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Z. Vision Therapy — Class Final > Vergence > Flashcards

Vergence Flashcards

(86 cards)

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1
Q

T/F: Bifoveal vision is mandatory for RDS

A

TRUE

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2
Q

T/F: Pt w/ CAET may see RDS

A

FALSE

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3
Q

T/F: Pt w/ IRXT may see RDS

A

TRUE; sometimes

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4
Q

Each Category of Vergence Dysfunctions (1-4), all are subdivided into Low (___ at distance), Normal (ortho at distance), and High (___ at distance)

A

Low — exo
High — eso

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5
Q

Why do we not want to correct LOW hyperopes with CI (that can accommodate)?

A

(+) can worsen CI

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6
Q

T/F: CI pts have excellent early prognosis with VT

A

TRUE; 85-95% success

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7
Q

What is the most common non-strabismus Vergence diagnosis?

A

CI

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8
Q

CI struggles with ____ (BI/BO)

A

BO; can’t converge

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9
Q

T/F: CI may cause suppression at N

A

TRUE

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10
Q

Who HATES (+)?

A

AE and CI

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11
Q

T/F: For CI pts, NV will be worse in the morning

A

FALSE; end of day

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12
Q

T/F: Add power is appropriate for CI pts

A

FALSE

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13
Q

When should we consider NOT Rxing BI prism for CI pt?

A

If SRx is FTW and pt is ortho at D —> will make them eso at D :(

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14
Q

Small lag/lead seen in (3)

A
  1. AE
  2. CI
  3. Basic exo
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15
Q

Systemic DDX for CI’s include (7)

A
  1. Ischemic infarction
  2. Myasthenia Gravis
  3. Infection (Viral/Flu)
  4. Demyelination (MS)
  5. Parkinson’s
  6. Parinaud’s
  7. Trauma
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16
Q

Parinaud’s Syndrome

A

Ophthalmoplegia 2/2 midbrain lesions:
1. Paralysis of conjugate mvmt
2. Upgaze paralysis
3. Nystagmus on attempted convergence
4. Light near dissociation
5. Bilateral papilledema

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17
Q

Associated Phoria is measured in ___, while Fixation disparity ins measured in ___

A

PD, mins of arc

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18
Q

Fixation disparity is measured under ___ (Associated/Dissociated) conditions

A

Associated (unlike phoria)

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19
Q

Least common/studied non-strabismic Vergence Dx

A

Divergence Insufficiency

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20
Q

Why is prism more effective for DI vs CI?

A

BO prism will make pt a bit more exo, which is acceptable

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21
Q

T/F: Add is an appropriate TX for DI

A

FALSE

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22
Q

DDX for DI: (2)

A
  1. 6th Nerve Palsy (noncomitant deviation + endpoint nystagmus)
  2. Divergence paralysis (sudden onset homonymous diplopia)
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23
Q

Basic ESO pts struggle with ___ (BI/BO) due to their limited ___ (NFV/PFV); this is also why they struggle with ___ (minus/plus)

