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BV Prac Exam 1 > BV > Flashcards

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1
Q

What are the instructions for the Titmus stereo tests?

A

● “I am going to test your depth perception”
● “Can you put these (polarised) glasses over your glasses for me?”

Suppression test
● “Can you tell me what you can see in this square and circle here?”

Stereo fly test
● “What do you see here? Can you come to the side and use your thumb and forefinger to pinch it’s wing here?”

Animal stereo test
● “Does one of these animals seem to come out closer to you than others? And the next line? And the next line?”

Circles stereo test (Wirt rings)
● “I want you to now look at these squares with circles within them. Starting from square 1 and going across, look at each of the four circles and tell me which one seems to come out closer to you - top, bottom, right or left? How about square 2? 3?”

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2
Q

What is the room illumination for Titmus?

A

Room but no reflections

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3
Q

When do you perform uncrossed disparity?

A

● If performance is poor in crossed disparity, test with uncrossed. If performance is markedly improved, Patient should be re-tested with crossed disparity

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4
Q

What can a monocular px view on Titmus chart?

A

● A monocular Patient can correctly identify the first 4 or 5 rings. This is because there is a monocular cue when wearing the polarisiers

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5
Q

What do you record for Titmus suppression, stereo fly test, animal stereo test and circles stereo test (wirt rings)?

A

● Test
● Test distance
● Stereoacuity in seconds of arc
● If no stereoacuity at all, record which eye is suppressing

Suppression test
● Record if R/L/both

Stereo fly test
● Positive = gross stereopsis, 59’

Animal stereo test
● Positive = local stereopsis, 100”
● Disparities vary from 400” to 100” at 40cm

Circles stereo test (Wirt rings)
● Positive = local stereopsis, 40”
● Disparities vary from 800” to 40” at 40cm

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6
Q

What is the testing distance in Titmus?

A

40cm

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7
Q

What is the purpose of random pattern stereograms in Randot tests?

A

● Includes random pattern stereograms (RDS) to overcome the problem of monocular cues (but also has tests that are not RDS)

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8
Q

What does testing at 80cm for Titmus and Randot tests do?

A

approximately halves the nominal disparities

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9
Q

What are the instructions for Randot tests

A

● “I am going to test your depth perception”
● “Can you put these (polarised) glasses over your glasses for me?”

Suppression test
● “Can you tell me what you can see in this rectangle here?”

Randot forms
● “In these top 4 areas, which area does not appear to have any shape in it? What about the other areas? Can you identify the shape as well? And how about the bottom 4 areas?”

Animal test (with random dot ground)
●	“Does one of these animals seem to come out closer to you than others? And the next line? And the next line?”
Circles test (with random dot ground)
●	“I want you to now look at these squares with circles within them. Starting from square 1 and going across, which one seems to float forward or appears different from the others - top, bottom, right or left? How about square 2? 3?”
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10
Q

What happens when px sees a fading letter in the suppression check

A

Note gross fading of R or L

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11
Q

How do you record the results for Randot tests?

A

● Test
● Test distance
● Stereoacuity in seconds of arc
● Record separately, for global and local tests

Suppression test
● Record if R/L/both and -/I/+ seen

Randot forms
● Record 500” or 250” at 40cm
● Positive = global stereopsis

Animal test
● Positive = local stereopsis
● Disparities vary from 400” to 100” at 40cm

Circles test
● Positive = local stereopsis, 40”

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12
Q

What is the testing distance for worth 4 dot test?

A

40cm and 6m

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13
Q

What does the worth 4 dot test test?

A

assesses flat fusion ability

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14
Q

What are the instructions for the worth 4 dot test?

A

● “This test checks whether you are using both eyes at the same time to see”
● “Can you put these (red-green) glasses over your glasses for me?”
● “How many dots do you see?
● If 5 dots are seen, ask if the red dots are to the right or left of the green dots

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15
Q

What illumination is the W4DT done in?

A

Room illumination

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16
Q

How should the torch be held in the W4DT?

A

slightly downwards at reading position

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17
Q

What will the eye with the red filter see at 40cm vs 6m and how about with the green filter?

A

● At 40cm: the RE with the red filter will see the red dots and the LE with the green filter will see the green dots
● At 6m: the eye with the red filter will see the green dots and the eye with the green filter will see the red dots

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18
Q

what do you record if px sees 4 dots in W4DT?

A

W 4-dot: flat fusion, 6m and 40cm, light and dark

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19
Q

what do you record if px sees 2 dots in W4DT?

A

W 4-dot: suppression of green filter/left eye, 6m and 40cm, light and dark

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20
Q

what do you record if px sees 3 dots in W4DT?

A

W 4-dot: suppression of red filter/right eye, 6m and 40cm, light and dark

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21
Q

What do you ask and what do you record if px sees 5 dots?

