8.1.3 Flashcards
What is heterophoria?
A latent deviation of the eyes controlled by fusional mechanisms to maintain binocular vision.
What symptoms indicate heterophoria?
- Eye strain (asthenopia)
- Headaches
- Blurred vision
- Difficulty focusing
- Intermittent diplopia
- Sensation of eye pulling
What should be assessed in a patient’s history for heterophoria?
- Onset (gradual vs. sudden)
- Duration and severity of symptoms
- Triggers (e.g., near work, stress)
- Medical history (e.g., head trauma)
What does the Cover Test (CT) determine for heterophoria?
Objective means
The direction and size of the phoria.
What does the Maddox Rod Test measure in heterophoria
Objective means
The magnitude of heterophoria.
What is classified as esophoria?
Inward deviation of the eyes.
What type of phoria is more symptomatic at distance?
Exophoria.
Which test is used to measure the AC/A ratio?
Subjective means
AC/A Ratio Measurement.
What refractive correction is recommended for esophoria with high AC/A ratio?
Bifocals or added plus lenses (+0.50 to +2.00D at near).
What is the purpose of prismatic management?
To assist patients who cannot compensate for their heterophoria.
What are Sheard’s and Percival’s Criteria used for?
- Sheard’s Criterion: Prism prescribed if compensating fusional reserve is less than twice the phoria size.
- Percival’s Criterion: Ensure the patient isn’t too close to either blur point.
What are some exercises for convergence insufficiency?
- Pencil Push-ups
- Brock String
- Jump Convergence
What is essential for the effectiveness of orthoptic exercises?
Consistency in performing the exercises.
When should a patient be referred for further management of a heterophoria
- Sudden onset heterophoria
- Persistent symptoms despite treatment
- Significant vertical heterophoria
What are key features of decompensating heterophoria?
- Eye strain
- Headaches
- Blurred vision
- Intermittent diplopia
What is the treatment for decompensating heterophoria?
- Refraction Correction
- Orthoptic Exercises
- Prisms
- Referral if symptoms persist
Under what conditions is surgery considered for heterophoria?
- Decompensated into strabismus
- Severe symptoms despite management
- Large and unstable deviation
What are the surgical options for decompensated heterophoria?
- Strabismus Surgery
- Superior/Inferior Oblique Surgery
- Botox Injections
Why is surgery rare for heterophoria?
Heterophoria is a latent deviation, usually controllable by the patient.
Fill in the blank: A decompensating heterophoria occurs when the _______ can no longer control the deviation.
fusion system
How does mallet unit (fix disp) test for heterophoria
Assessment small missalignments under binocular conditions
Help determine if prism correction is needed
Subjective means
How are fusional reserves (using prism bar or photophor) used to measure heterophoria
Measures the patient’s ability to overcome their phoria using base-in (divergence) and base-out (convergence) prisms.
• Blur, Break, and Recovery Points are noted.
What is the primary goal of orthoptic exercises?
To strengthen fusional reserves and improve ocular coordination.
What is a common exercise for Convergence Insufficiency?
Pencil Push-ups.
Describe the Brock String exercise.
Beads are placed at different points along a string; the patient must converge to fuse them.
What does the Jump Convergence exercise involve?
The patient alternates focus between distant and near targets.
What materials are used in Fusional Reserve Training?
Vectograms & Stereograms.
What is the purpose of Prism Flipper Therapy?
To strengthen fusion by alternating small prisms in front of the eyes.
What does Accommodation Training aim to improve?
Accommodative flexibility.
What exercise uses lenses to improve focus?
Lens Rock (Flippers).
Fill in the blank: Orthoptic exercises are most effective for _______.
exophoria, convergence insufficiency, and decompensating heterophoria.
