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Z. Vision Therapy — Class Final > Accommodation > Flashcards

Accommodation Flashcards

1
Q

While presbyopia is a crystalline lens problem, AI is a ___ problem

A

Sensorimotor

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2
Q

AI prevalence —
Kids (6-18): ?
University students: ?

A

Kids: 2.3%
Uni Students: 6.2%

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3
Q

DX criteria for AI (4)

A
  1. Low amps
  2. Large lag
  3. Difficulty w/ minus on MAF & BAF
  4. Low PRA
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4
Q

AI or AE: more likely to be ESO?

A

AE

Both are likely eso, but AE > AI

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5
Q

Accommodative Paralysis is associated with (5)

A
  1. Glaucoma
  2. Infection
  3. Lead poisoning
  4. Trauma
  5. Diabetes
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6
Q

Subcategories of AI? Which is more common?

A
  1. Accommodative Paralysis (rare)
  2. Developmental Accommodative Insufficiency (more common)
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7
Q

T/F: Accommodative Paralysis is unilateral and sudden

A

FALSE; AP can be gradual/sudden or bilateral/unilateral (both depending on cause)

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8
Q

T/F: Developmental Accommodative Insufficiency is always bilateral and gradual

A

TRUE

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9
Q

Etiology of Developmental Accommodative Insufficiency?

A
  • Idiopathic
  • Functional amblyopia
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10
Q

T/F: AI is associated with NV blur

A

TRUE

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11
Q

T/F: Add Power is appropriate TX for presbyopia, but not for an AI pt

A

FALSE; ADD power is the TX for AI

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12
Q

What is considered early stage or less severe AI?

A

Ill-Sustained Accommodation

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13
Q

What is the differential bw AI and Ill-sustained Accommodation?

A

Normal amps

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14
Q

Which accommodative dysfunction shows difficulty with both (+) and (-) lenses?

A

Accommodative Infacility

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15
Q

Intermittent near-far/far-near blur can be indicative of

A

Accommodative Infacility

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16
Q

What is the best TX for Accommodative Infacility?

A

VT

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17
Q

AE prevalence —
Kids: ?
Uni Students: ?

A

Kids: 2.2%
Uni Students: 10.8%

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18
Q

AE will have fluctuating ___ (distance/neasr) vision

A

BOTH; Distance and Near

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19
Q

In AI, the cause of eso is ____ (accommodative vergence/vergence accommodation)

A

Vergence Accommodation

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20
Q

In AE, the cause of eso is ____ (accommodative vergence/vergence accommodation)

A

Accommodative Vergence

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21
Q

In addition to accommodation, Accommodativ Spasm is also a spam of…

A

Miosis and convergence (near triad)

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22
Q

AE may also show up as…

A

Pseudomyopia or Latent Hyperopia

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23
Q

For patients ≥ 1 yrs old, what/how many drops?

A

2 drops of 1% cyclopentolate, each eye, 5 min apart

24
Q

For patients < 1 year, what/how many drops?

A

2 drops 0.5% cyclopentolate, each eye, 5 min apart

25
Q

In Nott Ret, you move the ___

A

Retinoscope

26
Q

In Bell Ret, you move the

A

Target

27
Q

Basic/Monocular VT for Accomm Dysfunctions (6)

A
  1. Near Far Hart Chart Rock
  2. Jensen Rock
  3. Monocular Accommodative Rock (MAR)
  4. Loose lens tromboning
  5. Lens sorting
  6. Split Pupil
28
Q

How to decrease difficulty in NFHC?

A

Move closer to far chart, bring near card farther.
(Decrease distance working distance, increase near working distance)

29
Q

How to increase difficulty of NFHC?

A

Move farther from far chart, bring near card closer.
(Increase distance working distance, decrease near working distance)

30
Q

T/F: Jensen Rock is more difficult than NFHC

A

TRUE (near point must be maintained for 3 sec and then relaxed to far chart)

31
Q

T/F: MAR can be conducted with any reading material

A

TRUE

32
Q

MAR ratio for AI

A

1:2, plus: minus

*should start with +1.00/-2.00 or use 1/4 of pts amps as starting minus

33
Q

Max lens for MAR

A

+2.50/-5.00

34
Q

MAR lens ratio for AE

A

1:1, plus:minus

35
Q

What lens is used for Loose Lens Tromboning?

A

AI — minus
AE — plus

36
Q

How to increase difficulty with Loose Lens Tromboning?

A
  1. Higher Power
  2. Move Faster
  3. Bring lens closer to eye
37
Q

Max plus/minus to be used in Lens Sorting

A

Max plus: +2.50 (if WD is 40 cm)
Max minus: 1/2 amps

38
Q

What questions should be asked during lens sorting to develop awareness? (3)

A
  1. Which lens makes print smaller/larger?
  2. Which lens do you feel more strain/effort?
  3. Does the lens make the object closer/farther?
39
Q

What is the endpoint of Lens Sorting?

A

When the pt can recognize 0.25 to 0.50 increments

40
Q

Lens sorting accommodation for AI

A

Plus to low minus (until can appreciate more minus)

41
Q

Lens sorting accommodation for AE

A

Minus lens only (until can appreciate plus)

42
Q

Lens sorting accommodation for Accommodative Infacility

A

Mark print larger (until pt can improve to smaller)

43
Q

T/F: during plot pupil, accommodative stimulus only changes when pt focuses on top image

A

FALSE; bottom image (where lens is applied)

44
Q

T/F: Alternating Accommodative Rock is both an unfused and bi-ocular technique

A

FALSE

45
Q

Unfused Accommodative Techniques (3)

A
  1. Alternating Accommodative Rock
  2. Loose lens bi-ocular rock
  3. Split spirangle
46
Q

T/F: when conducting, Loose Lens Bi-ocular Rock, the pt is supposed to see double

A

TRUE

47
Q

In Loose Lens Bi-ocular Rock. A ___ lens is placed over OD to ___ accommodation and creates the ___ image.

A

Minus; stimulate; top

48
Q

A ___ lens is placed over OS to ___ accommodation and creates the ___ image.

A

Base Up Prism; relax, bottom

49
Q

Peripheral Awareness Therapies (3) + Instructions

A
  1. Peripheral Awareness Chart
  2. Macdonald Chart
  3. Hart Chart Strips

Look at center letters and call surrounding letters w/o moving eyes

50
Q

T/F: Binocular Accommodative Rock may not work is pt is suppressing

A

TRUE

51
Q

Luster occurs with ___ glasses on a ___ background, indicating ___.

A

R/G, white, no suppression

52
Q

What type of pts could benefit from Peripheral Awareness and Plus Acceptance Training?

A

AE and CE

53
Q

According to Rouse 1987, VT is effective at… (3)

A
  1. Altering accommodative function
  2. Reducing/eliminating associated symptoms
  3. Altering physiologic components of accommodation (maintained post-VT)
54
Q

Plus Acceptance Training includes (3)

A
  1. Plus lens sorting
  2. Plus walk-away
  3. Plus lens tromboning
55
Q

Approx how many VT sessions before advancing?

A

8 monocularly —> 8 un-fused —> 8 binocular

Z. Vision Therapy — Class Final (7 decks)

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