Bv Lec 7

Question 1

What is vision training

Answer 1

Training programs to enhance visual performance.

Targets motor fusion MAIN
Sensory fusion and simultaneous perception as well

Question 2

Goals of vision training

Answer 2

Relieve symptoms and achieve stable comfortable and clear BSV

Question 3

What’s the logical progression of skills for designing a VT programme

Answer 3

Monocular skills

Accommodation

Anti suppression for large suppression scotomas

Anti suppression for small central suppression scotomas

Refixation (voluntary vergence)

Reflex fusional vergence

Sensory fusion and stereopsis

Question 4

What’s the purpose of training monocular skills

Answer 4

Improve accuracy of pursuits and saccades OR warm up

Question 5

What’s the method for training pursuits and saccades in monocular skills

Answer 5

Pursuit : broad H with variety in movement e.g circles or figure 8

Saccades : jump between real world targets or use prisms

Question 6

What’s purpose of accommodation training

Answer 6

Improve accommodation amplitude AND OR Facility so gives

Clear BSV AND useful for vergence training - for getting image clear after voluntary vergence or when it goes single

Question 7

What’s the method of accommodation training

Answer 7

Amplitude: push-up to blur with small letter or pic and repeat

Facility: jump ductions and +/- flippers

Question 8

What’s the purpose of anti suppression training for large suppression scotomas

Answer 8

Improve awareness of diplopia in intermittent strabismus with NRC and suppression

Aware of diplopia=triggers voluntary vergence response

Question 9

What’s the method for anti suppression training for large suppression scotomas

Answer 9

Binocular rotations with prism and red filter (pursuit)

Bar reading/TV trainers+R/G filters and glasses

Suppression check targets on vergence training tools

Question 10

When is anti suppression training contraindicated

Answer 10

Patients with constant strabismus and or ARC

Question 11

What is the purpose of anti suppression training for small suppression scotomas

Answer 11

Improve response to small disparities and prepare for reflex fusional vergence training

Question 12

What’s the INDICATIONS for anti suppression training for small suppression scotomas

Answer 12

Monofixation syndrome

Intermittent strabismus with small suppression on 4prism test that has NRC

Question 13

What are methods for anti suppression training for small suppression scotomas

Answer 13

Bar reading/TV trainers with R/G filters and glasses

Suppression check targets on vergence training tools esp small targets

Question 14

What’s the purpose of refixation training

Answer 14

Improves voluntary vergence in response to large disparities or diplopia

Question 15

What’s the INDICATION of refixation training

Answer 15

Intermittent strabismus or decompensating phoria with NRC

Question 16

What’s the method of refixation training

Answer 16

All free space, instrument based and anaglyph vergence training tools can be adapted to train voluntary vergence

Binocular jump ductions

Question 17

What’s the purpose of reflex fusional vergence training

Answer 17

Improve motor response to small disparities till they meet Percival (eso) or sheards (exo)

Question 18

What’s the INDICATION for reflex fusional vergence training

Answer 18

Have bifoveal fixation, NRC and no suppression under normal viewing

Question 19

What’s the difference between voluntary vergence and reflex fusional vergence

Answer 19

Voluntary vergence helps regain fusion when decompensated VS reflex fusional vergence helps maintain fusion and prevent decompensation strabismus

Question 20

What’s the method for reflex fusional vergence training

Answer 20

All free space, instrument based and anaglyphic vergence training tools can be used BUT increase disparity gradually while training

Question 21

What’s the purpose of sensory fusion and stereopsis training

Answer 21

Improves stability of sensory fusion so won’t activate suppression

Improves stereopsis threshold, decrease latency (faster processing) and increase accuracy

Question 22

What’s the INDICATION for sensory fusion and stereopsis training

Answer 22

STABLE bifoveal fixation, NRC, no suppression under normal conditions

Question 23

What’s the methods to train sensory fusion and stereopsis

Answer 23

Instrument and vectograph methods have suitable targets

Question 24

What does diplopia and blur mean as a feedback mechanism

Answer 24

Diplopia - there’s large angle misalignment of visual axes

Blur - there’s inaccurate accommodation

Question 25

What does suppression and luster mean as a feedback mechanism

Answer 25

Suppression - monocular targets visible under binocular conditions

Luster - there’s binocular rivalry of colours seen when targets are different coloured in each eye

Question 26

What’s the SILO feedback mechanism

Answer 26

When converge target appears smaller and when diverged it looks larger

Question 27

What’s the parallax feedback mechanism

Answer 27

Cue to depth where with a convergence demand the targets move to the right as patient moves right
With a divergence demand the target moves to the left when the patient moves to the right

Question 28

What’s the localisation feedback mechanism

Answer 28

Used to make px aware of where eyes are pointing/visual axes are crossing

So in non free space convergence training the axes cross in front of target and in divergence it crosses behind

Question 29

What’s the kinaesthetic awareness feedback mechanism

Answer 29

Making the px aware of the sensation of changing accommodation or vergence

“Pull your eyes together to focus” > “try being images together”