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MT 2 Flashcards

1
Q

Hypoaccommodation with have decreased ______

A

NRV

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2
Q

Hyperaccommodation will have decreased ______

A

PRV

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3
Q

Accommodative in facility AA

A

Not diagnostic but if it is low it may result in decreased facility

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4
Q

Acommondative in facility MEM

A

Not DX

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5
Q

Accommodative in facility BCC

A

Not DX

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6
Q

Accommodative in facility NRA/PRA

A

Not dx. low NRA or PRA may predict in facility. Decreased reduction seen in recoveries more often.

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7
Q

Accommodative in facility Vergence association

A

May be related to decreased vergence associations as well

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8
Q

False CI AA

A

Maybe subtle reduction. Not to AI label

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9
Q

False CI MEM

A

Increased Lap

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10
Q

False CI BCC

A

More plus than normal

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11
Q

False CI NRA/PRA

A

May have reduced PRA blur out or recovery

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12
Q

False CI Facility

A

Not Dx

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13
Q

False CI vergence association

A

Looks like CI

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14
Q

Key between false CI and CI

A

False CI will have normal or increased lag. CI will have low or reduced lag.

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15
Q

Ill-Sustained Acc. AA

A

Amp acceptable but reduced from ideal for age. Repeated NPA fatigues quickly.

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16
Q

Ill-Sustained Acc. MEM

A

Increased lag if fatigued

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17
Q

Ill-Sustained ACC BCC

A

More plus than normal if fatigued

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18
Q

Ill-Sustained ACC NRA/PRA

A

PRA may reduce with fatigue

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19
Q

Ill sustained accommodation facility

A

Progressive slowing through 2 minutes of facility testing. Especially on the minus side

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20
Q

Ill-Sustainted accommodating Vergence association

A

Not DX or consistently predictable. May see false CI pattern too

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21
Q

Accommodative insufficiency AA

A
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22
Q

Accommodative insufficiency MEM

A

Increased Lag

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23
Q

Accommodative insufficiency BCC

A

More plus than normal

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24
Q

Accommodative insufficiency NRA/PRA

A

PRA reduced. Must confirm with monocular testing.

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25
Q

Accommodative insufficiency Facility

A

Not dx but almost certainly reduced

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26
Q

Accommodative insufficiency Vergence association

A

Not dx but usually see a false CI pattern too

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27
Q

Accommodative insufficiency ddx

A

Must make sure it is not presbyope

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28
Q

Accommodative Paralysis AA

A

No signfigant accommodative response

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29
Q

Accommodative paralysis MEM

A

Large lag

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30
Q

Accommodative paralysis BCC

A

Must more plus than normal

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31
Q

Accommodative paralysis NRA/PRA

A

Limitations of NRA and/or PRA if they can be testing

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32
Q

Accommodative paralysis facility

A

Not dx. Would be very reduced though

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33
Q

Accommodative paralysis vergence associations

A

Not dx. Reduced NPC/near diplopia. False CI pattern.

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34
Q

Accommodative Excess AA

A

Not dx

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35
Q

Is Accommodative excess the opposite of accommodative insufficiency

A

NO! This is an accuracy based problem. Over acc. at near.

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36
Q

Accommodative Excess MEM

A

Zero lag or any lead

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37
Q

Accommodative Excess BCC

A

Less than normal plus maybe even into minus (confirm with monocular test) Pick up with BCC but confirm with DCC

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38
Q

Accommodative Excess NRA/PRA

A

May have difficulty with NRA blur out or recovery

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39
Q

Accommodative Excess Facility

A

Not dx but may notice reduced response in plus direction

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40
Q

Accommodative Excess Vergence Association

A

Assume AE main problem if find esophoria and/or reduced BI range. May be secondary to long standing CI (EXO found)

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41
Q

How to DDX AE against Convergence problem

A

Test monocular and consider phobia. Tendency to over accommodate at 40 cm may also occur at 6 m (may affect run).

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42
Q

Pseudomyopia AA

A

Not dx

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43
Q

Pseudomyopia MEM

A

Lead at far. May or may not be a lead at near

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44
Q

Pseudomyopia BCC

A

May or may not have reduced DCC or BCC

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45
Q

Pseudomyopia NRA/PRA

A

NRA blur out or recovery reduced or excessive (cannot decrease). Reduced 6m PRV blur. BO range at far blur=ACC doesn’t fight for distance clarity

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46
Q

Pseudomyopia facility

A

likely poor especially when trying to decrease accommodation

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47
Q

Pseudomyopia Vergence association

A

Varies with etiology. If eso at far, first assume accommodative in origin. If abnormal exo at far (3+ or more) more mergence origin

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48
Q

How is pseudo myopia commonly dx

A

myopia reducetion on retinoscopy, cylcoplege, etc. Other clues include over - or poor refraction, VA clues, acc and mergence test implications

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49
Q

Accommodative Spasm AA

A

Extream AE. Reported up to 25 diopters

50
Q

Acommodative Spasm MEM

A

Monocular and binocular lead

51
Q

Accommodative spasm BCC

A

Monocular CC result reduced, even into minus

52
Q

Accommodative spasm NRA/PRA

A

NRA reduced, if possible to test

53
Q

Accommodative spasm facility

A

not diagnostic

54
Q

Accommodative spsm verg. association

A

May result in secondary esophoria/tropia and reduced BI range.

