Flashcards in Amblyopia Treatment Deck (28)
Which eye is usually patched?
Direct: the dominant, NAE eye --> allows stimulation of AE and reduces competition/inhibition from NAE.
In _____ patching, the AE is patched, and the dominant eye is used to establish steady EF when direct occlusion is unsuccessful
What can you use for total occlusion
1. adhesive bandage/tape
2. pirate patch
3. clip on occluder for glasses
4. translucent tape
5. frosted lens
6. opaque contact lens
what can you use for partial occlusion aka penalization
1. occlusion foils
2. over plus optical correction (spectacle or CL)
3. atropine penalization
what eye do you partially occlude?
what is the wearing time for occlusion?
1. constant occlusion: during all waking hours
2. part time occlusion: between 2-8 hours/day
3. only during specific vision therapy procedures
Why is partial occlusion more beneficial than constant occlusion?
You still have binocularity; you improve depth perception and VA.
what do you need to consider for occlusion?
3. acuity and performance needs: can the pt perform daily activities w/o interfering with cognitive dev, academic performance and risk of bodily harm.
what is the behavioral approach of occluding
2-4 hours per day or only during home VT procedures.
what is the occlusion time frame for seeing results?
what are the 3 things to consider for occlusion therapy
1. starting VA: start with optical correction first
2. Patient's age
3. Patient's goals
What is considered moderate amblyopia? How long are you supposed to patch?
20/40-20/80 --> you usually see improvement in 3/more lines. You see first improvement in 5 weeks
What is considered severe amblyopia? How long are you supposed to patch?
20/100 -20/400 BCVA
6 hours; can split it into 3 and 3
T/F when you patch and have optical correction you see much better improvement
T/F When employing occlusion therapy for amblyopia, as VA improves, stereopsis generally also improves
How much are you supposed to penalize the good eye?
Two lines worse than their amblyopic eye
What type of occlusion are you supposed to use for eye and hand coordination
T/F patching provided better results than occlusion foils
T/F patching + perceptual learning (doing other activities) makes a bigger difference
true; with some people, performance of task actually gets better.
T/F Video game play induces plasticity in the visual system of adults with amblyopia
what is the plateau time for playing video games?
What is the purpose/goal for active amblyopia therapy
1. improve visual performance deficits
2. reduce symptoms
3. decrease total treatment time
4. enhance effects of occlusion
what are primary deficits in amblyopia
1. deficient eye movement/fixation skills
-unsteady and eccentric fixation
-increased saccadic latency
-decreased pursuit accuracy
2. poor form discrimination due to decreased CS
3. deficient accommodation skills
-decreased amplitude, accuracy and sustaining ability
4. spatial distortion/uncertainty
-increased contour interaction
-reduced visual info processing speed and ability
What does monocular in a BF technique do?
1. eliminates any suppression present when binocularly viewing; to reduce NAE's inhibition of the AE.
*have to put red filter over NAE, and no filter over AE and write/draw in red ink. if AE is suppressing, the red ink marks disappear.
What activities should you do for oculomotor control (pursuits and saccades)
1. monocular prism jumps
2. direct afterimages
3. line counting
4. hart-chart saccades
6. Tracking books
7. saccadic strips
*start with good eye first
Which activities should you be doing for accommodation?
2. spatial discrimination: lens sorting
3. minus lens
4. near far rock
5. lens flipper facility and power
6. split spirangle rock
7. wach's mental minus
what are some activities for eye hand coordination
2. stringing beads
3. computer and video games
4. pegboard activities