Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Neuro-Rehab > Binocular Conditions > Flashcards

Binocular Conditions Flashcards

1
Q

What are these symptoms associated with?

  • Eye discomfort/strain
  • Fatigue*
  • Blurred vision
  • Headaches
  • Diplopia
  • Difficulty concentrating
  • Sleepiness
  • Loss of comprehension over time*
  • Movement of the text on the screen*
A

associated w/ computer video display terminals (VDTs)/Computer use Complex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are these symptoms associated with?

  • Eyestrain
  • Headaches after brief periods of reading*
  • Blurry or fluctuating* vision
  • Diplopia
  • Loss of place when reading*
  • Sleepiness
  • Difficulty concentrating on near/reading tasks
  • Poor balance/coordination*
  • Dizziness*
  • Light sensitivity*
A

assoc. w/ acquired brain injury (ABI)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are symptoms of “at risk” patients post refractive surgery?

A 
Glare*
Monocular or binocular diplopia
Eyestrain
Headaches
Visual discomfort
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

These are tests to include for evaluation of what?

  1. Binocular tests
    - Cover test
    - Fusional vergences (step, smooth, vergence facility)
  2. Accommodative test
    - NRA/PRA (minus lenses test the ability to stimulate accommodation and indirectly checks NFV)
    - MAF
    - BAF
    - MEM
  3. Slit lamp evaluation
    - Rule out anterior segment conditions contributing to ocular symptoms
A

patients w/ computer use complex (CUC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

These are tests to include for evaluation of what?

  • Complete binocular, accommodative and oculomotor battery of tests for the basic visual efficiency evaluation
  • Additional binocular and oculomotor tests: Fixation disparity, Double Maddox rod test,Visagraph, diagnostic occlusion
  • If findings are normal but patient is still symptomatic (i.e. nauseous, fatigue, feels discomfort), repeat tests to assess stamina of visual skills
A

patients w/ acquired brain injury (ABI)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What treatment sequence is this for?

  1. Correction of refractive error
  2. Added lenses
  3. Prism
  4. Vision therapy
  5. Ocular Health*
  6. Ergonomics*
A

patients w/ CUC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What treatment sequence is this for?

  1. Correct refractive error
  2. Added lens power
  3. Horizontal prism
  4. Vertical prism
  5. Occlusion for diplopia*
  6. Vision therapy
  7. Surgery*
A

patients w/ ABI;
patients w/ symptom post refractive surgery

Note: Some patients with ABI show spontaneous improvement in symptoms over 6-12 months.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What type of treatment is this? Which patients?

Uncorrected refractive error can cause asthenopia and accommodative
fatigue
Uncorrected hyperopia leads to increase accommodative demand
Uncorrected astigmatism and anisometropia can lead to eyestrain/visual
symptoms (i.e. glare, unequal accommodative demand between the two
eyes)
Wearing myopia correction at near also increased the accommodative demand

A

correction of refractive error

pts w/ CUC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What type of treatment is this? Which patients?

Added plus, especially in patients with high AC/A and esophoria can help reduce visual
symptoms
Added plus for early onset presbyopia decreases accommodative demand
Pre-presbyopia with possible accommodative insufficiency or ill-sustained
accommodation can experience reduced symptoms with added plus (perform MEM to
determine power)
Added lenses do not work as well for conditions that have trouble relaxing
accommodation (i.e. Accommodative excess and infacility). Recommend VT instead.

A

added lenses

pts w/ CUC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What type of treatment is this? Which patients?

Use if there is an associated binocular vision problem contributing to computer use complex symptoms
Especially useful for esophoric patients with vertical heterophoria

A

prism

pts w/ CUC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What type of treatment is this? Which patients?

Helps to build flexibility in the binocular and accommodative systems to
reduced symptoms
Consider before surgery

A

vision therapy

pts w/ CUC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What type of treatment is this? Which patients?

