VT Theory and Programming: Oculomotor

Question 1

Basic overall sequence of Vision Therapy (7 phases)
What phases do most of your VT program fall in?

Answer 1

Phase 1: Optimal Lens prescription
Phase 2: Gross motor
Phase 3: Monocular
Phase 4: Bi-ocular
Phase 5: Binocular
Phase 6: Binocular with loading
Phase 7: VIP

Most of VT program falls in phase 3-5. Monocular, Bi-ocular, binocular.

Question 2

What are the Phase 3 activities?

Answer 2

Monocular accommodative
Monocular Oculomotor

Question 3

What are the phase 4 activities?

Answer 3

Bi-ocular / Anti-suppression accommodative activities
Bi-ocular / Anti-suppression oculomotor activities
Anti-suppression / Basic fusion (1st degree fusion)

Question 4

What are the phase 5 activities?

Answer 4

Binocular accommodation activities
Binocular oculomotor activities
Fusion therapy activities

Question 5

What are the phase 5 activities?

Answer 5

Binocular accommodation activities
Binocular oculomotor activities
Fusion therapy activities

Question 6

Where in VT do you start with a patient? Where do you move to?

Answer 6

Start where a patient can succeed then move to where the patient struggles

Question 7

What is the oculomotor hierarchy?

Answer 7

Gross motor –> fine motor –> oculomotor

Question 8

What is the hierarchy of skills for visual function? (4)

Answer 8

1) Orientation of the body in space
2) Oculomotor skills
3) Binocularity and accommodation
4) Perceptual function

Question 9

When all 4 skills of visual function work together, what does this give us?

Answer 9

Good vision

Question 10

The primary purpose of the ____________ is the derivation of meaning and the direction of action

Answer 10

visual system

Question 11

What does developmental Ocular motor dysfunction have to do with?

Answer 11

Poor body coordination, could have poor laterality and directionality

Question 12

What would be shown with testing on a patient who has developmental OMD?

Answer 12

Failing the “ability” on maples testing
Excessive body movement
Excessive head movement

Question 13

What would therapy for developmental OMD focus on?

Answer 13

Work on gross motor first
Improve rhythm

Question 14

What are 6 gross motor exercises you can do for patients with developmental OMD?

Answer 14

Army crawl
Balance board
Walking rail
Motor equivalent/ chalkboard circles
Handball
Bunting

Question 15

Laterality vs directionality (for developmental OMD)

Answer 15

Laterality: on self
Directionality: on other things

Question 16

True or false:
Oculomotor therapy is done in all VT programs?

Answer 16

True

Question 17

What does Functional OMD manifest as?

Answer 17

poor eye tracking skills

Question 18

If someone has a functional OMD, would they have a normal or abnormal “ability” on Maples Test?

Answer 18

Normal ability on maples test

Question 19

What therapy would you use for Functional OMD?

Answer 19

Begin working fixation
Move to saccades, then pursuits
Monocular, bi-ocular, binocular
Large saccades –> small saccades
Small pursuits –> large pursuits

Question 20

What can patients use when saccades are smaller than 30 degrees?

Answer 20

Eyes only

Question 21

What can patients use when saccades are larger than 30 degrees?

Answer 21

head/torso/body movements

Question 22

Basic order of functional OMD therapy

Answer 22

Work on accuracy first
Eliminate head and body movement
Then increase appetite and length (stamina)
Higher level accuracy of fine movements

Question 23

What age should you have no body movement by?

Answer 23

5.5-6.5 years old