Accommodative Theory & Programming Flashcards
What is the 1st line treatment for accommodative insufficiency/ill-sustained accommodation?
plus at near
Is VT a good option for accommodative insufficiency/ill-sustained accommodation?
yes, in combination with or following plus lenses
Which accommodative dysfunction is VT the least effective for?
accommodative spasm/excess
Which accommodative dysfunction is VT the most effective for?
accommodative infacility
What is the difference between accommodative spasm and excess?
excess is milder than a spasm
Why are plus lenses less useful in accommodative spasm/excess than in insufficiency/ill-sustained?
patients physiologically still over-accommodate just blur with plus lenses
What are three purposes of accommodative therapy?
improvement and enhancement of accommodative function, ability to identify objects at different distances under different dioptric demands, and increase range of function and allow for flexibility with other visual skills
What is the progression of accommodative therapy?
monocular –> bi-ocular –> binocular; make monocular skills equal b/w the eyes, make monocular skills meet norms in each eye (or at least close)
T/F accommodative skills should be in all VT programs
true
Change in accommodation –>
change in accommodative vergence and change in fusional vergence
T/F BV/accommodative/tracking conditions rarely occur in isolation
True
What does -1.00 OU do to the accommodative/vergence system?
stimulates accommodation, increases accommodative vergence, when target becomes double patient uses NFV to keep target single
What are accommodation improvement areas?
ability/accuracy, speed, range, stamina
What is ability/accuracy?
ability to have a normal accommodative response with different distances and different dioptric demands
What accommodative dysfunction is ability/accuracy particularly important for?
AE/spasm
How is ability/accuracy measured clinically?
lag testing, MEM and FCC
How do you train ability/accuracy?
emphasize the feeling of accommodation, look hard vs look soft
When should you emphasize accommodative ability/accuracy?
early in VT program
Patient needs to focus on ___ throughout the ability/accuracy accommodative procedures
clarity of vision
What are activities for ability/accuracy?
ability to… clear lenses during MAR/BAR loose lens rock, see letters clearly on the near and far Hart charts, clear and blur target during mental minus, sort lenses accurately by power using visual cues
What is accommodative speed?
ability to stimulate or relax accommodation quickly
What accommodative dysfunction is speed improvement important for?
accommodative infacility
How is speed measured clinically?
facility testing +/- 2.00D and distance/near accommodative rock
How do you train speed?
work on improvement in how fast patient can make the change; using lenses–change between plus and minus, increasing speed; using distance– change between near and far, increasing speed
When do you emphasize speed?
after accuracy, remember practice makes permanent