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vision rehab > 21 fucking steps > Flashcards

21 fucking steps Flashcards

1
Q

An objective method of examining the interior of the eye

A

ophthalmoscopy

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2
Q

To measure the anterior radius of curvature of cornea.

A

ophthalmometry

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3
Q

Assess the quality of tears (N° 3secs.)
To assess if cornea is steep or flat

A

ophthalmometry

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4
Q

To determine Base Curve for CLs Fitting (hard CLs)

A
  1. ophthalmometry
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5
Q

To assess any ocular pathology e.g. Keratoconus / Kl plana

A
  1. ophthalmometry
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6
Q

To measure the tonic innervation of the muscles at 20 ft.

A
  1. habitual phoria test at far
  2. induced phoria at far
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7
Q

To determine lateral muscular imbalance at far

A
  1. habitual phoria test at far
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8
Q

To measure the tonic innervation of the muscles at 16 inches/40 cm
To determine the relative horizontal position of the visual axes when fusion has been broken.

A

13a. habitual phoria test at near
13b. induced phoria at near

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9
Q

To determine the refractive power of the eye objectively

A
  1. static retinoscopy
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10
Q

Measures intensity & deterioration of visual pattern

A
  1. dynamic retinoscopy @ 20”
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11
Q

allows rapid assessment of accommodative ability. The key to the technique is the neutralization of the retinoscopic reflex that occurs when the patient accommodates on a target adjacent to the retinoscope.

A

dynamic retinoscopy

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12
Q

Measures of negative relative accommodation @ 40”

A
  1. dynamic retinoscopy @ 40”
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13
Q

to check the equality of spherical amount.

A
  1. subjective refraction @ far
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14
Q

the assessment of refractive status by a combination of spherical and cylindrical lenses to determine the best-corrected visual acuity with accommodation relaxed.

A
  1. subjective refraction @ far
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15
Q

Checking the equalization on both eyes using the 3^BU & 3^BD (upper left and lower right)

A

Equilibrium Test (Binocular Balance)

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16
Q

To subjectively determine the near refractive power of the patient’s eye
For px with presbyopia or Rx at near
For px with medium to high myopia
For px with plus at near

A

7a. subjective refraction @ near

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17
Q

For px with presbyopia or Rx at near
For px with medium to high myopia
For px with plus at near

A

7a. subjective refraction @ near

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18
Q

To measure the tonic innervation of the muscles at 20 ft.
To determine the relative horizontal position of the visual axes when fusion has been broken

A
  1. induced phoria test @ far
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19
Q

represents the point when the px can no longer compensate for the prism induced retinal disparity while maintaining stable accommodation
Indicate the limit of available positive fusional convergence in reserve

A

Blur Point

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20
Q

represents the reserve of the total convergence @ far with activation of accommodative convergence; Represents the point when the Px using all the vergence resources can no longer maintain single vision

A

Break Point

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21
Q

the limit of fusion field in a distance of 20 feet; indicates that the induced retinal disparity has been decreased to the point that the pxn can access the vergence system & regain single vision

A

Recovery Point

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22
Q

no accommodation.
At far, accommodation could not inhibit beyond zero.

A

NO BLUR

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23
Q

negative fusional reserve.

A

BREAK

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24
Q

To measure the vertical displacement under dissociation & equal vertical duction in view of relatively large # of pxs

A

12b. vertical duction test @ far
18b. vertical duction test @ near

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25
Q

Measures the integrity and deterioration of the visual pattern; measures the degree of embedding of the visual pattern; measures the recency of the visual problem and anisometropia @ near

A

14a. unfused crossed cylinder test @ near

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26
Q

Control lens for near point testing in the presence of low amplitude of accommodation; Measures the amount of accommodation free of convergence at near under fused condition

A

14b. fused cross cylinder test @ near

27
Q

To indicate the amount the positive fusional reserve available at the fixation distance. (blur point w/ prism BO)

A

16a. positive relative convergence @ near

28
Q

To measure the fusional innervation and accommodation convergence in reserve that can be supplied at the point

A

16b. positive fusional reserve test @ near

29
Q

Measures the maximum inhibition of convergence at near

A

17b. negative fusional reserve test @ near

30
Q

Blur point indicates the amount of negative fusional convergence or measures the amount of convergence relaxable at the fixation distance

A

17a. negative relative convergence

31
Q

Measures the vertical displacement under dissociation and unequal vertical ductions in view of relatively large number of pxs

A

18a. vertical phoria test @ near

32
Q

Measures the protection against senility
.

A
  1. amplitude of accommodation test
33
Q

Measures the amplitude of accommodation by using minus lenses to inc. the stimulus to accommodation

A

amplitude of accommodation test

34
Q

Stimulating the accommodation by increasing (-) lenses w/o affecting convergence

A

positive relative accommodation test @ near

35
Q

Measure the maximum amount of accommodation relaxation.

A

negative relative accommodation test @ near

36
Q
  1. ophthalmoscopy procedure
A
  1. Start at 16” w/ +8.00D in place in ophthalmoscope power
  2. Move closer to the Px and go more minus until you will arrive to the amount of lens that will give a clear fundus image at a distance of less than 1”

Methods: a) direct ophthalmoscopy b) indirect ophthalmoscopy
Illumination: Dim Illumination
Test Target: Gross Target
Test Distance: 20ft or 6m
Working Distance: 16”
Manner of Examination: OD to OD; OS to OS

37
Q
  1. ophthalmometry procedure
A

1.Adjust eye piece, adjust body, the drums (at 44D), align the patient’s lateral canthus with the canthus marker 2.Turn on the instrument and find the mires
3.Adjust the mires that the circle, + and – signs will be aligned.
4.Get the reading
5.Solve for the base curve: 337.5/flattest K
6.Get the corneal astigmatism:
Subtract the powers then use the axis of the meridian of the least power. Answer is always in minus sign.

