Midterm Review Flashcards
(97 cards)
1
Q
What are the 3 parts of a good case history?
A
- Interview
- Questionnaire
- Summary
2
Q
This is the visual needs of the patient’s daily life.
A
Visual demands
3
Q
This is the ability of the vision to keep up with visual demands.
A
Visual Efficiency
4
Q
When determining the patient’s chief complaint, what 6 criteria should be evaluated?
A
- F - frequency
- O - onset
- L - location
- D - duration
- A - associated factors
- R - relieving factors
5
Q
BV disorders can create negative effects in children and working adults by what 3 things?
A
- All assoc. w reading, computer work
- Poor academic/work performance
- Interfere w/ sports and career decisions
6
Q
BV disorders can create negative effects in retired adults by what 3 things?
A
- Difficulty reading/computer work
- Avoidance of reading or other nearpoint activities
- Interfere w/ distance activities (dissociated phorias)
7
Q
This vergence is our physiological resting position. What is the resting position?
A
- Tonic Vergence
- 1xp +/- 2
8
Q
This vergence is used in awareness of a near item; contributes up to 70% of vergence demands for near tasks
A
Proximal vergence
9
Q
Is proximal vergence related to accommodation?
A
No
10
Q
This type of vergence adds to tonic and proximal vergence to align a near stimulus.
A
Accommodative Vergence
11
Q
With a WD of 40 cm, accommodative vergence will contribute to how much accommodation?
A
~1.25D (half of the stimulus)
12
Q
This is reflexive vergence that maintains binocular alignment
A
Fusional Vergence
13
Q
These two components alter vergence level to achieve fusion. What are they?
A
PFV and NFV
- this only applies when other vergence is not enough
14
Q
PFV makes the patient ______.
A
converge
15
Q
NFV makes the patient _______.
A
diverge
16
Q
This type of vergence is stimulated by retinal disparity.
A
Fixation Disparity Vergence
- primarily responsible for maintaining binocularity
- improves vergence accuracy
17
Q
What is the compensatory vergence for esophoria?
A
NFV - esophoric eyes sit in, NFV diverges the eyes out
18
Q
What is the compenstory vergence for exophoria?
A
PFV - exophoric eyes sit out, PFV converges eyes in
19
Q
This is how much accommodation is necessary to achieve clear vision when looking from far to near.
A
Accommodative demand
20
Q
Calculate the accommodative demand for a patient viewing an object at 40 cm.
A
AD = 100/40 = +2.50D
21
Q
This is how much do the eyes have to converge to maintain single binocular vision when looking from far to near.
A
Convergence demand
22
Q
Calculate the convergence demand at a 40cm WD and 60mm pupil diameter.
A
CD = (10 * 60mm)/(40cm) CD = 600/40 CD = 15 D
23
Q
If a patient has a convergence demand of 15D, but undercompensates, what fusional vergence is needed to compensate
A
PFV
24
Q
If a patient has a convergence demand of 15D, but overcompensates, what fusional vergence is needed to compensate?
A
NFV
25
This allows eyes to converge the required amount for a given WD with no fusional vergence?
AC/A
26
What is the expected value of gradient AC/A?
4/1 +/- 2pd
27
Calculate the gradient AC/A:
- CT (N) = 3EP
- CT +1 = 4XP
(+3EP - (-4XP))/1 = 7/1
28
What is the expected value of calculated AC/A?
5pd +/- 2pd
29
Calculate the calculated gradient AC/A:
- IPD = 60mm
- WD = 40cm
- CT (N) = 10 XP
- CT (D) = 2 XP
AC/A = IPD(cm) + WD(m)[CT(N)-CT(D)]
```
AC/A = 6 + .4(-10-(-2))
AC/A = 2.8/1
```
30
This is a questionnaire used for CI suspect patients.
CISS - CI Symptom Survey
31
What are the symptomatic scores for children and adults?
```
Children = Score of 16 or above
Adults = Score of 21 or above
```
32
What 4 ways can we assess motor alignment?
