Accommodation/Convergence

Question 1

Name the types of accommodation

Answer 1

Proximal
Vergence
Tonic
Reflex

Question 2

Name the types of convergence

Answer 2

Proximal
Accommodative
Tonic
Voluntary
Fusional

Question 3

What is proximal accommodation?

Answer 3

Accommodation in response to a target closer than infinity (can just be perceived distance)

Question 4

What is tonic accommodation?

Answer 4

Baseline level of accommodation when no stimulus (~1D in young adults)

Question 5

What is vergence accommodation?

Answer 5

Accommodation that occurs when convergence happens (neurological link)

Question 6

What is reflex accommodation?

Answer 6

Fine tuning of accommodation to account for retinal blur

Question 7

What is proximal convergence?

Answer 7

Convergence caused by a stimulus closer than infinity (can just be perceived distance)

Question 8

What is tonic convergence?

Answer 8

Baseline level of convergence maintained by the tonus in the EOMs

Question 9

What is accommodative convergence?

Answer 9

Convergence induced when accommodation occurs due to neurological link

Question 10

What is fusional convergence?

Answer 10

Involuntary movement which corrects inaccuracies of proximal and accommodative convergence

Question 11

What is voluntary convergence?

Answer 11

The ability to converge your eyes voluntarily

Question 12

What does NPC screen for?

Answer 12

convergence insufficiencies

Question 13

What are the normal values for NPC?

Answer 13

equal to or less than 7cm break/11cm recovery (smooth and effortless convergence observed)

Question 14

Who is NPC unsuitable for?

Answer 14

Px’s with near strabismus

Question 15

When performing NPC, don’t forget to:

Answer 15

Repeat the test
Observe objectively
Move the target at a steady pace in a downwards gaze
Encourage px to make target single again when first breaks

Question 16

What does AoA measure?

Answer 16

Px’s full range of accommodation

Question 17

What is the normal range of accommodation for 20 year olds?

Answer 17

9-17D

Question 18

What is the normal range of accommodation for 30 year olds?

Answer 18

6.5-13D

Question 19

What is the normal range of accommodation for 40 year olds?

Answer 19

3.75-9D

Question 20

When is someone considered presbyopic?

Answer 20

Accommodation less than 5D

Question 21

By how much do results need to differ from average to be considered abnormal?

Answer 21

more than 1.50D lower than expected range

Question 22

At 4-11 years old, what result is being looked for on AoA?

Answer 22

Whether above or below 8D

Question 23

What is pseudomyopia?

Answer 23

Essentially too much accommodation, which creates the focus of light in front of the retina, like in myopia

Question 24

What is accommodative spasm?

Answer 24

Involuntary accommodation when no stimulus is present (can be caused by recent near focus)

Question 25

What is accommodative lag?

Answer 25

Not enough accommodation for the object in question - focal point behind the object

Question 26

When performing AoA, don't forget to:

Answer 26

Perform habitually Move target at a steady pace Use the letter chart on the budgie stick or RAF rule Encourage px to refocus once blurred the first time Repeat the test That some lag is normal