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Vision Therapy > Intro and Background > Flashcards

Intro and Background Flashcards

1
Q

What is vision?

A

the derivation of meaning and direction of action as triggered by light

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2
Q

Who is considered a founder of modern vision therapy?

A

Skeffington

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3
Q

What did Skeffington do?

A

educated practicing ODs on VT

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4
Q

What are Skeffington’s four circles of vision?

A

Anti-gravity, centering, identification, speech-auditory

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5
Q

T/F Skeffington’s circles have a hierarchy/order?

A

false

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6
Q

What is anti-gravity?

A

“where am I?” “where are my body parts in reference to one another?” the physical and physiological actions taken to determine body presence

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7
Q

Where does anti-gravity information come from?

A

vestibular information and proprioception

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8
Q

What gives vestibular information?

A

semicircular canals and otoliths

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9
Q

What gives proprioception information?

A

the body in general (stretch receptors in muscle and CT) and from afferent fibers from cervical ganglion in upper spine

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10
Q

T/F the fibers of the optic nerve give positional info

A

true, 20% of the fibers do

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11
Q

What is centering?

A

“Where is it?”

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12
Q

Can we tell where an object is by where its image hits the retina?

A

yes

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13
Q

Can we tell where an object is in space based on the posture of the binocular system?

A

yes, adds depth

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14
Q

How is centering info obtained?

A

monocular cues to depth and binocularity

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15
Q

What are monocular cues to depth?

A

size constancy, parallax, texture variations, tau

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16
Q

What is tau?

A

differing spatial flow with movement; brain can calculate tau value for how fast the angular size changes on the retina, gives sense of change in distance

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17
Q

What is identification?

A

“what is it?” we identify according to our experience

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18
Q

What does identification involve?

A

the entire storage and retrieval system of both short and long term memory and the classification systems used to organize stored memories

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19
Q

What is speech/auditory (communication)?

A

the manner in which we inform ourselves; how we are conscious of our experiences real or imaginary; how we use language to communicate experiences; how we use language to understand what others tell us

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20
Q

What emerges from the four Skeffington circles?

A

vision, we acquire vision through the interactions we have with the environment over time

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21
Q

T/F we create reality with our sensory systems

A

true

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22
Q

Piaget’s model of vision development involves two choices to conflict which are…

A

fight or flight

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23
Q

What are the three levels of Piaget’s fight reaction to conflict?

A

low level learning, high level learning, Ah-ha development

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24
Q

What is low level learning?

