Binocular Anomalies

Question 1

Do convergence insufficiencies have to do with exos or esos?

Answer 1

Exophorias / Exotropias

Question 2

Does convergence excess have to do with exos or esos?

Answer 2

Due to esophoria and esotropia

Question 3

Where do convergence abnormalities occur?

Answer 3

More commonly at near

Question 4

Do divergence insufficiencies have to do with exos or esos?

Answer 4

Esotropia primarily

Question 5

Does divergent excess have to do with exos or esos?

Answer 5

Exophoria or exotropia more common

Question 6

Where do divergence abnormalities occur?

Answer 6

More commonly in distance

Question 7

Eyes under-converge for the target distance

Answer 7

Convergence insufficiency

Question 8

Eyes over-converge for the target distance

Answer 8

Convergence excess

Question 9

What are two common types of binocular abnormalities in children?

Answer 9

Convergence abnormalities
Divergence Abnormalities

Question 10

What are 3 behaviors if a child has a binocular abnormality?

Answer 10

Avoid, Asthenopia(eyestrain), adapt

Question 11

On phoria, PFV, and NPC, and NRA testing, what would you expect if a patient has a convergence insufficiency?

Answer 11

Phoria: Exophoria at near of 4 prism diopters more than the distance

PFV: Fail Sheards or less than or equal to 15 prism diopters blur/break

NPC: Greater than 6 cm

NRA: Low

Question 12

What are convergence insufficiencies associated with?

Answer 12

Autism
ADHD
Concussions
Lyme Disease
Alzheimers
Parkinsons

Question 13

What is a Pseudo CI, what test results would you expect?

Answer 13

Accommodative problem instead of convergence issue.

Would see reduced NPC, PFV, exophoria at near, possibly reduced amps, high lag

Question 14

What would you retest Pseudo CI with?

Answer 14

Low plus, if they are pseudo CI, they will improve

Question 15

How do you treat a pseudo-CI?

Answer 15

Low plus glasses for near
Vision therapy

Question 16

How to distinguish between CI and pseudo CI?

Answer 16

Add plus lens. Would cause CI to get worse, pseudo CI to get better.

Question 17

Difficulty stimulating accommodation

Answer 17

Accommodative Insufficiency

Question 18

Difficulty changing accommodative response

Answer 18

Accommodative Infacility

Question 19

Medications associated with accommodative insufficiency

Answer 19

ADHD stimulant
SSRI

Question 20

Conditions associated with accommodative insufficiency

Answer 20

Down Syndrome
Cerebral palsy

Question 21

For accommodative infacility testing, how many cycles would you expect for an 8-12 year old?

Answer 21

7 cpm

Question 22

For accommodative infacility testing, how many cycles would you expect for people above 12 years old?

Answer 22

11 cpm

Question 23

How do you treat accommodative anomalies?

Answer 23

Plus at near
Vision therapy

Question 24

How do you treat oculomotor dysfunction?

Answer 24

Correcting refractive error
Correct accommodative issues
Vision therapy

Question 25

Amblyopia definition according to AOA

Answer 25

poorer than 20/20 in the absence of any obvious structural anomalies or ocular disease

Question 26

When is the critical time for amblyopia to develop?

Answer 26

first 8 years of life

Question 27

The two most common categories of amblyopia

Answer 27

Anisometropia
Strabismus

Question 28

What causes image degradation?

Answer 28

Physical obstruction in line of sight.
Cataracts, ptosis, hyphema, patch or occlusion.

Question 29

At age 2, what refractive error does a person 2 years or older have isoametropic for hyperopia, myopia, and astigmatism for them to be a refractive amblyope?

Answer 29

Hyperopia: > +5.00
Myopia: > -8.00
Astigmatism: >2.50

Question 30

Treatment for amblyope

Answer 30

Glasses for 8-12 weeks then reassess VA.
Use patches
Atropine 1% on weekends
Bangerter filters