OMD Flashcards
(80 cards)
1
Q
A sensorimotor deficit of the visual system characterized by poorly executed and inaccurate eye movements
A
OMD
2
Q
Sx of OMD (5)
A
While reading…
1. Head movement
2. Use of fingers
3. Skipping words
4. Slow reading speed
5. Poor comprehension
3
Q
Reading involves what two ocular movements
A
- Fixations
- Saccades
4
Q
Irregular, involuntary flicks of fixation off a target, followed by saccade onto target
A
Saccadic Intrusion
5
Q
Saccadic intrusion is associated with what severity of OMD?
A
Moderate to severe
6
Q
Small SI may be found in… (4)
A
- Elderly
- Strabismus
- Dyslexia
- Extreme fatigue
7
Q
Large SIs are associated with… (2)
A
- Cerebellar disease
- Multiple sclerosis
8
Q
Congenital vs. Acquired: which type of Nystagmus is MORE concerning?
A
Acquired
9
Q
Congenital vs. Acquired: which type of Nystagmus is LESS concerning?
A
Congenital
10
Q
Congenital Nystagmus is associated with… (3)
A
- Albinism
- Achromotopsia
- Leber’s
11
Q
Acquired nystagmus is associated with… (6)
A
- Stroke
- Multiple Sclerosis
- Head trauma
- Parkinson’s
- Brain Tumor
- Cerebellar Disease
12
Q
Pendular vs Jerk: bidirectional, slow/equal in both directions
A
Pendular
13
Q
Pendular vs Jerk: slow phase, followed by a fast phase
A
Jerk
14
Q
Jerk nystagmus is named after the ___ (fast/slow) phase
A
FAST
15
Q
Jerk Nystagmus: slow to the left, fast to the right would be called
A
RIGHT jerk nystagmus
16
Q
Jerk Nystagmus: slow to the right, fast to the left would be called
A
LEFT jerk nystagmus
17
Q
FUNBLOCS is associated with…
A
Congenital Nystagmus
18
Q
Pendular Nystagmus is associated with:
A
- Albinism
- Achromotopsia
19
Q
FUNBLOCS stands for
A
Fixation —> worsens nystagmus
Upgaze —> remains horizontal
Null point exists
Bilateral & conjugate
Latent component
OKN not superimposable
Convergence —> dampens
Symptomless (no oscillopsia)
20
Q
Treatment for Nystagmus (7)
A
- Correct RE
- Promote convergence (BO prism, closer working distance, surgery)
- Position to null point (yoked prism, surgery)
- Feedback (tactile — e.g. CL, auditory, visual)
- VT
- Low vision aids
- Pharm injections
21
Q
In Acquired Nystagmus, what occurs in upgaze?
A
Converts to upbeat
22
Q
Defective pursuits in elementary aged pts can be attributed to lack of… (3)
A
- Development
- Attention
- Experience
23
Q
Defective pursuits in adults pts can be attributed to: (5)
A
- Neurological dysfunction
- Drugs
- Fatigue
- Emotional stress
- Test anxiety
24
Q
Defective pursuits in adults pts can be attributed to: (5)
A
- Neurological dysfunction
- Drugs
- Fatigue
- Emotional stress
- Test anxiety
25
Monocular eye movement is also known as
Ductions
26
Binocular eye movement is also known as
Versions
27
Objective assessments of fixation (2)
1. Visagraph
2. RightEye
28
A normal/expected result for fixation would be:
Stability x 10 sec
29
In Gross Observation of Pursuits, the Wolff wand should be moved:
Horizontally, vertically, and in circular motions
30
In the NSUCO evaluation of Pursuits, the Wolff wands…
Are rotated CW x2 and CCW x2
31
When evaluating NSUCO for pursuits, we should also check for _____ (e,g, rolling tongue, moving eyebrows, etc)
Motor Overflow
32
Following normal NSUCO Pursuits, it should be repeated with…
Cognitive Loading (simple questions asked simultaneously)
33
What should be ruled out in the assessment of saccades?
Uncorrected RE and poor attention
34
Developmental Eye Movement Test (DEM) is used to evaluate ___ and ___ of fine saccades
Accuracy and speed
35
Developmental Eye Movement Test (DEM) is used to identify ___ and/or ___
OMD and/or learning-related automaticity deficits
36
The norms for DEM test are for _____ (age range)
6y0m — 13y11m (but can be performed on pts >14)
37
The norms for DEM test are for _____ (age range)
6y0m — 13y11m (but can be performed on pts >14)
38
T/F: The pt is permitted to use their fingers during the pre-test (during DEM test)
TRUE
39
DEM: A substitution error indicates that a number was ___ and is signified by a ___ symbol
Misnamed; “/“
40
DEM: An omission error indicates that a number was ___ and is signified by a ___ symbol
Skipped; circle (circle the letter skipped)
41
DEM: An addition error indicates that a number was ___ and is signified by a ___ symbol
Added; “+”
42
DEM: A transposition error indicates that a number was ___ and is signified by a ___ symbol
Read out of sequence; arrow
43
DEM: Vertical time score is calculated by:
Adding Test A and Test B time
44
DEM: What is the “essence” of DEM?
