7 - Dx and Management

Question 1

the largest concern for accommodative and non-strabismic disorders is _

Answer 1

overcoming symptoms

Question 2

2 symptom surveys:

Answer 2

Convergence Insufficiency Symptom Survey
COVD QOL (Quality of Life)

Question 3

Sequential Management Approach: (6)

Answer 3

Optical Correction of Ametropia
Added Lenses
Prism
Occlusion
VT
Surgery

Question 4

What should be the 1st consideration for all patients?

Answer 4

optical correction!! the foundation

Question 5

by 6-8 years old, most patients are within _

Answer 5

+0.50 to +1.00

Question 6

average cyclo refraction of infants is _

Answer 6

+1.00 to +2.50

Question 7

at 3 months, 16% have hyperopia greater than +3.50; _ occurs and at 9 months, 3% have hyperopia greater than +3.50

Answer 7

rapid emmetropization

Question 8

as patient gets older, _ to rx

more likely to rx for myopia or hyperopia?

Answer 8

more likely

myopia

Question 9

with _, static ret and cyclo ret are usually the same

Answer 9

myopia

Question 10

under 2% of children have myopia until _ years old when there is a consistent rise which levels off in teen years

Answer 10

8

Question 11

increased risk for myopia with:

Answer 11

near work, little outdoor time, myopia parents, premature

Question 12

minus lenses cause _ at near, which may take time to adapt to - secondary accommodative insufficiency

Answer 12

accommodation

Question 13

when patient is XT (especially IXT), rx _

Answer 13

myopia

Question 14

cycloplegic refraction will result in _, compared to ret

Answer 14

more +

Question 15

if a patient is <5 years old and eso and hyperopic, rx _

if >6, rx _

Answer 15

full cyclo.. don’t need distance

cyclo - 1D

Question 16

anisometropia, assess with _, rx _

Answer 16

cyclo, off cyclo - full rx

Question 17

clinically significatn anisometropia is _

Answer 17

> 1D

Question 18

if aniseikonia, consider _

Answer 18

CLs

Question 19

added lenses can be used for _

Answer 19

distance OR near

Question 20

are added lenses an effective treatment method if low AC/A

Answer 20

no

Question 21

segment height location for
3-5 year old _
6-7 year old _
>8 year old _

Answer 21

mid pupil
lower pupil margin
lower lid margin

Question 22

up to 15 months, instead of bifocal.. just _ SV glasses

Answer 22

over plus

Question 23

Sheard’s Criterion states that in order for a patient to be comfortable, the compensating fusional vergence should be _

Answer 23

twice the phoria

Question 24

Sheard’s Criterion works best for _
Percival’s Criterion works best for _
1:1 best for _

Answer 24

exophoria
esophoria
esophoria

Question 25

Sheards Criterion equation: Prism needed =

Answer 25

2/3(phoria)-1/3(compensating fusional vergence)

Question 26

Percival’s Criterion suggests that a patient should be operating in the _ of vergence ranges, independent of the phoria

Answer 26

middle 3rd

Question 27

Percival’s:

Prism needed =

Answer 27

1/3(greater of BI or BO)-2/3 (lesser of BI or BO)

if answer is positive, then prism is needed, if negative or 0.. no prism needed

Question 28

1:1 Rule

>

Answer 28

Recovery>Phoria

Question 29

for 1:1 Rule, 4pd EP’, the BI recovery should be at least _

Answer 29

4pd

Question 30

1:1 rule -

Prism to rx =

Answer 30

(EP-BI recovery)/2

Question 31

for vertical prism, use _ to determine amount to rx

Answer 31

associated phoria

Question 32

if both horizontal and vertical deviations, consider correcting _ first, _ may be secondary

Answer 32

vertical, horizontal

Question 33

moderate amblyopia is VA of _, patch _

Answer 33

20/30-20/80, 2 hours, at least one hour at near activity

Question 34

severe amblyopia is VA of _, patch _

Answer 34

20/100 or worse, patch for 6 hrs a day, 1 hour at near

Question 35

if surgery is last resort, it is important to do VT prior to it, because:

Answer 35

increases success