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Procedures > Accomodation > Flashcards

Accomodation Flashcards

1
Q

What is the accommodative system?

A

Focusing of the eye

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2
Q

What is the oculomotor system?

A

How the two eyes work together

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3
Q

What is functional evaluation?

A

Evaluation of the accommodative and oculomotor systems

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4
Q

What is accommodation?

A

The adjustment of the dioptric power of the eye beyond its static resting power brought about by a change in the shape of the crystalline lens

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5
Q

What is the stimulus to accommodation?

A

An out of focus retinal image or blur

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6
Q

What is the near triad?

A

Accomodation increase
Miosis
Convergence

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7
Q

What is tonic accommodation?

A

Resting or passive state in the absence of accommodative stimulus

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8
Q

When is the eye in tonic accommodation?

A

In complete darkness or looking at a bright empty field

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9
Q

What does an emmetropic eye become in tonic accommodation?

A

Myopic

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10
Q

What causes accommodation to a more distant stimulus from resting state?

A

Sympathetic response to blur

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11
Q

What causes accommodation to a more near stimulus from resting state?

A

Parasympathetic response to blur

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12
Q

How can you stimulate accommodation?

A

By placing the object at a distance closer than infinity
By using minus lenses
By using a combination of distance and lenses

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13
Q

With an object at 40 cm from the spectacle plane, what is the stimulus to accommodation?

A

2.50D

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14
Q

What is a haploscope?

A

Instrument that measure accommodative response

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15
Q

How is the accommodative response described clinically?

A

With regard to the dioptric accommodative stimulus

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16
Q

Amplitude of accommodation

A

Maximum amount of accommodative power an eye can exert measured in diopters

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17
Q

Facility of accommodation

A

Ability of the eye to quickly and aaccurately shift the accommodative posture

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18
Q

Lag of accommodation

A

The distance in diopters between the object of regard and the actual current position of accommodation

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19
Q

What is the considered norm of lag of accommodation?

A

The accommodative response to be less than the accommodative stimulus (demand)

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20
Q

Range of accommodation

A

Linear distance in cm over which one’s accommodative power allows maintenance of clear vision, from the near point to the far point

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21
Q

T/F Range of accommodation is alwasy real

A

False, uncorrected hyperope will have a partially virtual range

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22
Q

Presbyopia

A

Refractive condition in which the accommodative ability of the eye becomes insufficient for satisfactory near vision without the use of corrective plus lenses

23
Q

When is accommodative testing not done?

A

On presbyopes or when the refractive error is not maximally corrected

24
Q

What are the 4 tests for evaluating amplitude of accommodation?

A

Hoffstetter’s formulas
Donder’s age referenced table
The push-up test
Minus lens to blur test

25
Q

Hoffstetter’s formulas

A

Minimum: 15-0.25xage
Average: 18.5-0.30xage
Maximum:25-0.40xage

26
Q

What is the gold standard for evaluating amplitude of accommodation?

A

The push-up test

27
Q

How much greater are the binocular amplitudes compared to the monocular amplitudes on average for the push up test?

A

0.50D

28
Q

What is the near point of accommodation?

A

A linear measurment from the stoppedd position of the push-up stick to the patients spectacle plane

29
Q

When do you stop moving the push-up stick closer?

A

When the letters become and remain blurry

30
Q

What is the minification factor?

A

The letters for the minus lens to blur test get smaller due to the increase in minus lenses and a stationary target

31
Q

What is the difference in amplitde of accommodation between the push-up test and the minus lens to blur test?

A

2D less for the minus lens test

32
Q

What is the endpoint for the minus lens to blur test?

A

First sustained blur when the target cannot be cleared

33
Q

What is the total amplitude of accommodation from the minus blur test?

A

Amount of minus lenses added plus the accommodative demand for the near point card (2.50D)

34
Q

What are the two methods for evaluating the facility of accommodation?

A

The lens flipper test

The near-far test

35
Q

What is the gold standard test for facility of accommodation testing?

A

The lens flipper test

36
Q

What is the normal expected result from the lens flipper test?

A

6 cycles in 30 seconds or less

37
Q

Why is the near-far test not the gold standard?

A

Because most rooms are not long enough to completely facilitate relaxed accommodation

38
Q

What is the normal expected result from the near-far test?

A

10 cycles in 30 seconds or less

39
Q

What is the most common way to evaluate lag of accommodation?

A

Dynamic retinoscopy testing

40
Q

What are the three tests for evaluating lag of accommodation?

A

Nott retinoscopy
Monocular estimation method retinoscopy
Bell retinoscopy

41
Q

What is the expected normal finding for lag of accommodation?

A

+0.50 and symmetric

42
Q

What do findings greater than +0.50D of lag indicate?

A

Lazy accommodative demand or high lag

43
Q

What do findings of less than +0.50D of lag indicate?

A

Low, zero, or negative lag or a tight accommodative response

44
Q

What do asymmetric lag findings indicate?

A

Refractive or healh etiology

45
Q

How do you record positive lag of accommodation for Nott retinoscopy?

A

With motion is initially noticed, move back until neutral and measure dioptric distance with near point rod

46
Q

How do you record “no” lag of accommodation for Nott retinoscopy?

A

Neurality is initially noticed inidicating that the accommodative response is equal to the accommodative demand

47
Q

How do you record minus lag of accommodation for Nott retinoscopy?

A

Against motion is initially noticed, move forward until neutral, do not record magnitude because any minus lag needs to be remedied

48
Q

What is the retinoscopic test of choice for behind the phoropter?

A

Nott retinoscopy

49
Q

What is the retinoscopic test of schoice for outside of the phoropter?

A

MEM retinoscopy

50
Q

What makes depth of focus greater?

A

Smaller pupil or larger object

51
Q

How can the patient see the target clearly when the accommodative response does not equal the accommodative demand?

A

Depth of focus can make up for the lag of accommodation

52
Q

What is the difference btween depth of focus and depth of field?

A

Fous is for the retina and field is for object space

53
Q

What are the two methods for evaluating the sustaining ability of accommodation?

A

Amplitude of accommodation decay test and facility of accommodation decay test

Procedures (16 decks)

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