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1
Q

motor alignment group is a group of skills that…

A

a group of skills that measures how accurately the eyes point at the object of regard

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2
Q

Dissociated measures of alignment

A

a measure of the eye posture when fusion is broken (where do the eyes point at rest when they are not working together)

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3
Q

Dissociated measures include (3)

A

cover test, von graefe phorias, and maddox rod measures

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4
Q

Associated measures of alignment

A

are measures of the accuracy of eye alignmnet under FUSED conditions. (with both eyes open and pointing at the target

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5
Q

even under fused conditions the eyes will rest

A

slighty in front (eso) or slightly behind (exo) the target, this is measured as fixation disparity

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6
Q

Uuseful for prescribing prism

A

Fixation Disparity (associated measures of alignment )

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7
Q

Do AC/A and CA/C directly measure motor alignment?

A

no, they describe the association between convergence and accommodation as a ratio

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8
Q

______ quantifies the near triad

A

AC/A , can tell you how strong or weak it is

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9
Q

Useful for prescribing extra plus at near for high ACA Esos or over minus at distance for young HIGH ACA Exos

A

AC/A and CA/C

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10
Q

PFV group

A

tests that measure the visual systems ability to converge the eyes. This group is important for predicting the comfrort of a pt with exo motor alignmnet

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11
Q

NFV group

A

tests that measure the visual systems ability to diverge the eyes; group is important for predicting the comfort of a pt with an ESO motor alignmnet

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12
Q

ocular motor skills

A

these tests measures a pts pursuit and saccadic function. Includes: subjective saccades, subjective pursits, NSUCO, DEM, King Devick

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13
Q

Vertical Fusion

A

a group of tests that are used to evaluate pts with a hyper/hypo motor alignment . Supra/infra vergences, FD

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14
Q

Visual-verbal tests of ocular motor skills

A

The DEM and King Devick are visual-verbal tests of ocular motor skills.

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15
Q

Modified Thorington test (dissociated phoria with saladin)

A

using a maddox rod and shining the transluminator through the pin hole. Pt describes the location of red line

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16
Q

to measure a horizontal phoria using modified thorington

A

place maddox rod horizontally over pt right eye. And vice versa for a vertical phoria

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17
Q

What is the DOG card (on reverse of the wesson card) used for

A

to get a Convergence Accomodation/convergence range. Doing dynamic ret through central aperture. And re meaure dynamic ret while holding 6 BO

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18
Q

name the tools that can measure Fixation Disparity and associated phoria

A
  1. wesson fixation disparity card, 2. AO Vectographic card, 3. Saladin Near point card 4. Sheedy Disparometer
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19
Q

Saladin Card can be used to measure for Fixation Dispairty by using ? To measure Exo the pt should view the card _____, to measure eso the pt should view the card______

A

the vernier lines within the grey circles across the top and side of card. Exo=card right side up Eso=view the card held up side down .

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20
Q

AO vectographic card set up

A

pt wears polarized glasses; it’s the card with the circle in the middle. The top and the line to the right are OS.

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21
Q

Sheedy Disparometer set up

A

pt wears polarized glasses; pt keeps letters around venier lines clear; clinician rotates back of instrument to zero; ask if lines are aligned. Rotate and read back of instrument for FD. If FD zero=associated phoria zero.

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22
Q

I am getting one measurement on sheedy disparometer. But in two steps.

A

first step is getting if they are eso or exo. ask them if it is aligned and rotate until the lines are aligned. t=eso or exo.

2nd step: is getting the prism amnt. set it to zero. and use prism.

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23
Q

norms for cover test near

A

3xp (+/-3)