Evaluate for dry eye symptoms/TBUT (note: computer uses exhibit less
frequent blinking)
Evaluate for eyelid disease that can make dry eyes worse or contribute to
ocular discomfort (i.e. blepharitis, MGD)

A

ocular health

pts w/ CUC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What type of treatment is this? Which patients?

Check patient’s working distance and make sure optical correction is appropriate for that working distance. If multiple working distances, consider
multifocal or PAL.
Other considerations: lighting, glare, view angle, time spent on task, etc.
(see next photo)

A

ergonomics

pts w/ CUC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What type of treatment is this? Which patients?

Normally insignificant refractive error (i.e. hyperopia, astigmatism, anisometropia) can cause significant symptoms for a person with ABI

Correct even the slightest amount of refractive error as these patients may be hypersensitive due to having multiple problems at the same time

A

corrective refractive error

pts w/ ABI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What type of treatment is this? Which patients?

Patients with ABI commonly have accommodative insufficiency and ill-sustained accommodation

Trial tentative ADD in the exam room for 10-15 mins while patient is reading to assess response and adjust Rx appropriately

Add can be beneficial if patient has paralysis of accommodation or convergence excess

If unequal accommodation is present (usually due to organic cause), consider unequal ADD

Added lenses do not work as well for conditions that have trouble relaxing
accommodation (i.e. Accommodative excess and infacility). Recommend VT instead.

A

added lenses

pts w/ ABI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What type of treatment is this? Which patients?

Patient with ABI commonly have vertical, noncomitant deviations that may be difficult to treat with VT
Rx minimal amount of prisms that help mitigate patient’s symptoms
Monitor closely for the first year and modify prism amount as needed

A

prisms

pts w/ ABI

17
Q

What type of treatment is this? Which patients?

If giving the optical correction, added lenses and/or prisms does not eliminate the patient’s symptoms of diplopia, consider occlusion
Use if fusion is not comfortable or not obtainable to alleviate the patient’s symptoms
Consider best cosmetic option

A

occlusion for diplopia; pts w/ ABI

occlusion for refractive surgery; pts w/ symptoms post refractive surgery

18
Q

What type of treatment is this? Which patients?

Helps to build flexibility in the binocular and accommodative systems to
reduced symptoms
Prognosis may be guarded (i.e. patient with right homonymous hemianopsia) and/or treatment time may be longer than normal*
May involve modifying visual efficiency techniques in an adaptive manner*
Consider before surgery

A

vision therapy

pts w/ ABI

19
Q

These tests should be included for what?

Binocular testing (CT, NPC, comitancy, AC/A, Vergence ranges)
Accommodative testing (NPA, NRA/PRA, MAF, BAF, MEM)
Sensory testing (Worth 4 dot, stereopsis)
Other (fixation disparity, double Maddox rod, diagnostic occlusion)
A

risk of bino problems from refractive surgery prior to surgery

20
Q

What treatment is this for? Which patients?

correct significant anisometropia
correct residual hyperopia in pts w/ a esodeviation
undo monovision correction if pt cannot adapt

A

corrective refractive error

pts w/ symptoms post refractive surgery

21
Q

What treatment is this for? Which patients?

Consider near add in patients with accommodative esotropia and high AC/A

A

added plus lenses

pts w/ symptoms post refractive surgery

22
Q

What treatment is this for? Which patients?

Consider prism correction for patients with decompensated vertical deviation
or esodeviation at distance (i.e. DI)
Prism Rx may only be needed for specific tasks at specific distances (i.e. driving for patient with DI or reading for patient with SO palsy)

A

prism

pts w/ symptoms post refractive surgery

23
Q

What treatment is this for? Which patients?

Helps to build flexibility in the binocular and accommodative systems to
reduced symptoms
Patients that underwent refractive surgery can be resistant to wearing glasses*
-so might be more motivated with VT to reduce symptoms
Consider before surgery

A

VT for refractive surgery

pts w/ symptoms post refractive surgery

Neuro-Rehab (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions