Diagnosis Flashcards

1
Q

accommodative insufficiency must have

A

decreased accommodative amplitudes

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2
Q

accommodative insufficiency may also have

A
  • decreased MAF, BAF, PRA

- MEM

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3
Q

what is “ill-sustained accommodation”

A
  • form of accommodative insufficiency where function deteriorates over time
  • fatigue occurs with repeated accommodative stimulus
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4
Q

what is the definition of accommodative excess and prevalence?

A

= accommodative response greater than the stimulus requires

-prevalence depends on definition (1% for lead on MEM, and 2-10% for difficulty clearing plus)

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5
Q

accommodative excess must have

A

lead on MEM

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6
Q

accommodative excess may have

A

decreased MAF, BAF, NRA

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7
Q

what are some unique signs/symptoms for accommodative excess

A
  • decreased/fluctuating distance vision

- variable VAs and refraction

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8
Q

other than VT, what is a good “treatment” option to educate your accommodative excess patient on?

A

visual hygiene (working distance, lighting, rest periods)

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9
Q

accommodative infacility must have

A

decreased in MAF (plus and minus)

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10
Q

accommodative infacility may have

A

decreased BAF, decreased NRA/PRA

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11
Q

definition of paralysis of accommodation

A

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
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12
Q

definition for “spasm of the near reflex”

A
  • severe form of accommodative excess

- secondary to functional or organic causes, medication, and head trauma

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13
Q

what is the triad for “spasm of the near reflex”

A
  • over-accommodative
  • over-convergence
  • miosis
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14
Q

3 most important findings for convergence insufficiency

A
  • greater exo at near than at far > or = to 4 pd
  • receded NPC
  • decreased PFV’
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15
Q

some other related findings for convergence insufficiency

A
  • decreased vergence facility (BO)
  • exo FD at near, FDC has steep slope with BO
  • decreased NRA
  • decreased BAF (plus)
  • MEM lead
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16
Q

test findings for divergence excess

A
  • greater exo at far than at near (>10 pd), often an IXT
  • decreased PFV
  • exo FD at distance
  • decreased 2nd degree fusion at distance
17
Q

unique signs/symptoms of divergence excess

A
  • concerns about cosmesis (XT at far)

- squinting/covering an eye in bright light

18
Q

treatment options for divergence excess

A
  • VT 25 visits

- Over-minus for IXT

19
Q

treatment options for basic exophoria

A
  • VT 25 visits
  • Over-minus for IXT
  • Prism
20
Q

what is a differential diagnosis for divergence insufficiency?

A

VI CN Palsy

r/o with version testing, onset