Dynamic ret and Near Add

Question 1

What is accommodative lag?

Answer 1

When less accommodation is being used than is needed (underuse)
Patient can see further away than expected, is looking ‘behind’ the target

Question 2

What is considered ‘normal’ lag for pre-presbyopes?

Answer 2

+0.25 to +0.75D

Question 3

What is accommodative lead?

Answer 3

More accommodation is used than needed (overuse)
Patient can see a target closer than expected

Question 4

How do you work out the accommodative response?

Answer 4

Expected accommodation - actual accommodation

e.g. if expected = +3.00, and neutrality is at +2.00, response = +1.00D

Question 5

If lag is over +1.00D, what could be the cause?

Answer 5

Accommodative dysfunction
Overminused rx (causes accommodation)
Near ESOP (converging more bc of reduced accomm, trying to induce accomm)
Presbyope

Question 6

If lead is over -0.25D, what could be the cause?

Answer 6

Near EXOP
Accommodative spasm
Latent hyperopia
Under corrected myope

Question 7

What is the dioptric value of 50cm?

Answer 7

2D

Question 8

What is the dioptric value of 25cm?

Answer 8

4D

Question 9

What is the dioptric value of 75cm?

Answer 9

1.25D

Question 10

What is the dioptric value of 20cm?

Answer 10

5D

Question 11

What is the dioptric value of 33cm?

Answer 11

3D

Question 12

What is the dioptric value of 40cm?

Answer 12

2.50D

Question 13

What is the dioptric value of 80cm?

Answer 13

1.25D

Question 14

What is the dioptric value of 67cm?

Answer 14

1.50D

Question 15

What is the dioptric value of 44cm?

Answer 15

2.25D

Question 16

What is the dioptric value of 57cm?

Answer 16

1.75D

Question 17

What is the normal AOA and near point for a 5 year old?

Answer 17

AOA: 15D
Near point: 5cm

Question 18

What is the normal AOA and near point for a 10 year old?

Answer 18

AOA: 12.50D
Near point: 8cm

Question 19

What is the normal AOA and near point for a 20 year old?

Answer 19

AOA: 9.75D
Near point: 10cm

Question 20

What is the normal AOA and near point for a 30 year old?

Answer 20

AOA: 7.25D
Near point: 14cm

Question 21

What is the normal AOA and near point for a 40 year old?

Answer 21

AOA: 4D
Near point: 25cm

Question 22

What is the normal AOA and near point for a 50 year old?

Answer 22

AOA: 2.50D
Near point: 40cm

Question 23

What is the normal AOA and near point for a 60 year old?

Answer 23

AOA: 1.25D
Near point: 80cm

Question 24

What is the normal AOA and near point for a 70 year old?

Answer 24

AOA: 0.50D
Near point: 200cm

Question 25

What is the normal AOA and near point for a 75 year old?

Answer 25

AOA: 0D
Near point: Infinity

Question 26

How much of the AoA is used at once most of the time?

Answer 26

Half to a third

Question 27

When does presbyopia become clinically significant?

Answer 27

In px’s 40s

Question 28

What can cause earlier clinically significant presbyopia?

Answer 28

Hot climate
Short arms
Short WD
Hyperopes