A

an easy conflict resolution

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25
What is high level learning?
more complex problem solving
26
What is the ah-ha development?
an epiphany allowing resolution
27
What conflict resolution level of Piaget's vision development model is vision therapy under?
Ah-ha development
28
What is VT?
the arranging of conditions to provide a person with the opportunity to have the necessary meaningful experiences to acquire vision through development and learning
29
What are four ways to evaluate data?
graphical, analytical, normative, and integrative analysis
30
What is graphical analysis?
plot clinical findings on a grid to determine whether a patient is likely to have clear, comfortable, single, binocular vision
31
What is analytical analysis?
developed by OEP, uses a 21 point exam, helps identify small dysfunctions
32
What is normative analysis?
variation of data based on groups of testing, compared to Morgan's norms
33
What is integrative analysis?
compare individual tests to norms, group findings that deviate, and determine the diagnosis (what optometry does)
34
What are the three basic steps of integrative analysis?
1) compare individual tests to table(s) of expected findings 2) group the findings that deviate from expected 3) identify the syndrome diagnosis based on steps 1 and 2
35
What are some supplemental tests?
AC/A ratio (distance-near or gradient method), fixation disparity fusional vergence amplitudes, vergence facility, accommodative lag
36
What are three standard methods for evaluating binocular data?
sheard's, percival's and morgan's
37
What is sheard's criterion?
for comfortable BV, fusional reserve= 2x demand (phoria), useful for prescribing prism, especially with exo
38
What is percival's criterion?
patient's data should be in the middle third of their vergence range (phoria between BO and BI), useful for prescribing prism, especially eso
39
What are morgan's norms?
compare patient's test results to the expected findings, note there is an average and an expected range of normal
40
What happens when findings are outside of normal?
there is a possibility for a diagnosis
41
What is the maximum amp Hofstetter formula?
25 - (2/5 x age)
42
What is the average amp Hofstetter formula?
18.5 - (1/3 x age)
43
What is the minimum amp Hofstetter formula?
15 - (1/4 x age)
44
Which is the most important Hofstetter's formula?
minimum expected amplitude
45
What is the AC/A ratio?
tells how much accommodative convergence there is for a given amount of accommodation
46
T/F AC/A is different than PFV
true
47
When is the AC/A ratio useful?
when considering refractive correction and especially near adds
48
What is the CA/C ratio?
tells how much convergence accommodation there is for a given amount of convergence
49
T/F CA/C is the same as blur-driven accommodation
false
50
Why is CA/C rarely used clinically?
there is no set accepted testing protocol, may be used with TBI patients
51
What are the six areas of data where we look for trends?
PFV, NFV, accommodative system, vertical fusional vergence, oculomotor system, motor alignment and interaction
52
How do we evaluate PFV? (7)
smooth and step vergence, PFV facility, NRA, BAF with plus lenses, NPC, MEM retinoscopy, FCC
53
How does NRA evaluate PFV?
plus lenses OU relaxes accommodation and therefore vergence relaxes, patient uses PFV to prevent diplopia
54
How do we evaluate NFV? (6)
smooth and step vergences, NFV facility, PRA, BAF with minus lenses, MEM retinoscopy, FCC
55
How do we evaluate accommodation? (5)
monocular and binocular accommodative amp, MAF/BAF with +/- lenses, MEM, FCC, NRA/PRA
56
How do we evaluate vertical fusional vergence?
supravergence, infravergence, fixation disparity
57
How do we evaluate oculomotor ability?
fixation status, NSUCO saccades and pursuits, DEM, K-D, visagraph/readalyzer
58
How do we evaluate motor alignment and interaction?
cover test, phorias, fixation disparity, AC/A ratio, CA/C ratio
59
What are the three classical categories of visual skills conditions?
BV conditions, accommodative conditions, oculomotor conditions
60
What are BV conditions?
Duane White: CI, CE, DI, DE, + fusional vergence dysfunction, basic exophoria, and basic esophoria
61
What are accommodative conditions?
accommodative insufficiency/paresis, accommodative excess/spasm and accommodative infacility
62
What are oculomotor conditions?
saccadic deficiency, pursuit deficiency, and oculomotor dysfunction
63
What is vergence dysfunction?
involves disjunctive eye movements in which the visual axes convergence or diverge, resulting in ability of the eyes to accurately fixate and stabilize a retinal image
64
What is accommodative dysfunction?
interferes with ability of the eyes to focus clearly on objects at various distances, resulting in lack of clear retinal images
65
What are four possible goals of treatment?
to assist the patient in functioning efficiently, to relieve ocular physical and/or psychological symptoms, to rehabilitate the patient following injury, or to enhance athletic performance
66
What are methods of treatment?
traditional VT, lenses/prism, surgery
67
What is traditional VT?
accommodative therapy to increase the amplitude, speed, accuracy and ease of accommodative responses; vergence therapy to enhance sensorimotor fusion
68
What is prism therapy?
horizontal prisms to eliminate symptoms of asthenopia and reduce fusional vergence demand of vergence dysfunction; vertical prisms to eliminate vertical imbalance
69
What is surgery for?
to decrease the size of a deviation
70
What is lens therapy?
plus lenses to reduce the motor demand on either accommodative or vergence systems

Vision Therapy (21 decks)

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