EF And ARC Therapy Flashcards
Simultaneous prism cover test (SPCT)
A variation of CT to measure deviation
- estimates the deviation
- the amount of estimated prism is placed over the deviated eye as the occluder is placed over the fixating eye
- repeat, increasing the prism until no shift is seen as the prism and the occluder are introduced
- prism goes over the deviated eye
Eccentric fixation
- monocular sensory adaptation
- amblyopic eye using a non fovea point
- localization, size, steadiness
- in degrees or prism diopters
ARC
- binocular sensory adaptation
- fovea of fixating eye and non fovea of non fixating eye have common visual direction (under binocualr conditions)
- objective angle, subjective angle, angle of anomaly
- in prism diopters
Is EF the same as ARC?
No
Normal correspondence
Objective angle equals the subjective angle and the angle of anomaly is 0
Anamalous correspondence
Objective angle does not equal the subjective angle and the angle of an anomaly does not equal 0
Harmonious ARC
Objective angle equals the angle of anomaly, the subjective angle equals 0
Unharmonious ARC
Objective angles is greater than the angle of anomaly, objective angle is greater than the subjective angle
Which actually gets us some type of binocualr vision
ARC
-EF does not
EF is evaluated with
Visuoscopy
Haidinger brushes
After image transfer
ARC is evaluated with
W4D Bagolini lenses Red lenses Amblyopscope/synoptophore After image transfer (angle of anomaly) Haidinger brushes (angle of anomaly)
Classification of EF
- central or eccentric
- steady or unsteady
- location (nasal, temporal, superior, inferior)
- magnitude
Embeddness of ARC
Most natural (mildly) to the most artifical (deeply embedded: smaller angles)
- bagolini
- vertical prism to alignment (red lens)
- W4D
- after image test
Mildly embedded ARC
- about 80% of cases
- comprises of moderate angles, large angles or variable angles
- present only on bagolini
- no treatment for ARC is required
- strab can be treated with prisms, VT and/or surgery
Deeply embedded ARC
- smaller angle
- more stable angle
- early onset
- rarely possible to eliminate ARC
- Present on 3-4 test
Moderately embedded ARC seen on ___- ARC tests
2
Goals of treatment: criteria for cure
Cosmesis
Floms criteria
- functional cure
- almost cure
- moderate improve
- some improvement
- no improvement
Goal of treatment: cosmesis
This is to decrease the sizeto make it less noticeable
Functional cure
- clear single BV at all D and gazes
- stereopsis and normal vergence ranges
- deviation can occur (1% of the time), but when it occurs diplopia must occur
- may have prism (~5Pd) in the glasses to assist with fusion
Almost cure
- clear single BV
- some stereopsis
- deviation can occur (5% of the time), but diplopia must occur
- may have large amount of prism to assist with fusion