BLOCK REVIEW Flashcards
Define FOG
CAP:
REFINE:
BALANCE:
Blur their vision until they’re blurred enough to not see anything, walk them down on 20/40 line until they can first make out the letters add 3 clicks minus sphere, move on to CAP
Cylinder Axis Power: axis first, flip down JCC, stratle JCC, follow RED dots for MINUS phoropter, move 15 axis until pt stops, move on to REFINE
REFINE: fog again, 3 click blur out, walk them down again (3 clicks to refine)
DO LEFT EYE SAME WAY
Then BALANCE: can’t balance with amblyopia.
If they’re bouncing around, go with the least ______ power
Minus
If you want to double check your objective or subjective refractive findings (especially if they’re not seeing 20/20), what would you do FIRST?
PINHOLE to make sure nothing else is wrong with pt.
If patient sees 20/25 how many click blur outs??
20/30?
20/40?
20/50?
4 clicks
5
6
7
Which of the following is included ?
Binocular refraction
Replacing accommodation
Cylinder axis and power refinement
Binocular balance
Binocular balance
If you dont have cyl or axis when you do manifest what do you do than FOG CAP REFINE BALANCE??
CPAP!
Fish for 15 degrees
Interval of Sturm is what?
Difference between the vertical and the horizontal meridian.
Refining cylinder power..bringing them closer and closer together
-3.00-2.00x090
Whole lens -5.00, -3.00 at the 90
2D distance is the interval of sturm
When doing the R/G test what patients should you avoid??
Colorblind people
Amblyopic
Cataracts (affects colors)
Macular degeneration?
Give some reasons for doing a binocular refraction over monocular refraction
Reasons for doing binocular:
FUSION LOCK: helps with nystagmus
Anisometropia: BIG RX difference
Non-suppressing tropia’s (usually intermittent)
Electronic health records:
________ reimbursement levels from insurance providers
Makes transfer of knowledge ________
Makes the provider more accurate with his or her __________ skills.
Increases
Easier
Diagnostic
Define :
Amp Acc
Amp Response
Amp Facility
Amp Acc – maximum focusing
ability
Amp Response – over or under acc
How do you measure the following
Amp Acc – NRA and PRA
The comfortable range of accomodatioin is determined by what formula using Amp ACC?
Comfortable Acc Range = ½(Amp Acc)
Amp of Accommodation based on age is calculated by
Minimum= 15.00D-0.25(pts age) Mean = 18.50D-0.30(pts age) Maximum= 25.00D-0.40(pts age)
Patients UNDER 40yrs
40yrs their minimum would be 18.5
Give some reasons for a unilateral decrease in a patients Amp of ACC.
What would NOT show unilateral decrease in amp of ACC?
Anisocoric (unequal pupils) Addie’s
Inflammation or trauma to ciliary body
Improperly balanced manifest
Oral anticholinergic.. taken by mouth so BOTH pupils will be dilated
When you do a manifest and your patients acuity is 20/40 OD OS but pin hole is 20/20 OD OS
What should you do?
Don’t record it, redo it, get it right ya dummy
Using the minus lens technique for Amp ACC the patient reaches sustained blur at -1.50D You are working at 40cm What is the Amp ACC?
Find dioptic power, measure to be -1.50, WD is 2.5 (1/.4=2.5)
Their Amp ACC is…?
4!
2.5+1.5=4D
It be unwise to measure Amp ACC on a patient with?
Presbyopia
Based upon age appropriate prescribing for Presbyopia, what would you prescribe a 30 yr old 50 yr old 70 yr old
40 yr old 60 yr old???
30 NONE 40 +1.00 50 +2.00 60 +2.50 70 +2.50
What is the appropriate endpoint for a bino balance?
Perceived equality between the eyes
OR
Dominant eye better when equality can not be achieved
When you have no cyl axis or power in the manifest model you do FOG C-PAP Refine Balance
CPAP!!!
During a manifest refraction, your patient starts to show fatigue and is running you all over the place. What are some options to find the most accurate manifest refraction?
Give up and reschedule the patient?
Dilate the patient with cycloplegic meds and do the manifest
without the patient being able to accommodate
NRA is measured by using (+) or (-) lenses?
PRA is measured by using (+) or (-) lenses?
+
-
What’s the most common method used for prescribing presbyopia? Why?
Age (time is money)
What is your responsibility in educating the patient when it comes to the lenses they may choose to purchase?
Explain to them what it means (medical prescription by law). You need to tell them about lens options and warnings for ones that wont suffice