Compare vertical time with horizontal time
45
DEM: How do you calculate Horizontal Adjusted Time?
Time x (80/(80 - o + a))
46
DEM: “Ratio” refers to
Horizontal Adj. TIme/Vertical Adj. Time
47
DEM: vertical columns are mainly used to determine a pt’s
Rapid automatized naming (RAN)
48
DEM: horizontal columns are used to
Simulate usual reading demands
49
DEM: what is the following outcome?
Horizontal — increased
Vertical — normal
OMD dysfunction
50
DEM: what is the following outcome?
Horizontal — increased
Vertical — normal
OMD dysfunction
51
DEM: what is the following outcome?
Horizontal — increased
Vertical — increased
*approximately the same
RAN deficit
52
DEM: what is the following outcome?
Horizontal — increased (more than vertical)
Vertical — increased
OMD dysfunction + RAN deficit
53
Generally, a score at least ___ SD away from the norm usually indicated deficiencies
One
54
Generally, a score at least ___ SD away from the norm usually indicated deficiencies
One
55
DEM: what percentile is considered significant?
≤ 16%
56
Percentile considered:
Above average — ?
High average — ?
Average — ?
Low average — ?
Poor — ?
57
T/F: King Devick is better for older children/adults
FALSE
58
T/F: King Devick can differentiate between OMD and RAN deficits
FALSE
59
The visagraph is used to determine ___
Reading efficiency
60
Advantages of Visagraph? (3)
1. Objective measurement
2. Permanent recording
3. More sophisticated information
61
Visagraph should be performed at what reading level?
One grade below reading level (based on case history or practice)
62
What types of questions are asked after a paragraph is read on a visagraph?
True/False Questions
63
Visagraph: how many questions correct to be considered valid?
7 out of 10
64
Visagraph: if reading difficulty is decreased but efficiency does not improve, ___
OMD
65
Visagraph: if reading difficulty is decreased and efficiency improves, ___
Reading Problem
66
Principles of Oculomotor Therapy (3)
1. **Visual motor support** (using a pointer)
2. **Visual motor integration** (motor task while reading, eg. Michigan Tracking)
3. **Cognitive Loading** (adding distractors; simulates real world scenario)
67
What is the FIRST thing to do when training saccadic eye movements?
Ensure pt is able to maintain fixation on a stationary target
68
Which is easier and thus should be trained first, when training saccadic eye movements: gross or fine saccades?
GROSS
69
Which is easier and thus should be trained first, when training saccadic eye movements: slow or fast saccades?
SLOW
70
When training saccadic eye movements, it is best to start: monocularly or binocularly? How do you know when to move on to the other?
Train monocularly until both eyes are trained equally
71
One general approach in saccadic training is to develop _____ saccades, which means that eye movements should not be more difficult with cognitive loading
Automated
72
In saccadic training, what should be eliminated if possible? (4)
1. Overshoots
2. Undershoots
3. Regressions
4. Inefficient return sweeps
73
When training pursuit eye movements, to increase difficulty, how could you increase vergence demand?
Add prism
74
How to increase difficulty with Four Corner Saccades (4)
1. Move pt farther from wall (decrease saccades)
2. Perform in random pattern
3. Increase speed
4. Incorporating cognitive loading
75
How to decrease difficulty with Four Corner Saccades (4)
1. Move pt closer to wall (makes saccades larger)
2. Follow a CW or CCW pattern
3. Decrease speed
4. Allow use of pointer
76
Oculomotor Training Techniques: Basic (4)
1. Thumb Rotator
2. 4 Corner Saccades
3. Flash Light Tag
4. Marsden Ball (Follow)
77
Oculomotor Training Techniques: Intermediate (4)
1. Keystone/Pegboard Rotator
2. Hart Chart Saccades
3. Large Michigan Tracking
4. Marsden ball (catch/hit w/ hand)
78
Oculomotor Training Techniques: Advance (4)
1. Rotator w/ loading
2. Hart Chart Saccades w/ loading
3. Smaller Michigan Tracking
4. Marsden ball bunt w/ loading
79
How to increase difficulty with Hart Chart saccades? (3)
1. Move pt further from wall (smaller saccade)
2. Read lines closer together (eg columns 4 & 7)
3. Add loading
80
How to decrease difficulty with Hart Chart saccades? (3)
1. Move pt closer to wall (larger saccades)
2. Have to read lines further apart (eg columns 1 & 10)
3. Allow use of pointer
