Case Analysis and Diagnosis of Nonstrabismic BV Disorders (M1) Flashcards
For the graphical analysis of binocular vision, what is the marking made for dissociated phoria? 1. BO and BI blur? 2. Break? 3. Recovery? 4
- x
- circle
- square
- triangle
What are the benefits to graphical analysis of binocular vision?
1/ helps show relationships
2. helps identify data that doesn’t fit
What are the disadvantages to graphical analysis of binocular vision?
- fails to evaluate some areas
2 fails to identify common binocular vision anomalies - inefficient
- relies on guidelines for diagnosis or management
What areas of binocular vision are not evaluated in graphical analysis?
accommodative facility, fusional facility, fixation disparity, lag, and eye movements
What common binocular vision anomalies does graphical analysis fail to identify?
accommodative excess, accommodative infacility, accommodative fatigue, fusional vergence dysfunction, and ocular motor dysfunction
Do esophores prefer glasses with prism or without? 1. Exophores? 2
- with
2. without
What is the best indicator of symptoms for esophores? 1. Exophores? 2
- slope of fixation disparity curve
2. Sheard’s criterion
What is done during the analytical analysis of OEP?
- checking (compare data to expecteds)
- chaining (group high and low findings according to rule)
- case typing (diagnosis)
What are the concepts of OEP analytical analysis?
- visual anomalies occur as an adaptation to visual stress
2. vision problems can be prevented with appropriate intervention
What values are in the Morgan’s system group A? 1. Group B? 2. Group C? 3
- BI break at dist., BI blur at near, BI break at near, PRA, amplitude
- BO blur and break @ dist, BO blur and break @ near, binocular cross-cylinder, monocular cross cylinder, NRA
- phoria, AC/A ratio
What is the advantage to Morgan’s system of normative analysis?
groups of data are evaluated
What are the disadvantages to Morgan’s system of normative analysis?
- does not include all clinically significant findings
2. some binocular, accommodative, and oculomotor problems are not identified
What are the clinically significant findings not included in Morgan’s system of normative analysis?
accommodative facility, vergence facility, acommodative response, fixation disparity, eye movement skills
What are the binocular, accommodative, and oculomotor problems not identified in Morgan’s system of normative analysis?
accommodative infacility, vergence infacility, fixation disparity, eye movement inefficiency, accommodative spasm
What are the advantages to fixation disparity analysis?
- binocular test
2. effective for prescribing prism for some binocular vision anomalies
What are the disadvantages to fixation disparity analysis?
accommodation & eye movements not directly evaluated
For a case analysis, what are the sources of direct info about PFV?
- BO fusion range
- NPC
- vergence facility with BO
For a case analysis, what are the sources of indirect info about PFV?
- Binocular accommodative facility when looking through plus lenses
- NRA
- accommodative response
For a case analysis, what are the sources of direct info about NFV?
- BI fusion range
2. Vergence facility with BI
For a case analysis, what are the sources of indirect info about NFV?
- binocular accommodative facility with minus lenses
- PRA
- accommodative response
For a case analysis, what are the sources of direct info about accommodative ability?
- monocular accommodative amplitude
- monocular accommodative facility
- accommodative response
For a case analysis, what are the sources of indirect info about accommodative ability?
- binocular accommodative amplitude
- binocular accommodative facility
- NRA/PRA
What is Duane’s classification of a patient with a low AC/A ratio and greater exophoria at near than at distance?
convergence insufficiency (CO)
What is Duane’s classification of a patient with a low AC/A ratio and greater esophoria at distance than at near?
divergence insufficiency (DI)
What is Duane’s classification of a patient with a normal AC/A ratio and about the same amount of esophoria at distance and near?
basic esophoria
What is Duane’s classification of a patient with a normal AC/A ratio and about the same amount of exophoria at distance and near?
basic exophoria
What is Duane’s classification of a patient with a high AC/A ratio and greater esophoria at near than at distance?
convergence excess (CE)
What is Duane’s classification of a patient with a high AC/A ratio and greater exophoria at distance than at near?
divergence excess (DE)
What is the condition with reduced fusional ranges and/or facility with orthophoria or a small phoria?
fusional vergence dysfunction
What are common etiologies of BV disorder symptoms?
- aniseikonia
- cyclophoria
- latent hyperopia
- fixation disparity
What is the limit to be considered a low amplitude of accommodation?
2D or more below the lower limit for a patients age
What is the CITT definition for convergence insufficiency?
- 4 more exo at near than at distance
- Receded NPC (≥ 6cm)
- Insufficient positive fusional vergence (Fails Sheard’s Or minimum positive fusional vergence < 15pd BO break or blur)
What is the first line treatment approach for the treatment of symptomatic CI in children 9 to 17?
office based vergence and accommodative therapy with home reinforcement
What is a possible management of an adult presbyope with CI?
PAL with BI prism at near only
What are triggers to divergence excess?
- inattention
- fatigue
- illness
- daydreaming
What are the possible etiologies of a vertical phoria?
- hyperorbit (small deviations)
- improper EOM insertion
- secondary to lens extraction
- vertical rectus anomalies
- oblique dysfunction
- skew deviation (supranuclear)
- CN III px
- CN IV px
- ocular myasthenia
- IO or SO overaction
What are the things to consider if diagnosis from initial analysis is unclear?
- accuracy and reliability of test results
- nonfunctional etiology
- effect of time of day
- malingering
What are the things that should be presented to the patient when talking about their BV disorder?
- Explain in laymen’s terms
- Link any signs and symptoms
- Explain common symptoms
- Explain no symptoms with signs
- Demonstration
- Once have complete diagnosis explain proposed treatment plan and give options
