Visual Efficiency Diagnosis Flashcards
Recite the three basic steps of integrative analysis
1) compare individual tests to tables of expected findings 2) group the findings that deviate from expected 3) identify the syndrome based on steps 1 and 2
What are common signs and symptoms of vergence and accommodative anomalies?
blurred vision, headache, asthenopia, fatigue, diplopia, motion sickness, loss of concentration
Why do we need to diagnose vergence and accommodative anomalies as early as possible?
prevention of accommodative esotropia, prevention of decompensation into other strabismus, and prevention of academic/learning difficulties
What are the three categories of binocular anomalies?
Low AC/A, Normal AC/A, High AC/A
What categories of binocular anomalies do Duane-White classification fall under?
Low AC/A and High AC/A
What are low AC/A anomalies?
convergence insufficiency and divergence insufficiency
What are normal AC/A anomalies?
fusional vergence dysfunction, basic exophoria, basic esophoria
What are high AC/A anomalies?
convergence excess and divergence excess
What is convergence insufficiency?
exo N>D; exo at near > 4 ^; ortho or low exo at distance, receded NPC, reduced PFV (low BO); low AC/A
Which anomaly is often seen in early presbyopic patients when their accommodation decreases?
CI because they can’t compensate for convergence difficulty
What is the convergence insufficiency prevalence?
the most common of all non-strab BV disorders
How can you determine a pseudo-CI from a CI?
CI has problem with convergence, pseudo CI has accommodation problem– run CT through +1 and the pseudo CI will improve
What is a pseudo CI?
accommodative issue; reduced accommodation=less accommodative convergence
What presentation does a pseudo CI have?
greater XP at near, patient uses more PFV to maintain single vision resulting in a reduced ability to converge
What may a pseudo CI have that a true won’t?
low amps, high MEM, reduced (-) on facility
What is divergence insufficiency?
eso D>N, reduced BI at distance (NFV low), low AC/A, normal versions
What is the prevalence of DI?
least common and least studied, warning flag!
Why is a DI a warning flag?
must rule out pathology like brain stem tumors, vascular conditions, etc. especially in sudden onset, refer for MRI and check for divergence paralysis
Which anomaly is a red flag?
DI if sudden onset
What is convergence excess?
eso N>D, eso at near, ortho or low eso at distance, reduced NFV (BI), high AC/A
What is the prevalence of CE?
fairly common
What is divergence excess?
exo D>N, greater exophoria at distance than at near, may see IXT at distance, normal stereo at near, typically normal PFV, high AC/A
What divergence excess finding may throw you off?
normal PFV, this condition is often hidden until fatigue
Which anomaly can be found in conjunction with strabismus (XT)?
divergence excess
