slow reading
conv insuff/excess

Visual Ana FINALS (4 decks)

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