8.1.2 Flashcards
What is diplopia?
Double vision
Diplopia is a key symptom in patients with binocular vision anomalies.
What is asthenopia?
Eye strain
Asthenopia is often reported by patients with binocular vision issues.
What does suppression refer to in binocular vision anomalies?
Brain ignoring one eye’s image
Suppression can lead to reduced visual function in one eye.
What is reduced stereopsis?
Poor depth perception
Reduced stereopsis affects the ability to perceive distances accurately.
List some key symptoms of binocular vision anomalies.
- Diplopia
- Asthenopia
- Suppression
- Reduced stereopsis
- Headaches
- Dizziness
- Difficulty with reading
- Eye deviations
- Abnormal head postures
What examination detects tropia and phoria?
Cover test
The cover test is a fundamental assessment in diagnosing binocular vision anomalies.
What does the Maddox rod/Worth 4-dot test assess?
Suppression and BV status
This test helps determine how the brain is processing images from each eye.
What is the purpose of the prism cover test?
Quantifies deviation
This test measures how much deviation exists in ocular alignment.
What does AC/A ratio measurement evaluate?
Accommodative convergence
AC/A ratio is critical in understanding how the eyes converge when focusing.
What is the RAF rule used for?
Tests convergence ability
The RAF rule assesses how well a patient can converge their eyes.
What are some stereopsis tests?
- Titmus Fly
- TNO
These tests evaluate depth perception and binocular function.
What is the goal of refractive management in binocular vision anomalies?
Correcting refractive error
Managing refractive errors helps alleviate symptoms like accommodative esotropia.
How are bifocals used in the management of accommodative esotropia?
To reduce excessive near accommodation
Bifocals help patients focus more comfortably on near tasks.
What is a common benefit of contact lenses over spectacles?
Better cosmesis and improved binocular function
Contact lenses can enhance visual experience in some strabismus cases.
What are orthoptic exercises designed to improve?
Convergence, divergence, fusional reserves, and accommodation
These exercises are particularly useful for conditions like convergence insufficiency.
What is Near Point of Convergence (NPC) Training?
A fixation target is moved towards the patient’s nose while maintaining single vision
NPC training is specifically used for convergence insufficiency.
What is a pencil push-up exercise?
Patient pushes a small object toward their nose while keeping it single and clear
This exercise helps improve convergence ability.
What is the purpose of the Brock String exercise?
Improves convergence and divergence control
The Brock String helps patients focus on beads while maintaining awareness of diplopia.
What does jump convergence involve?
Alternating fixation between a near and distant target
This exercise enhances the ability to converge effectively.
What is the Barrel Card Exercise?
A card with three circles of increasing size is fused at the nose
This exercise improves convergence by challenging the visual system.
What are fusion exercises like Vectograms and Prism Flippers used for?
Strengthening fusional reserves
These exercises help improve the eyes’ ability to work together.
What is accommodative therapy?
Patients switch focus between lenses of different powers
This therapy trains accommodative flexibility, useful for insufficiency or excess.
What is the role of prismatic management?
Alleviate symptoms of diplopia or decompensating heterophoria
Prisms can help reduce the strain on the visual system.
What are relieving prisms?
Small amounts incorporated into spectacles to reduce fusional demand
Relieving prisms can help manage conditions like divergence excess.
What is a common surgical management option for strabismus?
Recession
Recession involves repositioning a muscle to weaken its action.
What does resection do in strabismus surgery?
Strengthens a weak muscle by shortening it
Resection is used to correct conditions like exotropia.
What are adjustable sutures used for in surgery?
Allows post-operative fine-tuning to optimize alignment
This technique enhances surgical outcomes in strabismus treatment.
What is amblyopia?
Reduction in best-corrected visual acuity due to abnormal visual development
Amblyopia often coexists with strabismus or anisometropia.
List the types of amblyopia.
- Strabismic Amblyopia
- Anisometropic Amblyopia
- Deprivation Amblyopia
- Meridional Amblyopia
What is the management strategy for amblyopia?
- Refractive correction
- Occlusion therapy
- Atropine penalization
- Bangerter filters
- Perceptual learning
Early intervention is critical for effective treatment.
What is occlusion therapy?
Patching the stronger eye to stimulate the weaker eye
This therapy is typically prescribed for several hours a day.
What is atropine penalization?
Blurring the better eye with atropine drops to force usage of the amblyopic eye
This method encourages the weaker eye to develop better vision.
What is perceptual learning in the context of amblyopia?
Newer techniques using games and contrast sensitivity training
These methods aim to enhance visual processing in the amblyopic eye.
What are some clinical decision-making considerations for intermittent exotropia?
Prism or orthoptic exercises
Treatment options depend on the symptoms presented.
What management option is often used for convergence insufficiency?
Pencil push-ups, Brock string, or base-in prism
These interventions target the specific functional deficits of convergence insufficiency.
What should be considered for constant esotropia with poor vision in one eye?
Consider amblyopia therapy + possible surgery
This approach addresses both alignment and visual acuity issues.
What is the treatment for accommodative esotropia?
Full hyperopic correction with possible bifocals
Correcting refractive errors is crucial in this condition.
What is the management for decompensating heterophoria?
Fusional reserves training or small prism prescription
These strategies aim to stabilize the visual system.
What does Post-Operative Orthoptic Therapy refer to?
Vision therapy, exercises, and other interventions provided after strabismus surgery to optimize binocular vision, strengthen ocular muscles, and prevent regression.
Why is post-operative therapy necessary after strabismus surgery?
Surgery aligns the eyes but does not automatically restore normal binocular function.
What is the purpose of Worth 4-Dot Test Training?
Helps patients with recent alignment regain fusion.
Name two tools used in Sensory Fusion and Binocular Vision Training.
- Vectograms
- Stereograms
What do Bagolini Striated Lenses help detect?
Suppression and encourage simultaneous perception.
What exercises improve convergence ability post-exotropia surgery?
- Pencil Push-ups
- Brock String
What is the goal of Jump Convergence Training?
Strengthens near vision control in convergence issues.
What type of training helps recover normal eye movements?
Smooth Pursuit and Saccade Training.
What is Occlusion Therapy used for?
Temporary diplopia relief through partial occlusion.
What can be used for minor residual deviations after surgery?
Fresnel prisms.
What do Orthoptic Exercises aim to strengthen?
Fusional reserves to prevent decompensation.
What is the purpose of Refractive Adaptation?
Updating prescriptions for optimal post-op alignment.
When might Botulinum Toxin (Botox) Therapy be used?
Occasionally for minor overcorrections.
When is Post-Operative Therapy needed? Fill in the blank: Large-angle deviations _______.
pre-surgery.
What condition is indicated by long-standing strabismus with deep suppression?
Need for Post-Operative Therapy.
What leads to persistent diplopia after surgery?
Partial sensory adaptation.
What is a risk of consecutive strabismus?
Overcorrection of esotropia causing exotropia.
How to explain amblyopia to a patient
Amblyopia, or ‘lazy eye,’ happens when one eye doesn’t develop normal vision because the brain starts ignoring it. This can be due to an eye turn, a big difference in prescription, or something blocking vision early in life.
To treat it, we encourage the brain to use the weaker eye by prescribing glasses, using an eye patch, blurring the stronger eye with drops, or doing vision therapy. The earlier we start, the better the results.”
