Bv Lec 7 Flashcards
What is vision training
Training programs to enhance visual performance.
Targets motor fusion MAIN
Sensory fusion and simultaneous perception as well
Goals of vision training
Relieve symptoms and achieve stable comfortable and clear BSV
What’s the logical progression of skills for designing a VT programme
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
What’s the purpose of training monocular skills
Improve accuracy of pursuits and saccades OR warm up
What’s the method for training pursuits and saccades in monocular skills
Pursuit : broad H with variety in movement e.g circles or figure 8
Saccades : jump between real world targets or use prisms
What’s purpose of accommodation training
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
What’s the method of accommodation training
Amplitude: push-up to blur with small letter or pic and repeat
Facility: jump ductions and +/- flippers
What’s the purpose of anti suppression training for large suppression scotomas
Improve awareness of diplopia in intermittent strabismus with NRC and suppression
Aware of diplopia=triggers voluntary vergence response
What’s the method for anti suppression training for large suppression scotomas
Binocular rotations with prism and red filter (pursuit)
Bar reading/TV trainers+R/G filters and glasses
Suppression check targets on vergence training tools
When is anti suppression training contraindicated
Patients with constant strabismus and or ARC
What is the purpose of anti suppression training for small suppression scotomas
Improve response to small disparities and prepare for reflex fusional vergence training
What’s the INDICATIONS for anti suppression training for small suppression scotomas
Monofixation syndrome
Intermittent strabismus with small suppression on 4prism test that has NRC
What are methods for anti suppression training for small suppression scotomas
Bar reading/TV trainers with R/G filters and glasses
Suppression check targets on vergence training tools esp small targets
What’s the purpose of refixation training
Improves voluntary vergence in response to large disparities or diplopia
What’s the INDICATION of refixation training
Intermittent strabismus or decompensating phoria with NRC
What’s the method of refixation training
All free space, instrument based and anaglyph vergence training tools can be adapted to train voluntary vergence
Binocular jump ductions
What’s the purpose of reflex fusional vergence training
Improve motor response to small disparities till they meet Percival (eso) or sheards (exo)
What’s the INDICATION for reflex fusional vergence training
Have bifoveal fixation, NRC and no suppression under normal viewing
What’s the difference between voluntary vergence and reflex fusional vergence
Voluntary vergence helps regain fusion when decompensated VS reflex fusional vergence helps maintain fusion and prevent decompensation strabismus
What’s the method for reflex fusional vergence training
All free space, instrument based and anaglyphic vergence training tools can be used BUT increase disparity gradually while training
What’s the purpose of sensory fusion and stereopsis training
Improves stability of sensory fusion so won’t activate suppression
Improves stereopsis threshold, decrease latency (faster processing) and increase accuracy
What’s the INDICATION for sensory fusion and stereopsis training
STABLE bifoveal fixation, NRC, no suppression under normal conditions
What’s the methods to train sensory fusion and stereopsis
Instrument and vectograph methods have suitable targets
What does diplopia and blur mean as a feedback mechanism
Diplopia - there’s large angle misalignment of visual axes
Blur - there’s inaccurate accommodation
What does suppression and luster mean as a feedback mechanism
Suppression - monocular targets visible under binocular conditions
Luster - there’s binocular rivalry of colours seen when targets are different coloured in each eye
What’s the SILO feedback mechanism
When converge target appears smaller and when diverged it looks larger
What’s the parallax feedback mechanism
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
What’s the localisation feedback mechanism
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
What’s the kinaesthetic awareness feedback mechanism
Making the px aware of the sensation of changing accommodation or vergence
“Pull your eyes together to focus” > “try being images together”
