Diagnosis Flashcards
accommodative insufficiency must have
decreased accommodative amplitudes
accommodative insufficiency may also have
- decreased MAF, BAF, PRA
- MEM
what is “ill-sustained accommodation”
- form of accommodative insufficiency where function deteriorates over time
- fatigue occurs with repeated accommodative stimulus
what is the definition of accommodative excess and prevalence?
= accommodative response greater than the stimulus requires
-prevalence depends on definition (1% for lead on MEM, and 2-10% for difficulty clearing plus)
accommodative excess must have
lead on MEM
accommodative excess may have
decreased MAF, BAF, NRA
what are some unique signs/symptoms for accommodative excess
- decreased/fluctuating distance vision
- variable VAs and refraction
other than VT, what is a good “treatment” option to educate your accommodative excess patient on?
visual hygiene (working distance, lighting, rest periods)
accommodative infacility must have
decreased in MAF (plus and minus)
accommodative infacility may have
decreased BAF, decreased NRA/PRA
definition of paralysis of accommodation
severe accommodative insufficiency where amplitude is markedly reduced (paresis) or totally absent (paralysis)
- may be associated with fixed, dilated pupil and strabismus
- rare but secondary to disease, medication, or head trauma
definition for “spasm of the near reflex”
- severe form of accommodative excess
- secondary to functional or organic causes, medication, and head trauma
what is the triad for “spasm of the near reflex”
- over-accommodative
- over-convergence
- miosis
3 most important findings for convergence insufficiency
- greater exo at near than at far > or = to 4 pd
- receded NPC
- decreased PFV’
some other related findings for convergence insufficiency
- decreased vergence facility (BO)
- exo FD at near, FDC has steep slope with BO
- decreased NRA
- decreased BAF (plus)
- MEM lead
test findings for divergence excess
- greater exo at far than at near (>10 pd), often an IXT
- decreased PFV
- exo FD at distance
- decreased 2nd degree fusion at distance
unique signs/symptoms of divergence excess
- concerns about cosmesis (XT at far)
- squinting/covering an eye in bright light
treatment options for divergence excess
- VT 25 visits
- Over-minus for IXT
treatment options for basic exophoria
- VT 25 visits
- Over-minus for IXT
- Prism
what is a differential diagnosis for divergence insufficiency?
VI CN Palsy
r/o with version testing, onset