A

record W 4-dot: diplopia, 6m and 40cm, light and dark
■ “Are the red dots to the right of the green dots?” → uncrossed diplopia, eso deviation
■ “Are the red dots to the left of the green dots?” → crossed diplopia, exo deviation
■ “Are the red dots below the green dots?” → R/L deviation or right hyper or left hypo deviation
■ “Are the red dots above the green dots?” → L/R deviation or left hyper or right hypo deviation

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22
Q

What are the 4 ways to measure amplitude of accommodation?

A
  1. push up method
  2. push up method with -4.00D lens
  3. pull away method
  4. minus lens method
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23
Q

What are the expected values for push up method?

A

tend to overestimate
(MEAN) = 18 - age/3 (+/- 2 SD)
E.g. age 20 = 11.33 D, age 21 = 11 D

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24
Q

What are the expected values for pull-away method?

A

tend to be over estimated but lower than push up method

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25
What are the expected values for the minus lens method?
2D < push up-values thus tend to be underestimated due to minification
26
What is the expected amp of accommodation for age 20, 44 and 60?
``` Hofstetter calculation for MINIMUM expected AA: 15-age/4 ● Age 20 → 10 D ● Age 44 → 4 D ● Age 60 → 0 D ● 1 D for every 4 years ```
27
What are the instructions for push up method (binocular and monocular)?
● “I am going to measure the focusing power of your eyes” ● If patient has Rx, “Keep your glasses on.” ● “What is the smallest line of letters you can read?” ● “Read out the first 2 letters of that line for me.” ● “I am going to be moving this target towards your eyes and I need you to keep on looking at those letters for me. Try to keep the letters clear. Please tell me when it first becomes blurry and with further effort you cannot resolve the letters.” ● “In this position, are the letters staying blurred?” ● If yes, this is the distance to measure from. If no, keep moving target towards patient.
28
What are the instructions for pull-away method?
● “I am going to measure the focusing power of your eyes” ● If patient has Rx, “Keep your glasses on.” ● “I’ll be putting this chart stick close to your face and I want you to focus on the very top letter for me. I am going to move the stick away from your eye and I want you to tell me what the letter is as soon as you can read it.”
29
What are the instructions for minus lens method?
● “I am going to measure the focusing power of your eyes” ● If patient has Rx, “Keep your glasses on.” ● “I will be changing the lenses in front of your eyes. Try to clear the print after each lens change. Tell me when the letters (1 line above patient’s near VA) are slightly blurred, still readable, but cannot be cleared by further effort.”
30
What is the room illumination when measuring amp of accommodation?
normal room lighting
31
What rx should the px be measuring when measuring amp of accommodation?
distance rx
32
What is the target for push up method?
smallest letters that px can read on the chart stick
33
What does using the -4 lens in the push up method mean?
● The use of -4.00 D places the near point further from the spectacle plane which ensures that depth-of-focus errors are minimised
34
Is the pull away method done monocularly, binocularly or both?
monocularly
35
Is the minus lens method done monocularly, binocularly or both?
monocularly
36
How should the amplitude of accommodation be calculated in the minus lens method?
By counting the number of clicks and adding +2.50D for a target at distance 40cm
37
How do you record the results for push up method?
● Measure the distance from the spectacle plane to the stick in cm ● Convert to dioptres and record ● Amp. of Accommo (push-up) OD 8.50 D, OS 8.50 D, OU 10.00D
38
How do you record the results for pull away method?
● Measure the distance from the spectacle plane to the stick in cm ● Convert to dioptres and record ● Amp. of Accommo (push-up) OD 8.50 D, OS 8.50 D, OU 10.00D
39
What do you do when the px is wearing glasses and you have to do the minus lens method?
put the px's rx into the phoropter
40
How do you set up the phoropter for the minus lens method?
1. Sanitise the head rest and cheek rest 2. Place the near card rod with the near letter chart at 40cm 3. Dial in the px's distance rx 4. Adjust to near rx using the lever on both sides of the phoropter 5. Align the spirit level 6. Secure it in front of the px
41
What is the expected values of monocular accommodative facility?
MEAN = 11 cpm (at 40 cm). Range = 6 cpm or more (at 40 cm), i.e. cut-off at 6 cpm A difference of more than 2 cpm or more between eyes is not normal
42
What are the instructions for monocular accommodative facility?
● “I am going to test how quickly your focusing can change” ● If patient has Rx, "Keep your glasses on." ● Cover LE with eyepatch ● “On this card there are words inside the squares. I am going to place a lens in front of your eye that may make the word appear blurred. I want you to focus and make the print clear again as soon as you can. As soon as it becomes clear, say the word. We will start at box 1 and move across each time I flip the lenses. Try and look only at the square you up to and not further ahead. When I do flip the lenses, the print will become blurry again and I want you to quickly refocus, and say the word when it becomes clear. We will repeat this for 60 seconds.”