1. Cover Test
2. Von Graefe
3. Modified Thorington
4. Fixation Disparity
33
What direct tests assess PFV?
1. Step Vergence
2. Smooth Vergence
3. Vergence Facility
34
What indirect tests assess PFV?
1. NPC
2. NRA
3. BAF c plus
4. MEM
35
What direct tests assess NFV?
1. Step Vergence
2. Smooth Vergence
3. Vergence Facility
36
What indirect tests assess NFV?
1. PRA
2. BAF c minus
3. MEM
37
What direct (monocular) tests assess accommodation?
1. Acc.Amps
| 2. MAF
38
What 2 tests are used to assess accom. amps?
1. Donder's push up/away
| 2. Minus Lenses
39
Donder's overestimates one's accommodation by how much?
2D
40
Minus lenses underestimates one's accommodation. What must be added to the amount of minus the patient can sustain?
- 2.50
- Ex: First blur at - 6.00
- Amps = -6.00 + (-2.50) = -8.50
41
What are the indirect (binocular) tests of accommodation?
1. MEM
2. NRA/PRA
3. BAF
42
What is the expected value of MEM?
0.50 +/- 0.25D
43
If a patient has a High MEM (> +0.75D), what is happening to their accommodation?
- underaccommodating
| - lag of accommodation
44
If a patient accommodates behind plane of MEM card, what type of motion will the examiner see?
with motion
45
If a patient accommodates in front of MEM bard, what type of motion will examiner see?
Against motion
46
What are the 4 types of non-strabismic binocular & accom. vision problems?
1. Fixation issues
2. Saccades
3. Pursuits
4. Accommodation
47
What are the SxS of fixation issues?
```
Symps = Oscillopsia
Signs = nystagmus, saccadic intrusion
```
48
What are the symptoms of saccadic issues?
Symps:
1. Loss of place/uses finger
2. Slow reading speed
3. Short attn span
4. Difficulty copying from board
49
What are the signs of saccadic issues?
1. Poor performance on readalyzer
2. Score below 15% on DEM
3. Low score on NSUCO
50
What are the SxS of pursuit issues?
```
Symps:
- excessive head movement
- Poor performance in sports
- Possible reading diff.
Signs = Low score on NSUCO
```
51
This assesses the flexibility in the link between accom. and vergence
NRA/PRA
52
What is the purpose of NRA/PRA
to determine if an add is needed / if the system is balanced
53
What are the expected values of NRA/PRA?
```
NRA = +2.00 +/- 0.50
PRA = -2.37 +/- 1.00
```
54
The end-point of PRA is determined by what 3 factors?
1. Amplitude
2. NFV
3. AC/A ratio
55
Binocular Disorder:
- higher XP at near
- reduced NPC
- reduced BO
- VF = slow BO, low cpm
- Low NRA
- BAF, fails +
- Low MEM
Convergence Insuffiency
56
What is the primary issue of a pseudo CI?
Accommodative issue
57
How will the testing differ for a pseudo CI vs. a true CI?
- All accommodative testing will be low
- low on minus testing
- true CI would be low on plus
58
Binocular Disorder:
- greater EP at near
- Low BI
- VF = slow BI, low cpm
- Low PRA
- BAF, fails (-)
- High MEM
Convergence Excess
59
What is the treatment for a CE?
- Provide patient with an add (plus)
| - use NRA/PRA data to determine how much
60
Binocular Disorder:
- no assoc. w/ phoria
- Low BI/BO
- Reduced VF
- Fails + and - on BAF
- Passes + and - on MAF
- Low NRA and PRA
Fusional Vergence Dysfunction
61
What's the best treatment option for FVD?