A

BI; NFV; minus

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24
Q

Basic ESO has a Type ___ FD curve

A

2

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25
Basic ESO has a ___ (smaller/larger) lag
LARGE; due to Accommodative Vergence (trying to diverge by relaxing/lessening accommodation)
26
Basic EXO pts struggle with ___ (BO/BI) due to their limited ___ (NFV/PFV); also why they struggle with ___ (minus/plus)
BO; PFV; plus
27
Basic EXO has a Type ___ FD curve
3
28
T/F: Binocular Instability has an excellent prognosis with VT
TRUE
29
Binocular Instability is aka
Fusional Vergence Dysfunction
30
In Binocular Instability, ___ (NRA/PRA) will likely be reduced
BOTH
31
What binocular dysfunction can simulate Binocular Instability?
Pt with both Accomm and Vergence Issues
32
T/F: Prism is an appropriate TX for Binocular Instability
FALSE; fails BO and BI
33
DDX for Fusional Vergence Dysfunction (7)
1. AI 2. Latent hyperopia 3. Vertical/cyclo-deviation 4. FD 5. Aniseikonia 6. Medication induced 7. Sensorimotor issue
34
DDX for CE (4)
1. Acc/Conv spasm due to inflammation (eg, iritis, scleritis, uveitis) 2. Sympathetic paralysis 3. Syphilis 4. Drugs (seediness, pilo, VitB1, sulfonamides)
35
CE will show a ___ (larger/smaller) EP at NEAR
Larger
36
CE pts hate ___ (BI/BO) due to their limited ___ (NFV/PFV); also, they struggle with ___ (plus/minus)
BI, NFV, minus
37
Prognosis for CE in VT
“Good to very good” (no excellent) — 62-84%
38
T/F: Add is appropriate for CE pts
TRUE
39
DE: more ___ (eso/exo) at ___ (distance/near)
Exo at distance
40
Who closes their eyes in bright light?
CI or DE *think near triad*
41
T/F: pts with DE will have reduced BO and increased BI
FALSE; **normal/limited DBI** and **adequate DBO**
42
T/F: Low NFV/DBI can occur in both DI and DE pts
TRUE
43
“Hypo” is reserved for vertical ____ (phoria/tropia)
TROPIA
44
T/F: vertical phorias remain similar at **all** distances
TRUE
45
Parks 3 Step
1. Hyper (R or L) 2. Worse in which gaze (R or L) 3. Worse in which head tilt (R or L)
46
Parks 3: Right hyper, left gaze worsens, and right head tilt indicates
RSO (CN 4) Palsy
47
Parks 3: Left hyper, right gaze worsens, and left head tilt indicates
LSO (CN 4) Palsy
48
Refer to systemic/endo/neuro if hyper + (3)
1. Recent onset diplopia 2. Non-comitant EOMs 3. VF defect
49
Binocular vision DDXs for Dry Eye (5)
1. CI 2. Accommodative Dysfunctions 3. Vertical Imbalance 4. FD 5. Proprioceptive Disparity
50
NON-accommodative target NPC removes ___, therefore, you are only testing ___
Accommodative Vergence; Fusional & Proximal Vergence
51
Difference between Pseudo CI & TRUE CI
In Pseudo CI… 1. NPC: acc ≈ non-accom target 2. Additional (+) at near —> improved NPC 3. Possible low PRA and BAF (AI hates minus) 4. Low amps, large lag, low MAF REMEMBER: Pseudo CI = AI
52
Keystone: Card 1
Dog/Pig: checks simultaneous perception
53
Keystone: Card 2
Line through the circle; Checks vertical posture
54
Keystone: Card 3
Arrow pointing at number; Checks horizontal posture
55
Card 3 is for distance; Card ___ is the same card but for near
10
56
Keystone: Card 4
4 Circles (red, green, white); Checks H posture & flat fusion
57
Card 4 is for distance; Card ___ is the same card but for near
11
58
Which Rx used for Keystone?
Distance at distance; near at near
59
Rx for Cheiroscope Tracing?
Distance
60
Chiroscope Tracing: midline of design should be lined up with
0 **not** NP 0
61
Cheiroscope: if the pt is LEFT handed, the blank side should be on the ___ side
LEFT
62
Cheiroscope Tracing: a separation of ___ indicates ortho ; greater indicates ___, less indicates ___
68 mm Greater = exo Less = eso
63
Cheiroscope: If pt’s separation is 64 mm, describe the pt’s posture
2 PD eso 2 mm = 1 PD > 68 = exo < 68 = eso
64
Right Hyper
65
ESO shift
66
HIGH eso
67
Anisometropia OR pt’s drawing (not tracing)
68
What do you measure for Van Orden (VO) Star?
Tips of triangles
69
Vectogram: letters = ___ (BI/BO)
BI
70
Vectogram: numbers = ___ (BI/BO)
BO
71
What should be assessed on vectogram? (5)
1. Blur/Break/Recovery 2. Float 3. Localization 4. SILO vs SOLI 5. Parallax
72
SOLI vs SILO: what happens in real life?
SOLI
73
SILO vs SOLI: what is the expected for this test?
SILO
74
Parallax: with BO, pt should see ___ (with/against) mvmt
WITH
75
T/F: Barrel cards are mainly used for training CE
FALSE!! Trains CI (**not** CE)
76
Management Considerations (4)
1. Optical/refractive correction 2. Fusional prism 3. Plus/minus added, as needed 4. Vision Therapy
77
VT can be considered for…
1. Anti-suppression 2. Sensory Motor: Improve Fusional Vergence, Accommodation, and Versional Accuracy
78
What does jump duction measure?
Recovery
79
What is measured in BOP/BIM?
Recovery
80
Lifesaver: Transparent card is associated with ___ (BI/BO)
BI
81
Lifesaver: Opaque card is associated with ___ (BI/BO)
BO
82
Lifesavers: increase difficulty with BO
Try to “look close” + move card forward and backwards
83
Lifesavers: if difficulty with BI
Try “looking far”
84
Lifesavers: increase difficulty
Move cards H, V, and circular
85
Aperture Rule: Single Windows trains
PFV
86
Aperture Rule: Double Windows trains
NFV

Z. Vision Therapy — Class Final (7 decks)

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