Flashcards in Psychogenic Amblyopia Deck (13)
what are the different types of psychogenic amblyopia
1. hysterical amblyopia: associated with stress
2. malingering: faking it
3. Streff syndrome: bilateral juvenile amblyopia; stress trigger
What tricks can you use for malingering amblyopia?
1. Use disassociated prisms so they can observe that you changed something.
2. give them a strong rx in the horopter so they see blurry.
3. use stereo or CS to determine rough VA
What are key findings of streff syndrome
1. Distance VA is 20/25 or worse
2. Near VA is worse than distance
3. They have a really close working distance
4. Stereo is reduced
5. Tubular VF (VF is the same even when WD is changed- lazy focus)
6. Female prevalance 2:1
8. Difficulty in school
9. possible clumsiness
How do you treat streff syndrome?
+0.25 - +0.50 lenses for FTW to magnify their F and enhance the ground (periphery) and dorsal pathway (where)
-Depending on the reason for onset of streff, you may want to refer to psychologist even when VA is improved.
What is the critical period?
0-3 years old
What is the sensitive period?
3-6 years old
T/F With strabismus, stereo and color will still be intact
T/F Bc you have improved VA, it does not mean you will have improved stereo
true; stereo is due to binocularity
T/F if a patient has central steady fixation and see 20/100 their prognosis to correct VA is much more less.
true; make sure they do the task with amblyopic eye fixating
What are two main objectives in treatment of functional amblyopia
1. Establish steady central fixation
2. attain maximum VA
what are other things we hope to accomplish in treating functional amblyopia
1. normal oculomotor function
2. normal accommodative function
3. normal binocularity
4. normal spatial and visual information processing ability
What is the treatment sequence
1. Optimum refractive correction
-base on cycloplegic refraction and based on improvement in performance and behavior, not by the VA chart.
-full correction of aniso/astigmatism
2. Behavioral lens prescription
-refractive compensation based upon minimal compensation to achieve desired results
-If you need to cut plus, to it equally.
-undercompensate until fixation is steady and centric