Vision therapy
62
Binocular Disorder:
- greater XP at distance
- often IXT at distance
- Tests in PFV group will be low at distance but normal at near (low BO, Low VF BO)
- high AC/A
Divergence Excess
63
Binocular Disorder:
- equal mag XP at d and n
- tests in PFV will be low at distance and near
- reduced NPC
- Low NRA
- Low MEM
- Fails (+) BAF
Basic Exophoria
64
Binocular Disorder:
- high EP at distance
- Low BI at distance
- low VF, BI
Divergence Insufficiency
65
Binocular Disorder:
- Equal mag EP at d and n
- Low BI at d and n
- Low VF at d and n
- Low PRA
- BAF, fails -
- High MEM
Basic Esophoria
66
What conditions are found with low AC/A?
1. CI
| 2. DI
67
What conditions are found with high AC/A?
1. CE
| 2. DE
68
What conditions are found with normal AC/A?
1. Basic XP
2. Basic EP
3. FVD
69
Accom. Cond:
1. Low Amps
2. Low PRA
3. Fails - on MAF/BAF
4. High MEM (lag)
Accom. Insufficiency
70
What is the treatment for an AI?
- Prescribe plus (an add)
| - depends on NRA/PRA or MEM data
71
What are the DD of an AI?
1. Ill-sustained accom.
2. Accom. paralysis
3. Unequal accom.
4. Pharmacological
5. Neuro
72
What is the main difference between an AI and Ill-sustained accom?
Patient will have normal amps
73
Accom. Cond:
- Low NRA
- Fails (+) on MAF/BAF
- Low MEM (lead)
Accom. Excess
74
What is the tx for AE?
Vision therapy
75
What are the DD of AE?
1. Accom. Spasm
2. Pseudomyopia
3. Disease
76
This is having difficulty changing accommodative response from one distance to another.
- low NRA and PRA
- fails both + and - on MAF/BAF
Accom. Infacility
77
What are the visual-verbal observations for saccades?
1. DEM
| 2. King Devick
78
Which test differentiates between a saccadic problem and automaticity (name-calling) problem?
DEM
79
DEM Interpretation: Normal horizontal, normal vertical, normal ratio
Type 1
80
DEM Interpretation:
| Abnormal horizontal, normal vertical, abnormal vertical
Type 2 - oculomotor dysfunction
81
DEM Interpretation: Abnormal horizontal, abnormal vertical, normal ratio
Type 3 - automaticity problem
82
DEM Interpretation:
| Abnormal horizontal, abnormal vertical, abnormal ratio
Type 4 - Mixed problem
83
When testing 2 different reading levels on the readalyzer, what does it mean if testing is still poor when dropping a level?
Oculomotor dysfunction
84
When testing 2 different reading levels on the readalyzer, what does it mean if testing is better when dropping a level?
Reading problem
85
What are the 4 types of monocular cues?
1. Motion Parralax
2. Accommodation
3. Angular Declination
4. Pictorial Monocular cues
86
What are the 3 types of motion parallax?
1. Kinetic Depth Cue
2. Near Object Fixation
3. Distant Object Fixation
87
This type of motion parllax is produced by relative motion of 2 or more objects.
Kinetic Depth Cue
88
In this type of Motion paralax, far objects move with head movement.
Near object fixation
89
In this type of motion parallax, near object move opposite of head movement.
Distant object fixation
90
What are the 2 perceptual factors associated w/ accomodation?
1. Proximity or size of object
| 2. Perspective
91
This is when the object makes an angle w/ the horizon; the visual system uses this angle to determine object distance.
Angular Declination
92
What layer of the striate cortex receives the primary input from the parvo and magnocellular LGN layers?
Layer 4C
- magno (ventral) = 4c alpha
- parvo (dorsal)= 4c beta
93
On the cortical neuron dominance histograms, what categories are monocular? Which eye? Which category is binocular?
category 1 = contralateral eye
category 7 = ipsilateral eye
Category 4 = binocular
94
What layer of the striate cortex dont ocular dominance columns go through?
Layer 4
95
This is the period during which the visual system can be influenced by environmental manipulation
Critical/Sensitive period
96
What is the critical period in humans?
7-9 years of age
97
In monocular deprivation, what happens?
- Most cortical cells were monocular and responsive only to the non-deprived eye
