Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Z Strab, VT, & Amblyopia -MT > 6 - Vergence Therapy > Flashcards

6 - Vergence Therapy Flashcards

1
Q

CITT Study

A

Placebo VT vs pencil pu vs VT

CI = exo N>D, reduced NPC & PFV (@N)

Results: pencil pu are no more effective than placebo, VT/orthopics is best option

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

VT Guidelines: begin therapy stressing

A

Direction of difficulty:
CI - convergence therapy, BO stressed
CE - divergence therapy, BI stressed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

VT Guidelines: begin therapy with (2)

A

Easier techniques —> harder

L periph targets w/ high stereo demand (3rd) —> S central (2nd/1st
Opposite of suppression therapy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

VT Guidelines: initially allow some

A

Blur - if it helps maintain fusion (i.e. allow inappropriate accomm response if needed to drive vergence system)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

VT Guidelines: emphasize (2)

A

Quality (not quantity) - speed of fusional vergence/accomm responses & feeling of converging/diverging

Amplitudes —> facility (tonic—>phasic)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

VT Guidelines: eventually train

A

PFV & NFV, regardless of initial dx - improve weakness & maintain strengths/avoid regression
Typically start “good” range about midway thru therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

VT Guidelines: train all __ regardless of initial dx

A

Accommodative skills - vergences & accomm are linked

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Vergence VT Stages

A

Early: weakest, easier techniques, L periph 3rd deg, allow blur, slow/tonic ranges

Later: both, free space (chiastopic/orthopic), S central 2nd deg, must be single & clear, jump/step ranges

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Vergence VT Guidelines: sequence

A

Vergence awareness —> tonic range extension *—> jump range extension —> chiastopic/orthopic fusion —> BOP/BIM

*before moving on to jump ranges, must have normal accommodation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Vergence VT Goals

A

Near: 15-20 BI, 25-30 BO

Dist: 10 BI, 20 BO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Vergence VT Modifications

A

Easier:
Convergence = (-) lenses, BI, incr working dist

Divergence = (+) lenses, BO, incr working dist

(Harder opposite)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Vergence Awareness activities (5)

A 
Brock string
Walk the bug
Stick & straw
Barrel card
Pencil pu

*esp helpful in training gross convergence in CI pts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Tonic Range Extension acitivities (5)

A 
Vectrograms
Variable tranaglyph
Computer
Wheatstone
Brewster
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Jump Range Extension acitivities (5)

A 
Prism jumps
Vectogram jumps
Tranaglyph jumps
Computer jumps
Non-variable tranaglyph
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Chiastopic/Orthopic Fusion acitivities (3)

A

Aperture rule
Eccentric circles
Lifesaver card

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

BOP/BIM acitivities (3)

A

Vectrogram BOP/BIM
Tranaglyph BOP/BIM
Double flipper BOP/BIM

17
Q

Brock string

A

Awareness

“Golden rule” - wherever strings intersect is where eyes are pointed

Cross in front of bead = ESO - “relax”
Cross behind bead = EXO - “cross eyes”

Progression: work on facility (bounce bead-to-bead), move beads closer/farther

18
Q

Walk the bug

A

Awareness

Slowly

Emphasize good control of convergence

19
Q

Stick & straw

A

Awareness

Parallel to floor

Don’t let pt hold both/feel for the straw

Requires depth perception & alignment

20
Q

Barrel fusion

A

Awareness

Fusion = luster

Progression: hold each 10-12 seconds

21
Q

Variable tranaglyph

A

Tonic ranges

R sees G, G sees R

Convergence = BO = Red to the Right (CORR)
Divergence = BI = Green to the Right (DIGR)

Steps:

1) depth appreciation - stereo (-) suppression
2) apprec. of conv/div - feedback cues (SILO)
3) vergence demand - gradually incr & coach

22
Q

Vectograms (“variable”)

A

Tonic ranges

Similar to variable tranaglyph, but more $$$

BIL BON

23
Q

Prismatic demand calculations (tonic range extensions)

Ex: measure 42mm of target separation w/ red slide to the right. What is the prism demand with a working distance of 33cm?

A

Working dist/target separation = 100cm/1cm

PD = sep of 1cm @ 1m distance

Ex: 14pd BO

24
Q

Wheatstone

A

Tonic ranges

Aka variable mirror stereoscope

Set to distance w/ +3.00 lenses

W wider = diverge, narrower = converge

25
Q

Brewster

A

Tonic ranges

Aka Bernell-o-scope

Septum separates eyes

Uses +5.00 lenses w/ 95mm separation (induces BO)

Far point (highest BO/conv demand) = 20cm

Convergence/BO training: start close, PFV demand incr as card moves away
Divergence/BI training: start at far point, NFV demand incr as card moves closer

26
Q

Non-variable tranaglyph

A

Jump ranges

All targets have fixed vergence demand

BO = Red to Right (CORR)
BI = Green to Right (DIGR)
27
Q

Tranaglyph jumps

A

Jump ranges

Recoveries = change fixatio from target to another point in space -> break fusion by covering an eye

Use top for BI and bottom BO (or vice versa) & look back and forth

28
Q

Vectogram jumps

A

Jump ranges

Similar to tranaglyph jumps

29
Q

Loose prism jumps

A

Jump ranges

Can be D or N, need an accomm target

No suppression controls - add Brock String if desired

30
Q

Describe chiastopic and orthopic

A

Chiastopic: convergence/BO - pt’s visual axes crossed relative to target’s fixation distance

Orthopic: divergence/BI - pt’s visual axes uncrossed relative to target’s fixation distance

31
Q

Aperture rule

A

Chiastopic/Orthopic Fusion

Single aperture = chias/conv/BO - goals 25-30pd
Double aperture = orth/div/BI - goals 15-20pd

Steps:

1) fusion & clarity (-) suppression
2) recovery - look away, regain fusion
3) change card to incr demand

Includes suppression checks (eccentric circles)

Vergence demand = 2.5 x card number

Coaching: pointer may help fusion, C = relax accomm, O = stimulate

32
Q

Lifesaver & Eccentric circles

A

Chiastopic/Orthopic Fusion

Free space activities - transparent = div, opaque = conv

Each card has 3rd deg targets, anti-supp cues, & accomm controls

Working dist of 40cm —> 4mm = 1pd
Center circles sep by 12cm = 30pd

33
Q

Lifesaver & Eccentric circles: number of circles seen

A

2 - looking at card itself

3 - converging on appropriate plane
Chiastopic = in front of plane of accomm, bigger/outer circle forward
Orthopic = behind plane of accomm, smaller/inner circle forward

4 - over/under-con/diverging, due to physiological diplopia

34
Q

Variable tranaglyph & Vectogram BOP/BIM

A

Goals: 33 BO/BI with +/-2 flippers

35
Q

Double flippers BOP/BIM

A

View reading material & gradually incr powers

Coaching:
BOP = converge eyes, relax accomm
BIM = diverge eyes, tighten accomm

Goals: 8-10pd with +/-2.50 @ N

36
Q

Vergence therapy coaching

A

Convergence/BO: cross eyes, look hard to fuse, think about looking close

Divergence/BI: relax eyes, think about looking thru the target, think about looking far away/behind target

Z Strab, VT, & Amblyopia -MT (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions