Accommodation Dysfunction Flashcards
What is the MEM test used to measure?
Accommodative response
T or F: When a patient has a large lag of accommodation, this could influence the AC/C gradient findings.
True
What is the key finding for accommodation insufficiency?
Reduced accommodation amplitude
T or F: In accommodation excess, the patient will have more problems clearing minus.
False
T or F: in ill-sustained accommodation, the patient’s accommodative amplitude will be lower than expected.
False - they just can’t maintain it
What is the accommodation system’s resting point?
About 1 D
T or F: In accommodation infacility, the patient’s NRA and PRA will be within the normal limits.
False - they generally have a hard time “releasing” accommodation
T or F: In accommodation insufficiency, the patient will have more problems to clear the (-) portion of the test
True - they have a lack of accommodation to be able to clear the minus
T or F: the MEM and FCC findings are used to determine the near Rx.
True
Esophoria could be found as a sign in which accommodative dysfunctions?
Accommodative excess
Accommodative insufficiency
Diplopia is a symptom of which accommodative dysfunction?
Accommodation excess
In accommodation excess, the results of all the tests that measure the patient’s ability to relax accommodation will be:
Lower than normal
In accommodation excess, the results of all the tests that measure the ability to stimulate accommodation will be:
Higher than normal
In accommodation insufficiency, the results of tests that measure the ability to stimulate accommodation will be:
Lower than normal
Measuring NRA forces a patient to use what, in order to maintain single vision?
Positive fusional vergence (PVF)
If a patient has a normal 4:1 AC/A ratio and the NRA result is +2.50, how many D of fusional convergence would the patient use to maintain fusion?
10 Pd (2.5D of stimulus, so 2.5*4 = 10)
While testing PRA minus lenses are used. Therefore accommodation will ___, and convergence will ___.
Increase
Increase
While testing NRA plus lenses are used. Therefore, accommodation will ___, and convergence will ___.
Decrease
Decrease
If there is a +1.75 lag on MEM, the findings on the +/- 2.00D accommodative facility test will likely be ___, especially on the ___ portion of the test.
Low
Minus (-)
If there is a +1.50 lag on MEM, it is likely that the PRA findings will be ___, and the NRA findings will be ___.
Low
Normal or high
During the accommodative test battery we find: a lead of accommodation, low NRA, high PRA. Which phoria posture is likely present?
Eso - with a lead of accommodation, they are overaccommodating, which will likely cause convergence. Low NRA, because they are over accommodating, so adding more plus lenses won’t work well.
If we find a lead of accommodation, low NRA, and high PRA, would the expected AC/A ratio be low, normal, or high?
High - they can and will accommodate like crazy
Which accommodative conditions show symptoms at distance?
Accommodative spasm
Accommodative excess
What are the signs of accommodation infacility?
Normal or high accommodation amplitude
Low PRA
Low NRA
Failure to clear (-) on facility test
What are the signs of accommodation excess?
Normal or high accommodation amplitude
Low NRA
Low lag or a lead of accommodation
Failure to clear (+) on facility test
What are the 8 types of accommodation?
Chromatic accommodation Positive relative accommodation Negative relative accommodation Meridian accommodation Absolute accommodation Physiological accommodation Consensual accommodation Convergence accommodation (CA/A)
In accommodative insufficiency, what would you expect for accommodative amplitude?
Low
In accommodative insufficiency, what would you expect for PRA?
Low - they can’t accommodate to adapt to the added minus lenses
In accommodative insufficiency, what would you expect during the facility test?
Trouble clearing (-)
Which phoria posture at near would likely be seen in accommodative insufficiency?
Esophoria at near
In accommodative insufficiency, what would you expect with MEM and FCC?
Higher than usual (>+0.75), since they are can’t accommodate as well, there will be a lag of accommodation
In ill-sustained accommodation, what would you expect to see for accommodative amplitude?
Normal if only done once
Reduced if done repeatedly
What would you expect to get during PRA in ill-sustained accommodation?
Low - probably would come in and out of focus (just a guess)
In ill-sustained accommodation, what would you expect to see during the facility test?
Trouble clearing (-), that gets worse as you continue
What phoria posture at near would you likely see in a patient with ill-sustained accommodation?
Eso
In ill-sustained accommodation, would you expect FCC and MEM to be low, normal, or high?
High - they will have a larger lag than normal, since they struggle to accommodate
In accommodative excess, what tests would you get low results in?
MEM/FCC - lead of accommodation, since they are overaccommodating all the time
NRA - they won’t like plus lenses/have a hard time relaxing it
In accommodative excess, what would you expect when testing mono and binocular accommodation facility?
Trouble clearing (+)
In accommodative infacility, what would you expect to see with NRA and PRA?
Low result for both
What results would you expect from the accommodation facility test on a patient with accommodative infacility?
Can’t clear either (+) or (-) 2.00D
