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EOM Testing Flashcards

1
Q

What is EOM testing used to evaluate?

A

actions of extraocular muscles for overactions or restrictions

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2
Q

How does one perform EOM testing (basic explanation)?

A

have patient follow a target in a pattern

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3
Q

What is different about infant/toddler EOM testing?

A

you may have to turn their head

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4
Q

What are the EOMs?

A

LR, SR, IO, IR, SO, MR

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5
Q

(Aslin) When is the youngest that children have convergence and when on average will children have convergence?

A

youngest= 1 month, average=1-3

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6
Q

When are infants capable of convergence without delay?

A

3 months

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7
Q

What is the purpose of NPC?

A

assess convergence amplitude (free space)

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8
Q

What is a normal NPC for children?

A

5 cm/7cm

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9
Q

What is the purpose of phoria testing?

A

subjective measurement of binocularity, cannot differentiate a phoria from intermittent tropia

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10
Q

What is the procedure for phoria testing?

A

risley prisms, 1 base up/out and other base in, perform headlights on a car and buttons on a shirt

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11
Q

What is the purpose of vergence testing?

A

to test fusional vergence amplitude with prisms, vergence-accommodation system, quality of binocular function

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12
Q

What is the procedure for vergence ranges?

A

distance and near test, record blur/break/recover

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13
Q

What are the two tests that can be used for vergence ranges?

A

prism bar/step vergences and smooth/risley prism vergences

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14
Q

What is the prism bar/step vergences method?

A

“tell me when the target gets double and then single again” // can observe objective eye movements

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15
Q

What is the smooth/risley prism vergences method?

A

can’t observe eye movements, “tell me when the target gets blurry, double, and then single”

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16
Q

What are normal step vergence ranges?

A

near BI X/12/7 and near BO X/23/16

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17
Q

What are normal smooth vergence (morgan’s norms) tanges?

A

distance BI X/7/4 distance BO 9/19/10 near BI 13/21/13 near BO 17/21/11

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18
Q

What are Worth’s three degrees of fusion?

A

1st- simultaneous perception, 2nd- flat fusion, 3rd- stereopsis

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19
Q

Under what age is stereopsis generally not demonstrable?

A

8 weeks

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20
Q

When does stereopsis emerge?

A

3-4 months

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21
Q

At what age can almost 100% of infants appreciate stereopsis?

A

6 months

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22
Q

What is the Bernell Functional Binocular Assessment test?

A

(prior keystone basic binocular), tests for stereopsis with R/G glasses at 20-30 cm, observe if child reaches for page

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23
Q

What is the preferred stereo test in infants?

A

PASS test (preschool assessment stereopsis w/ smile), use polarized glasses at 40 cm, preferential looking test, disparity levels 480”, 240”, 120”, 60”, does child look and smile?

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24
Q

What are stereopsis tests in toddlers/preschoolers?

A

lang stereo test I and II, Random dot E

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25
What shape can everyone see on the lang stereo test?
star
26
What is lang stereo test I and II?
no glasses, 40 cm, ask child to point to/name figure
27
How do you do random dot E tests?
polarized glasses, preferential looking w/ cards (raised E, stereo E, blank card)
28
What are the stereo equivalents for 50 cm, 100 cm, and 150 cm on the random dot E?
504 sec, 252 sec, 168 sec of arc
29
What is the randot tests?
polarized glasses with global and local stereopsis
30
What is the randot global stereopsis?
shapes 500 sec (top) and 250 sec (bottom)
31
What is the local stereopsis on randot?
wirt circles (400 sec to 20 sec), animals (400, 200, 100 sec), with random dot background
32
What are the titmus fly and stereo butterly?
gross stereo 3000 sec and stereo 1200-2500 respectively, both tests have local stereopsis with wirt circles to 40 sec, animals, NON randot background
33
What stereo tests are used in preschool/school aged children?
randot, stereo/titmus fly and stereo butterfly, flashlight tests
34
What are the flashlight tests?
determine binocularity not stereopsis and help determine level of binocularity (2nd degree) if no stereopsis
35
How do you do the flashlight tests?
can tests at different distances or different positions of gaze (16 in or 20 ft)
36
What are indications for using flashlight test?
patient has strabismus at distance, patient has decreased VA in 1 eye without significant Rx, complaint of double vision
37
What is the 3 figure flashlight procedure?
R/G glasses (red on right), done in bright and dim illumination, tests for deepness of suppression, just ask what the patient sees
38
What is the 4 dot flashlight procedure?
R/G glasses (red on right), done in bright and dim, tests for deepness of suppression, ask how many dots the patient sees
39
On 4 dot flashlight what does 2 red mean?
OS suppression
40
On 4 dot flashlight what does 3 green mean?
OD suppression
41
On 4 dot flashlight what does 4 dots (no turn) mean?
fusion
42
On 4 dot flashlight what does 4 dots (eye turn) mean?
anomalous correspondence
43
How do you investigate diplopia on 4 dot?
red on right= uncrossed=eso while red on left= crossed = exo
44
How is 4 shape flashlight different than 4 dot?
not really, same procedure but with red heart, green star and moon, white circle
45
Which EOM and stereo tests are used on infants?
hirschberg, bruckner, krimsky, NPC, bernell, lang, stereo smile
46
What EOM and stereo tests are used on toddlers?
hirschberg, bruckner, krimsky, NPC, bernell, lang, stereo smile
47
What EOM and stereo tests are used on preschoolers?
cover test, prism bar ranges, NPC, 3/4 figure/worth4, randot, random dot E, lang
48
What EOM and stereo tests are used on school aged children?
covert test, phoria, vergence ranges, randot, worth 4 dot
49
What is the purpose of saccade and pursuit testing?
test eye movements important for reading and sports
50
At what age do you start testing saccades and pursuits?
school age 5+ or if symptoms warrent
51
What are indications for saccades and pursuits?
loss of place when reading, brain injury/concussion, athletes
52
Infants as young as ___ could make pursuit to a small target (constant velocity)
1 month
53
T/F infants have the ability to make pursuits, but not very well or consistently
true, depends on test conditions
54
What are two tests for pursuits?
NSUCO (later) and Physiologic H
55
How do you perform physiologic H?
wolff wand movements in directions based on development
56
What is the progression of pursuit directions for development?
horizontal, vertical, diagonals, circles, z-axis, start/stop, speed change
57
What did the 1975 Aslin study show about infant saccades?
1-2 month olds lying on back made initial saccade in wrong direction, succession of saccades, longer latency
58
What did the Hainline study show about infant saccades?
5 month olds looking at pattern, saccades were different sizes
59
When are infant saccades adult like?
13 months
60
What are the chairside tests for saccades?
wolff wand and NSUCO/maples
61
What are the paper tests for saccades?
developmental eye movements, king devick, nysoa
62
What are the eye tracking tests of saccades?
readalyzer, right eye
63
What is NSUCO?
standardized way to measure ocular motor skills, judges ability, accuracy, head movements, and body movements
64
How do you preform NSUCO?
standing, feet shoulder width apart, target: wolff wands for saccades two wands 20 cm apart and pursuits 20 cm circle with one want, test performed at 40 cm at one extreme and the patient's Harmon distance at the other

Pediatrics (22 decks)

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