55
Q

How to dx accommodative spasm

A

> 1.5-2 difference between manifest and cycloplegic refraction. Less=pseudomyopia

56
Q

AE not confirmed without monocular ________ verification

A

posture

57
Q

AI not confirmed without monocular ______ Verification

A

Amplitude

58
Q

What to do when several related diagnoses apply to a patient

A

DX the worse one

59
Q

First clinical assumption with exo findings

A

Secondary problem

60
Q

First clinical assumption with eso findings

A

Primary problem

61
Q

If find ESO and Lag assume _____ primary problem

A

Vergence

62
Q

If find ESO and lead assume _____ primary problem

A

Accommodation

63
Q

If find EXO and lag assume _____ primary problem

A

Accommodation

64
Q

If find EXO and lead assume ______ primary problem

A

Vergence

65
Q

If find ESO and Pseudomyopia or latent hyperopia assume _______ primary problem

A

Accommodation

66
Q

If find EXO and Pseudomyopia or latent hyperopia assume ______ primary problem

A

Vergence

67
Q

Duane White Divergence disorder

A

Farpoint disorder

68
Q

Duane white convergence disorder

A

nearpoint disorder

69
Q

Duane white insufficiency

A

Decreased AC/A

70
Q

Duane white excess

A

Increased AC/A

71
Q

Duane White CI

A

More exo then normal at near.

72
Q

Duane white DE

A

More eco then normal at far

73
Q

Duane white DI

A

More eso than normal at far

74
Q

Duane white CE

A

More eco then normal at near

75
Q

CI AC/A and phoria

A

Low AC/A. 40 cm phobia more eco than expected

76
Q

CI NPC

A

Receeded

77
Q

CI PRV

A

Low

78
Q

CI NRV

A

Not dx

79
Q

CI AA

A

Not dx

80
Q

CI accommodation posture

A

Reduced lag or even a lead at near.

81
Q

CI and NRA

A

May have low NRA

82
Q

DE AC/A and phoria

A

High AC/A. 6m phobia more eco than expected

83
Q

DE NPC

A

Normal

84
Q

DE PRV

A

6m PRV reduced

85
Q

DE NRV

A

Not dx

86
Q

DE AA

A

Not dx

87
Q

DE accommodation posture

A

May lead at far. easy to overminus

88
Q

When do you consider over minus rx at far with DE

A

DE IXT

89
Q

CE AC/A and phoria

A

High AC/A. Phoria at 40 cm more eso than expected

90
Q

CE NPC

A

Superior

91
Q

CE PRV

A

not dx

92
Q

CE NRV

A

reduced

93
Q

CE AA

A

Not dx. Recall acc. strain can create eso

94
Q

CE accommodative posture

A

Greater lag than normal. Maybe normal lag with high AC/A.

95
Q

CE and PRA

A

May have a reduced PRA. AC/A ratio explains

96
Q

DI AC/A and Phoria

A

Low AC/A. 6m phobia is eso.

97
Q

what patients do you see DI in

A

Those that are overminused

98
Q

DI NPC

A

Normal

99
Q

DI PRV

A

not dx

100
Q

DI NRV

A

Reduced at far; possibly reduced at near also

101
Q

DI AA

A

not dx

102
Q

DI accom. posture

A

maybe more lag than normal at near

103
Q

DI acc. and vergence facilities and PRA

A

Acc. and mergence facilities likely reduced. Maybe reduced PRA

104
Q

Basic ESOs are like a combination of what

A

DI and CE

105
Q

Basic ESOs AC/A + phoria

A

Normal AC/A. Eso at all distances

106
Q

Basic ESOs NPC

A

Maybe superior

107
Q

Basic ESOs PRV

A

not dx

108
Q

Basic ESOs NRV

A

Reduced at far and/or near

109
Q

Basic ESOs AA

A

not dx

110
Q

Basic ESOs Acc. posture

A

Probably greater than normal lag

111
Q

Basic ESOs vergence facility

A

May be reduced

112
Q

Basic EXO is a combination of…

A

CI and DE together.

113
Q

Basic EXO AC/A and Phoria

A

Normal AC/A. EXO phoria at all distances

114
Q

Basic EXO NPC

A

Maybe receeeded

115
Q

Basic EXO PRV

A

May/probably problem far and near

116
Q

Basic EXO NRV

A

Not dx

117
Q

Basic EXO AA

A

Not dx

118
Q

Basic EXO acc. posture

A

Probably a reduced lag or a slight lead.

119
Q

Vergence infacility

A

consistently slow facility/increased mergence response time. MAY gain suspicion with reduced PRV and/or NRV. Especially recoveries

120
Q

General binocular dysfunction

A

When mergence skills are clearly poor, but don’t follow a decisive dx trend. Easily becomes a garbage can term. Avoid using this as a default dx.

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