43
What do you record for monocular accommodative facility?
``` Test performed Test distance Eye tested Cycles/min (remember to halve) Which lens powers were used (+/-2.00D) Which lens (IF ANY) was more difficult ```
44
What is used as a suppression check in binocular accommodative facility and what is expected?
- Pen torch is used - Hold the pen torch and try to find a point where px sees double images. When found, let px hold the pen torch at that position for the rest of the test - If double vision was not found, record "Binocular accommodative facility: no diplopia seen" - If pen torch changed from two to one, record "Binocular accommodative facility: suppression mid-test"
45
What are the instructions to test binocular accommodative facility?
● “I am going to test how quickly your focusing can change” ● If patient has Rx, "Keep your glasses on." ● Both eyes open ● “While looking at the words with the pen in the way, how many pens do you see?” (Should be 2) ● “I’ll get you to hold the pen yourself so that you still see 2 pens while looking at the chart” ● “I am going to place a lens in front of your eyes that may make the word appear blurred. I want you to focus and make the print clear again as soon as you can. As soon as it becomes clear, say the word. We will start at box 1 and move across each time I flip the lenses. Try and look only at the square you up to and not further ahead. When I do flip the lenses, the print will become blurry again and I want you to quickly refocus, and say the word when it becomes clear. We will repeat this for 60 seconds. Let me know if the pen ever changes from being 2 to 1.”
46
What do you record for binocular accommodative facility?
``` Test performed Test distance Eye tested Cycles/min (remember to halve) Which lens powers were used (+/-2.00D) Which lens (IF ANY) was more difficult ```
47
What are the expected values for binocular accommodative facility?
MEAN = 10 cpm (at 40 cm). Range = 5 cpm or more (at 40 cm), i.e. cut-off at 5 cpm
48
What does NPC test?
Determines convergence amplitude and if there is an insufficiency
49
What targets can be used in NPC test?
● Non-accommodative target (pen torch) ● Pen torch with R/G goggles ● Accommodative target
50
What are the expected values of NPC?
● Average is 2.5/3 cm ● Non-accommodative target = 7/10 or closer ● Accommodative target = 5/7 or closer
51
What are the instructions for NPC with a non-accommodative target?
● “This test determines how well your eyes can turn in to follow a close object” ● “Can you put these (R-G) goggles over your glasses (near Rx) for me?” ● Both eyes open ● “Can you see the light here? will be moving the pen torch towards you so tell me as soon as it becomes doubled - not blurred but doubled (pull-in)” ● “And when you see single again (pull-away)”
52
What are the instructions for NPC with an accommodative target?
● “This test determines how well your eyes can turn in to follow a close object” ● “Keep those (R-G) goggles over your glasses (near Rx) for me” ● Both eyes open ● “Can you read the smallest line that you can see on this chart stick? Okay I want you to look at this line of letters (2 lines above their best VA) and I want you to keep it clear and single. I will be moving the chart towards you so tell me as soon as it becomes doubled - not blurred but doubled (pull away)”
53
What is the target in the pul-away test?
The smallest line of letters seen on chart
54
What is the target in the minus lens method
1 line above px's near VA
55
Why is a pen torch with R/G goggles used in NPC?
● Use a pen torch with R-G goggles so Patient can notice the diplopia easier with the two colours
56
What do you need to observe when you do NPC?
Observe for any eye turn
57
What do you record for NPC?
● Record break/recovery in cm, along with which eye turned, if any eg 7/10, left eye out ● If the Patient never reports diplopia and if you do not see an eye turn, record “to the nose” or “TTN”. In this case, you won’t be able to record a “recovery” ● Record if test was done in downgaze
58
How would you be able to get an objective NPC?
By measuring the distance at which you see the eye turn
59
What is the abbreviation for within normal limits?
WNL
60
What is the abbreviation for worth 4 dot
W-4-D
61
What is the abbreviation for alternating esotropia?
ALT SOT
62
What is the abbreviation for esophoria?
SP
63
What is the abbreviation for exophoria?
XP
64
What is the abbreviation for left/right esotropia
L/RST
65
What is the abbreviation for left/right exotropia
L/RXT
66
What is the abbreviation for left/right hypertropia
L/RHyperT
67
What is the abbreviation for left/right hypotropia
L/RHypoT
68
What is the abbreviation for push-up method
PUT
69
What is the abbreviation for binocular?
Binoc
70
What is the amp of Acc if near blur point was 10cm, 11c, 12cm
10D, 9.09D, 8.33D
71
What is the amp of Acc if near blur point was 13cm, 14cm, 15cm
7.7D, 7D, 6.7D
72
What is the amp of Acc if near blur point was 16cm, 17cm, 18cm
6.25D, 6D, 5.5D
73
What is the amp of Acc if near blur point was 19cm, 20cm
5.25D, 5D
74
What is the amp of Acc if near blur point was 7cm, 8cm, 9cm
14D, 12.5D, 11.11D
75
What do you do if px passes all 9 sets of circles at 40 cm
Retests at 80 cm (Wirt rings). The disaprities are approximately halved

BV Prac Exam 1 (1 decks)

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