Acc/Verg/OMD/Amb/Strab

Question 1

Vergence movements are driven by…

Answer 1

retinal disparity

Question 2

What is the most common type of oculomotor deviation in the general population

Answer 2

Exophoria

Question 3

If a patient has a right microtropia, what will be the results of the 4BO prism test if the prism is placed on the right eye? left eye?

Answer 3

• right eye: no movement due to presence of microtopia (basically causing a central scotoma)
• left eye: OS will adduct, OD will abduct, but OD will not adduct to re-fixate

(Normal movement of 4BO test: both eyes will make conjugate eye movement away from the prism, then the eye without prism will adduct to refixate)

Question 4

Which test is used for eye-hand coordination

Answer 4

Rosner TVAS

Question 5

What is a visual perceptual skills test considered?

Answer 5

Poor reading comprehension, trouble concentrating, difficulty recognizing or identifying objects and patterns

Question 6

Which eye movement has the fastest velocity?

Answer 6

Saccades

Question 7

Sherrington’s law

Answer 7

Reciprocal innervation (agonist and antagonist muscles in the same eye)

Question 8

Which of the four involuntary vergence stimuli is driven by neural innervation?

Answer 8

Tonic

Question 9

The measured accommodative response is typically ____ than the accommodative stimulus

Answer 9

less

(AR < AS)

Question 10

What is grade B fusion?

Answer 10

momentary diplopia followed by fusion

Question 11

What is grade C fusion?

Answer 11

diplopia with no eventual fusion

Question 12

Grade D fusion?

Answer 12

suppression

Question 13

A patient reports blur when looking at a near target 40 cm away with a -3D lens and a +2.5D lens. What is the patient’s amp of accommodation?

Answer 13

5.5 D

*just add the powers together

Question 14

Alexander’s Law

Answer 14

nystagmus is more pronounced when gaze is directed toward the fast-beating component

Question 15

Donder’s Law

Answer 15

every tertiary eye position is associated with a specific torsional rotation

Question 16

What are the three categories of fusion

Answer 16

sensory fusion (corresponding retinal points project to the same location in the visual cortex), motor fusion (vergence movement) and stereopsis

Question 17

What is refractive accommodative esotropia

Answer 17

high eso at distance and near and high hyperopia

Question 18

A child with mono fixation syndrome will likely see how many lights at distance and near with Worth 4 dot?

Answer 18

2 or 3 lights at distance; 4 at near

(central scotoma at distance)

Question 19

What age does stereopsis begin to reach adult-like levels?

Answer 19

5-7 years

Question 20

Which age is accommodation fully developed?

Answer 20

4 months

Question 21

Describe the fixation here

Answer 21

3 pd temporal fixation OS

Question 22

Answer 22

2 pd temporal OD

( 4 mm = 1 pd )

Question 23

Fixation here

Answer 23

1 pd inferior and 2 pd nasal OD

Question 24

Answer 24

4 pd nasal OD

Question 25

Answer 25

1 pd nasal eccentric fixation OD

Question 26

EF formula. What is the expected VA for 2pd fixation

Answer 26

• 20/ [(1+ pd)*20]
• 20/60

Question 27

Does Duane’s Retraction Syndrome violate Sherrington or Hering’s Law and why?

Answer 27

Sherrington bc in Duane’s, there is retraction of the eye upon adduction, which means the MR and LR muscles are not equally antagonistic.

Question 28

At what age is a strabismic deviation considered congenital

Answer 28

Under six months

Question 29

Mnemonic (SLOFUN) for congenital nystagmus

Answer 29

S - symptomless
L - latent component (seen when one eye is covered)
O - OKN abnormal
F - fixation worsens nystagmus
U - horizontal nystagmus on upgaze
N - null point

Question 30

What is the pathological movement in nystagmus

Answer 30

Slow

(The fast movement is a corrective movement)

Question 31

A patient with a complete left hemianopsia will have LESS nystagmus looking … and MORE nystagmus toward which side of the brain?

Answer 31

Left; right

Question 32

Caloric nystagmus uses the mnemonic COWS, which stands for …

Answer 32

COLD OPPOSITE ; WARM SAME (fast movements)

Question 33

Spasmus nutans

Answer 33

Typically develops ages 4-12 months
Resolves after 2-8 years
Disconjugate pendular nystagmus
Compensatory head nodding
Uncommon

Question 34

The point a patient prefers viewing through is called the

Answer 34

Preferred retinal locus

Question 35

Neutral point in nystagmus

Answer 35

Direction of gaze where nystagmus changes direction

Question 36

Null point

Answer 36

Point of lowest amplitude in nystagmus

Question 37

Convergence-Retraction is seen in…

Answer 37

Dorsal Midbrain syndrome (Parinaud) - upgaze paresis

Question 38

What is our threshold stimulus velocity

Answer 38

60-80

Question 39

Which child is most at risk for reduced vision secondary to amblyopia?
A. congenital esotropia with equal cross fixation
B. cyclo refraction +4.00sph OD; +1.00sph OS
C. cyclo refraction -1.00sph OD; -4.00sph OS
D. child with unilateral anterior polar cataract

Answer 39

B

(anisometropic hyperopia is the worst form)

(anterior polar cataracts rarely cause reduced vision)

Question 40

What occurs in latent nystagmus when an eye is covered

Answer 40

bilateral jerk nystagmus with fast phase toward the non-occluded eye