VT for Accommodative Disorders Flashcards
Before you start designing a VT program for a patient, make sure you consider the lenses they’re wearing, any physical limitations they have or medications they may be on, or whether there is a bigger problem.
Free card.
When training a patient’s blur sensitivity, you would ideally work to lenses of 0.25D increments in plus lenses and no less than ______D increments in minus lenses.
0.50
How would a patient achieve accommodative awareness?
By achieving clarity through a minus lens and then trying to describe the sensations they feel, and trying to hold accommodation steady with lens insertion and removal.
What is meant by Dr. Cooper’s term “mental minus”?
It’s part of the training process of accommodative awareness in which the patient tries to voluntarily increase accommodation before looking through a minus lens (or voluntarily decreasing before removing the lens)
In training the phasic controller in acommodative infacility, what sorts of tasks could you consider?
Near-Far Rock Split Pupil Rock Loose Lens Rock Plus/Minus Flippers BOM/BIP-->BOP/BIM facilities
Treatment for accommodative insufficiency involves minus lens activities. Which minus lens activity involves holding a near chart a few cm further than the NPA, then doing a near-far rock?
Jensen rock. This test can be modified by holding the near chart at the NPA for about 5 seconds, then doing a near-far rock with the near chart at 40cm (and repeating).
As a task for accommodative insufficiency, minus lens tromboning can be used. What is another task that is very similar to this one?
Minus lens walk up (use a minus lens, then move closer to the target one step at a time, keeping the target perfectly clear for 10 seconds between steps).
Part of the goal for in therapy for accommodative insufficiency is to get the adaptive controller of accommodation to work best. What three variables work best to train this controller?
Make a large change
Make it all at once
Hold the change
Ill-sustained accommodation is a lesser degree of accommodative insufficiency. True or false: if the program seems to be succeeding without sustained accommodative activities, it’s okay to leave them out of the program.
False; you should still do sustained accommodative activities.
One of the goals of treating false CI is to challenge accommodation against an opposing vergence demand. What sort of tasks could be done to challenge these two against each other?
Near-far rock with BI at near, but not at far
BIM/BOP facilities
Binocular walk up task, adding BI with each step
How can a crossed-cylinder setup be used to help treat false CI?
Have patient try to appreciate the difference in degrees of clarity, and to try and alternate keeping the vertical and then horizontal lines clear.
For the following tests, what results might you expect from a patient with accommodative excess?
MEM
BCC
NRA
MEM: reduced lag, or a lead
BCC: less than +0.50
NRA: low
What specific tests can you use to help an AE patient learn how to relax their accommodation?
Split pupil rock, plus lens and/or BO walk away, Jensen rock–all of these with an emphasis on releasing accommodation rather than cranking it up.
Trying to train the adaptive controller of a patient with AE can be done with what types of tasks?
Plus add wear
Large lens changes every two minutes of reading
Rest from near tasks, with BO when looking in the distance
VT for pseudomyopia is similar for that of AE. The exception is that since pseudomyopia typically has more issues with facilities, phasic training in emphasized more with pseudomyopia than with AE.
Free card.
