3?

Question 1

A kid gets retted at +1.00 and auto refraction gives you -2.00. What kind of accommodation is responsible?

Answer 1

Proximal accommodation

Question 2

What is the most correct theory of accommodation?

Answer 2

Ciliary muscle contraction cause relaxation of the lens zonules.

NOT CHANGE IN PUPIL SIZE OR CHANGE IN LENS POSITION

Question 3

Pt has no problems with reading or distance, you get a ret with an add of +1.00 and the right eye slightly myope and left eye slightly hyperope. What kind of presbyopia?

Answer 3

Objective presbyopia

-basically they have like monovision.

Question 4

When the zonules relax, what happens to the distance between the anterior part of the lens and the posterior part?

Answer 4

It gets longer. The lens becomes more round

Question 5

Of the lens and the capsule, which one becomes more elastic?

Answer 5

Capsule is more stretched, so more elastic, lens gets less elastic/more dense

Question 6

What are the three things part of the primary factory leading to presbyopia?

Answer 6

1. Lens capsule gets more stretched
2. Lens becomes more stiff
3. Lens size/volume increases with age

Question 7

Which factor contributes to 44% of the loss of accommodation?

Answer 7

The lens becoming more stiff

Question 8

What are the three factors that do not cause presbyopia?

Answer 8

• zonules elasticity (it remains constant)
• ciliary muscle power (it actually increases with age)
• control pathways and structures (remain constant)

Question 9

What does the amplitude of accommodation usually start at (10 years old)?

Answer 9

12.5D and decreases with age

Question 10

What is hofsetter’s formula?

Answer 10

Mean: 18.5-(0.30)(age)
Min: 15-(0.25)(age)
Max: 25-(0.40)(age)

Question 11

What is the min, mean, and max for a 10 year old?

Answer 11

12.5,15,21D

Question 12

What is the first stop for your patients for add?

Answer 12

0.75D

Question 13

If a patient thinks they need to up their add, how much do you add?

Answer 13

Usually no more than 0.25 or 0.50

Question 14

Add is prescribed mostly based off?

Answer 14

Age. Usually start 0.75 and bump it up 0.25/0.5 each time.

Question 15

What is a common add given to a 50 year old patient?

Answer 15

+1.50D

Question 16

What is lag/lead accommodation? What is it measured with?

Answer 16

• disparity between retinal defocus and accommodative mechanism
• measured with retinoscopy

Question 17

What is accommodative spasm?

Answer 17

• you focus too much (lead)
• you turned yourself into a myope (accommodate for a long period of time and now you can’t relax)
• latent hyperopia

Question 18

How could you get rid of accommodative spasm?

Answer 18

• fog them over and over again
• use cyclo to help relax ir
• sudden unfogging: +/- 2.00 trial lens to fog then rapid bring them out of it.

Question 19

What is accommodative facility?

Answer 19

• have them look at something near (40cm) then flip between +2 and -2 and have them tell you when they get a clear image
• measure number of cycles in 60 seconds.

Question 20

When measuring accommodative facility, what amount of accommodation are you switching between?

Answer 20

• 4D switch

- from 4.50 to 0.50

Question 21

Would monocular for binocularly be a faster accommodative facility?

Answer 21

Monocular would be 2-3 CPM faster than binocular

Question 22

How do myopes accommodate? Hyperopes?

Answer 22

• myopes accommodate less

- hyperopes accommodate more

Question 23

What is the accommodation for an emmetrope equal to?

Answer 23

The stimulus to accommodate.

-depth of field may reduce stimulus

Question 24

Someone with contact lenses has what kind of accommocateion? Glasses?

Answer 24

CL-same as emmetrope

Glasses-use vertex distance of glasses to calculate accommodative demand at cornea.