38
Q
  1. habitual phoria test at far procedure
A

1.Dec. 12^BI until vertically aligned

39
Q

13a. habitual phoria test at near procedure

A
  1. Dec. 12^BI until vertically aligned
40
Q
  1. static retinoscopy procedure
A
  1. Procedure:
    - if Against movement = add minus lenses
    - if With movement = add plus lenses
41
Q
  1. dynamic retinoscopy @ 20” procedure
A

1.Procedure:
-if Against movement = add minus lenses;
- if With movement = add plus lenses

42
Q
  1. dynamic retinoscopy @ 40” procedure
A

1.Procedure:
*if Against movement = add minus lenses;
*if With movement = add plus lenses

43
Q
  1. subjective refraction @ far procedure
A

1.Monocularly correct the Ametropia
2.Fog 2 lines above best VA
3.Present astigmatic chart (ask if all lines are equally blur/dark)
*if equally blur/dark proceed to duochrome test
*if there are darker lines (ask what lines are darker and get the middle then x30 to get the tentative axis)
* if 4 lines are darker add 0.25 then get TA
4. place Cyl. Scale handle on the TA
5.add Cyl. Lens until all lines are equal
6.Unfog px until 20/20 on DSC is clear
7.check Cyl. Axis: JCC handle on TA (compare lenses: better lens, move 10-15 degrees to the red dot, 2nd move 5 degrees towards the red dot, next, 5 degrees till equal)

7a,8
*Tell the px:
“Px,I will flip this lens, and tell me if they are equal or the other is distinctively better than the other.”
6.compare and get final axis

8.Check Cyl. power:
JCC red dot along final axis
*flip and let the px compare if the two positions are equal or clear or the other is distinctively better or clearer than the other
*if red dot is near the Final axis, add more (-) cyl.
*if white dot is near the Final axis, dec. (-) cyl. Check for Sphere Component: Duo Chrome Test: -room illumination -compare letters inside the red and green chart
*if red darker, dec. (+) sphere; if green darker inc. (+) sphere

9.Repeat with OS

10.Check OU: Equilibrium balance:
Prism OD 3^BU & OS 3^BD
If equal or if there is a clearer target, add + sphere lens:
Upper Chart clearer, add (+) sph on the right;
Lower Chart clearer, add (+) sph on the left

44
Q

7a. subjective refraction @ near procedure

A

1.Binocularly add + lens until J1+ or until clear

45
Q
  1. induced phoria test @ far procedure
A

1.Dec. 12^BI until vertically aligned

46
Q
  1. True adduction test @ far procedure
A

1.Binocularly, gradually and smoothly increase ^BO until slight blur

47
Q
  1. Convergence test @ far procedure
A
  1. Increase ^BO until diplopia; Decrease ^BO until single
48
Q
  1. Abduction test @ far procedure
A

1.Inc. ^BI until diplopia; Dec. ^BI until single

49
Q

12a. vertical phoria test @ far procedure

A
  1. Procedure: Dec. 6^BU until horizontally aligned
50
Q

12b. vertical duction test @ far procedure

A

1.Procedure
Done in one eye only because it’s duction
Inc. ^BU or ^BD until double
Dec. ^BU or ^BD until single

51
Q

13b. induced phoria test @ near procedure

A
  1. Dec. 12^BI until vertically aligned
52
Q

13b+1D. induced phoria test @ near +1.00D procedure

A

1.Dec. 12^BI until vertically aligned

53
Q

14a. unfused crossed cylinder test @ near procedure

A
  1. Let Px choose which one to concentrate
    2.*if all lines are equal: Add (+) lens until vertical lines are darkest
    3.Dec (+) lens until vertical and horizontal lines are equal
54
Q

14b. fused cross cylinder test @ near procedure

A

1.*if all lines are equal: Add (-) lens until horizontal lines are darkest
2.Dec (-) lens until vertical and horizontal lines are equal

55
Q

15a. Induced phoria test thru 14A
15b. Induced phoria test thru 14B

procedure

A
  1. Dec. 12^BI till vertically aligned
56
Q

16a. positive relative convergence @ near procedure

A
  1. Binocularly, gradually increase ^BO until 1st blur
57
Q

16b. positive fusional reserve test @ near procedure

A
  1. Continue to increase ^BO until double; Dec. ^BO until single
58
Q

17b.negative fusional reserve test @ near procedure

A
  1. Continue to increase 17A^ until double; Dec. until single
59
Q

18a. vertical phoria test @ near procedure

A
  1. Dec. 6^BU until horizontally aligned
60
Q

18a. vertical phoria test @ near procedure

A
  1. Dec. 6^BU until horizontally aligned
61
Q

18b. vertical duction test @ near procedure

A
  1. Inc. ^BU or ^BD until double
    2.Dec. ^BU or ^BD until single
62
Q
  1. amplitude of accommodation test procedure
A

1.(NPB) Add (-) lenses; (PB) Add (+) lenses, # of clicks x 0.25

63
Q
  1. positive relative accommodation test @ near procedure
A

1.Add (-) lens till 1st blur

64
Q
  1. negative relative accommodation test @ near procedure
A

1.Add (+) lens till 1st blur

vision rehab (4 decks)

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