1 - BV Review

Question 1

Von Graefe

Answer 1

Measures phoria

1 ± 2pd @D

3 ± 3pd @ N

AC/A = do at D&N or at 1 distance w/ +1.00D

Question 2

Smooth/Step Vergences

Answer 2

Measures vergences

D: x/7/4 BI 9/19/10 BO

N: 13/21/13 BI 17/21/11 BO

Always start with BI

Question 3

Vergence Facility

Answer 3

Assess vergence response to change

15 ±3 cpm

Question 4

Accommodative Amps

Answer 4

Measures accomm

Hofstetter’s

Push-up, pull-away, or minus-to-blur (remember to add 2.50 WD)

Question 5

NRA/PRA

Answer 5

Ability to incr/decr accomm

+2.50/-2.50

Do NRA first

Question 6

BAF/MAF

Answer 6

Ability to make accurate accommodative changes

BAF: 8 cpm

MAF 11 cpm

Question 7

MEM

Answer 7

Measure accomm response

+0.25 to +0.50

Question 8

W4D

Answer 8

Fusion, central scotoma

Expect fusion

Question 9

4BO

Answer 9

Small central scotoma detection

Conjugate movement -> vergence movement

Question 10

FCC

Answer 10

Assess accuracy of accomm response, tentative add

+0.50 ± 0.50 D

DIM illumination

Question 11

Bagolini

Answer 11

Suppression & retinal correspondence

Expect fusion

Question 12

Visuoscopy

Answer 12

Eccentric fixation

Expect no EF

Test non-amblyopic eye first

Question 13

Red lens

Answer 13

Comitancy, retinal correspondence

Expect alignment

10pd BD over fixating eye

Question 14

After Image

Answer 14

Eccentric fixation, retinal correspondence

Expect no separation/a cross

Separation = angle of anomaly

At 1m, the separation in cm = Pd

Question 15

Haidinger

Answer 15

Eccentric fixation, retinal correspondence

Expect brush on center dot

Question 16

CT

Answer 16

Objectively measure alignment

1 ± 2pd @D

3 ± 3pd @N

Question 17

Simultaneous CT

Answer 17

Measure strab with prism

Estimated prism over deviated eye, occluder over fixating eye

Question 18

Maddox/MT

Answer 18

Measure phoria

1 ± 2pd @D

3 ± 3pd @N

For horiz phoria use horiz grooves

Question 19

Parks 3 Step

Answer 19

ID abnormal EOM causing vertical deviation

1) eye that’s hyper in primary
2) incr with L/R gaze
3) incr with L/R head tilt

Question 20

Forced Duction

Answer 20

Restriction due to mechanical or paresis

(+) = mechanical

(-) = paresis

Question 21

Double Maddox

Answer 21

Assess torsion

Question 22

Hess Lancaster

Answer 22

Assess alignment & movement

Smaller field = underacting eye

Larger field = overacting eye

DIM lighting, @ 1m

Question 23

NSUCO

Answer 23

Saccades & pursuits

Expected based on age & gender norms

S = 5 rounds

P = 2 CW, 2 CWW

Question 24

DEM

Answer 24

Ocular motor abilities

1) normal
2) high H, abn ratio = OMD
3) high H&V, normal ratio = automaticity
4) high H&V, abn ratio = both

Question 25

Parks Examples:

1) L hyper in primary, incr in R gaze, incr with L head tilt
2) R hyper in primary, incr in L gaze, incr with L head tilt

Answer 25

1) L SO
2) L SR

Question 26

AC/A equations

Answer 26

Calculated = PD(cm) + NFD(m) * (Pn-Pd)

Eso +, exo -

Gradient = absolute change in phoria/absolute change in accomm

Question 27

AC/A example: Pt with PD 64mm, 1.5 EP @ D, 3 XP @ 40cm

Answer 27

AC/A = 6.4 + .4(-3-1.5) = 4.6