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24
Q

cover test distance norm

A

1xp or +/-1

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25
ACA norm
4/1 (+/-2)
26
CA/C norm
0.5D per 6 prism diopter
27
nra norm
2.50 give or 0.50 more or less
28
pra norms are
-2.37 +/-1.00
29
accom amps
min 15-age/4 - 2
30
monocular accom therapy goals 5-10 yrs
6cm
31
monocular accom therapy goals 10-20 yrs
8cm
32
monocular accom therapy goals 20-25 yrs
10cm
33
monocular accom therapy goals 25-30 yrs
12cm
34
monocular accom facility goal is to achieve
+2.50/-6.00 lens changes comfortably
35
Bi-Ocular
refers to an activity done with both eyes open but the two eyes are viewing different targets (not working together).
36
Bi -Ocular Accomodative therapy goals
is to achieve +2.50/-6.00
37
binocular accomodative skills indirectly work
convergence and divergence training
38
goal for binocular accom training is
+2.50/-2.50
39
rock is used to denote
the accomo action of changing focus from near to far during facitility changes. ("rocking" between a small near chart and a large distance chart. Or rocking between plus and minus lens
40
t/f binocular accomodative rock begins once ____ and ____ goals are achieved AND vergence ranges are normailzed
mocuar and bi-ocular goals
41
If a pt is unable to clear a target requiring accomadition the coach
can decrease the accom demand to a level where they can successfully perform the activity
42
if pt unable to clear a target require them to relax their accomod the coach can help the pt by
Decreasing the target distance or plus lens power to a level that permits the patients success
43
during monocular amplitude therapy: push up training: the patient reports the target is blurry. How should you coach them?
"look hard" "tighten eyes" " think about looking close"
44
Monocular Rock VT activites
Push up training, distance/near targets (HART-CHART), HART CHART lens rock, lens sorting , flipper lens therapy
45
the goal for monocular rock activities are
+2.50/-6.00
46
Tools needed for distance/near targets monocular rock
hart chart and a distance chart and eye patch. This test is also testing accom facitlity )
47
to make distance/near target challenging monocularly
have patient walk heel to toe as approaching the distance target
48
to emphasize the accomodative facility with distance/near targets =, I can
have pts read 3-4 letters on distance and near target
49
how should you coach a patient having difficulty clearing distance
relax! Look far away!
50
the GOAL FOR MONOCULAR DISTANCE/NEAR TARGETS
they should be able to quickly change focus from near to distance with each eye equickly *1-2 seconds). Distance =10-20t and near target 3-4 inches I s the set up
51
minus lens blanks and distance hart chart rock
monocular accomodative rock test. Ehances accom amps, monocular facilty, and tightening accom during minus lens
52
minus lens blanks&distance hart chart procedure
pt patches one eye, reads hart chart without minus lens and then puts lens over eyeglasses as close as possible.
53
what can you do to make minus lens and hart chart difficult
increase power of minus lens but have them to move closer to account for the minification effect
54
pt struggling to clear minus lens on minus lenses blanks, what can you do ? What does this do for the patient
allow pt to pull lens farther away. It decreases the accomodative demand and decreases effective power of - lenses
55
goal for minus lens/hart chart
change focus from with and without lens equally well. Set up= standing 10ft from target and and up to a a power of -6.00, but can be pushed to -8.00
56
Lens sorting is a test
to familarize the pt with tightening and relaxing accomodating through lens and to improve accommodate facitiy
57
patient set up and procedures for lens sorting
pt holds a near target, pt holds +1.00 lens and clears target, pt holds -1.00 lens and clears target. Ask pt the differences between the two. And other questions. Then set test up for lens sorting
58
Goal of lens sorting
for the pt to appreciate the difference between tightening & relaxing accomodation; be able to successfully sort lens 0.50D increments from +2.00 to -6.00
59
lens sorting set up
pt asked to look through each of the 6-8 lens on table. Sort throguh each lens to clear text. Weakest to stroungest (more minus)
60
coaching for lens sorting
think about how the print looks (larger or smaller) or eyes feel (relax or tightening)
61
flipper lens therapy purpose
to equalize and ehance monocular accom FACITILTY
62
materials for flipper lens therapy
reading material with small print (accomodative demand), childs favorite book.
63
flipper lens therapy procedure
pt reads text start with +1.00 on fliper, patient reads next line start with -1.00 on flipper
64
goal of flipper lens therapy with moncular acom rock.
10-15 cycles per minutes ; that is equal OD and OS with +2.50/-6.00 . Eso pts and accom excess should NOT exceed -3.00.
65
what can you ask during flipper accom testing
is one side of flipper harder than the other? Are your eyes tightening or relaxing? Does the print look smaller or bigger?
66
to clear plus flipper coach pt
relax your eyes! Look through the target…like looking far way.
67
to clear minus flipper coach pt
look hard! Tighten eyes! Like looking up close!
68
loose prisms and lens rock are what type of tests
BI-OCULAR ACCOMMODATIVE ROCK ; each eye has two different images
69
procedure for loose prisms and lens rock
left eye has base down in front of it and a minus lens. The right eye has just a plus lens. Pt insurstructed to read few letters from target on (eye looking through minus) and letters through target on bottom eye looking through plus. Patient switches fixation
70
are your eyes tightening or relaxing on the top lines. Is a good questin for
loose lens and lens rock
71
goal for loose prisms and lens rock
rock between +2.50 and -6.00. Ideally 10-15cpm .. Pts pushing plus like esos and accom excess SHOULD NOT EXCEED -2.50 to -3.00D
72
stereoscope BI-ocular rock
to enhance and equalize monocular accom facitily under bi-ocular conditions (2 eyes open BUT viewing different targets)
73
two small letter charts placed at number ____ on the seteroscope. What lens should be placed in steroscope?
11. +1.00 in one well and -1.00 in other well , pt is clearing one line at a time alternatively. But both carts are visible.
74
if patient struggling to clear plus, on steroscope
check targets position, they may be too far away (beyond 10 or 11) that’s beyond the far point of total plus power in the system
75
if pt struggling to alternately clear lenses on steroscope
therapist can briefly occlude one eye to allow the other eye to see monocularly.
76
goal of steroscope BI-OCULAR ROCK
to quickly and easily change accomo from +2.50 to -6.00 bi-ocularly through the stereoscope.
77
Minus Lens/Hart Chart BI-OCULAR ROCK
to improve and equalize accom faciltiy
78
set up for minus lens/hart chart bi-ocular rock
2-3 ft from large hart chart. Holiding minus lens 2-3cm from left eye. Pt asked to look into lens and clear the distant hart chart. And next to look with the right eye(lthe one with no lens) and read the whole next line. Goal is to QUICKLY and ACCURATELY rock -6.00/plano bi-OCULArly.
79
how to coach minus lens with hart chart bi-ocular rock.
difficulty clearing minus ask them to pull lens further away and look hard
80
to make chart visible through large lens blank
have pt look through lower edge of the blank and this indues base down. Making the image be higher than the other eyese image.
81
BINOCULAR accom rock flipper lens therapy
pt must have good vergence rances, and can bring their own reading material
82
TO MONITOR SUPPRESSION , pt should have
bar reader with red/green or polaroid glasses may be used in conjunction with the +- flippers. MAKE SURE SUPPRESION IS NOT PRESENT

Binocular Vision I (3 decks)

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