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Flashcards in Exam Techniques Deck (23):
1

Limitations of Fix, Follow, Maintain?

NOT QUANTITATIVE - not accurate for MILD vision loss, may show fixation preference w/o amblyopia

2

Limitations of FPL (forced choice preferential looking?

NEAR ACUITY ONLY assessed - won't ID any pt over -2.00D
-UNDERestimates acuity loss d/t amblyo, Rf error and macular pathology (gratings large enough to be OUTSIDE macular area)
-time consuming, expensive

3

Limitations of Lea grating PADDLES?

-examiner's FACE can be distracting; examiner bias

4

Cardiff acuity used for which two populations? Test distance? Main limitation?

-toddlers, individuals w/ disabilities
-1m
-limitation: VERY poor at determining Rf error.

5

Three GOOD tests to use to check VA in peds:
Advantages?

Lea, Patti pics, HOTV
-all are WELL standardized, and available in logMAR forms

6

Three LIMITED (not so good) acuity methods? WHY Is each not so good?

-Tumbling E - laterality (R/L) may be an issue - otherwise good
-Broken Wheel (Landolt C) - 50/50 chance - it's only two forced choice
-Allen figures - NOT STANDARDIZED!! - NO consistent, critical detail

7

"____'s Technique" - a NEAR retinoscopy technique - describe it.

**MAIN problem??

Mohindra's technique.

-Ret @ 50cm, NOT under cyclo, in a completely DARK room, subtract correction factor
-PROBLEM: UNDERESTIMATES HYPEROPIA!!

8

What is the MOST ACCURATE way to assess a kid's TRUE refractive error? What's the main problem with it you must be conscious of?

CYCLOPLEGED Ret

-Problem: retting off axis. OK to have kid look directly @ retinoscope

9

Major problem with Autorefractors in peds population (what do they underestimate?)

-MOST accurate for what type of Rf error?

-underestimate HYPEROPIA

-accurate for ASTIGMATISM; esp AXIS.

10

Bruckner can quickly provide all of the following....

-Presence of STRAB (strab eye = brighter)
-Presence/equality of RF ERROR
-Presence of MEDIA OPACITY
-Presence of PUPIL SIZE ASYMMETRY.
-Insight as to whether amblyopia may be present.

11

Which TYPE of refraction is recommended in peds? Hints?

TRIAL FRAME refraction w/ peds frame (phoropter=accommodation/distracting)
-Use ret as starting point
-Don't over-minus
-make them READ LETTERS - not just "is it clearer"

12

Most appropriate cyclo potency in kids

1Y/O: 1.0% cyclo
Premie/LBW = cyclomydril (0.2% cyclo, 1% phenyl)

13

Sensitivity in picking up a strab is just as high when using an accommodative target as using an interesting light.

FALSE - only ACCOMM TARGET will p/u strab.

14

Is a dilated eye exam recommended, or required?

STANDARD OF CARE - DILATE EVERY PATIENT at least q 2 yrs. In peds, MUST do it on first eye exam (including BIO!)

15

Can OKN be "normal" even when pt is FUNCTIONALLY blind? How about when they have a massive CENTRAL scotoma? How about if it's a peds pt w/ a nystagmus?

YES-YES-hard to interpret if nystagmus present.

--so, it has its limits

16

RP and Usher's syndrome will cause WHAT changes to the ERG?

Reduced SCOTOPIC response

17

Cone-rod dystrophy and achromatopsia will cause what changes to an ERG?

No cones/cone pigments - difficulty in light
-Decreased PHOTOPIC response

18

Albinism will cause what change to the ERG?

No pigment - odd one - EXCESSIVE SCOTOPIC response

19

Congenital stationary night blindness will completely eliminate WHICH ERG wave?

B-wave (Bipolar, Mueller)

20

Leber's congenital amaurosis will cause what change to the ERG?

Honey badger - reduces PHOTOPIC AND SCOTOPIC ERG.

21

What, specifically, does an EOG measure?

Health of the RPE - but specifically, the VOLTAGE difference b/w the cornea and the PP.

-Recall: Arden ratio - want high--> anything

22

VEP - a direct measure of which part of the visual pathway?

Visual CORTEX - most commonly used to bypass orbit and assess cortical VA potential.

23

One of the WORST targets you can choose for fix and follow?

Anything w/ an AUDITORY cue (i.e. Finger puppet w/ bells) - doesn't isolate vision.