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Vision Therapy > Intro and Background > Flashcards

Intro and Background Flashcards

1
Q

What is vision?

A

the derivation of meaning and direction of action as triggered by light

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2
Q

Who is considered a founder of modern vision therapy?

A

Skeffington

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3
Q

What did Skeffington do?

A

educated practicing ODs on VT

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4
Q

What are Skeffington’s four circles of vision?

A

Anti-gravity, centering, identification, speech-auditory

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5
Q

T/F Skeffington’s circles have a hierarchy/order?

A

false

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6
Q

What is anti-gravity?

A

“where am I?” “where are my body parts in reference to one another?” the physical and physiological actions taken to determine body presence

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7
Q

Where does anti-gravity information come from?

A

vestibular information and proprioception

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8
Q

What gives vestibular information?

A

semicircular canals and otoliths

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9
Q

What gives proprioception information?

A

the body in general (stretch receptors in muscle and CT) and from afferent fibers from cervical ganglion in upper spine

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10
Q

T/F the fibers of the optic nerve give positional info

A

true, 20% of the fibers do

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11
Q

What is centering?

A

“Where is it?”

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12
Q

Can we tell where an object is by where its image hits the retina?

A

yes

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13
Q

Can we tell where an object is in space based on the posture of the binocular system?

A

yes, adds depth

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14
Q

How is centering info obtained?

A

monocular cues to depth and binocularity

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15
Q

What are monocular cues to depth?

A

size constancy, parallax, texture variations, tau

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16
Q

What is tau?

A

differing spatial flow with movement; brain can calculate tau value for how fast the angular size changes on the retina, gives sense of change in distance

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17
Q

What is identification?

A

“what is it?” we identify according to our experience

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18
Q

What does identification involve?

A

the entire storage and retrieval system of both short and long term memory and the classification systems used to organize stored memories

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19
Q

What is speech/auditory (communication)?

A

the manner in which we inform ourselves; how we are conscious of our experiences real or imaginary; how we use language to communicate experiences; how we use language to understand what others tell us

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20
Q

What emerges from the four Skeffington circles?

A

vision, we acquire vision through the interactions we have with the environment over time

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21
Q

T/F we create reality with our sensory systems

A

true

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22
Q

Piaget’s model of vision development involves two choices to conflict which are…

A

fight or flight

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23
Q

What are the three levels of Piaget’s fight reaction to conflict?

A

low level learning, high level learning, Ah-ha development

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24
Q

What is low level learning?

A

an easy conflict resolution

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25
Q

What is high level learning?

A

more complex problem solving

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26
Q

What is the ah-ha development?

A

an epiphany allowing resolution

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27
Q

What conflict resolution level of Piaget’s vision development model is vision therapy under?

A

Ah-ha development

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28
Q

What is VT?

A

the arranging of conditions to provide a person with the opportunity to have the necessary meaningful experiences to acquire vision through development and learning

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29
Q

What are four ways to evaluate data?

A

graphical, analytical, normative, and integrative analysis

30
Q

What is graphical analysis?

A

plot clinical findings on a grid to determine whether a patient is likely to have clear, comfortable, single, binocular vision

31
Q

What is analytical analysis?

A

developed by OEP, uses a 21 point exam, helps identify small dysfunctions

32
Q

What is normative analysis?

A

variation of data based on groups of testing, compared to Morgan’s norms

33
Q

What is integrative analysis?

A

compare individual tests to norms, group findings that deviate, and determine the diagnosis (what optometry does)

34
Q

What are the three basic steps of integrative analysis?

A

1) compare individual tests to table(s) of expected findings 2) group the findings that deviate from expected 3) identify the syndrome diagnosis based on steps 1 and 2

35
Q

What are some supplemental tests?

A

AC/A ratio (distance-near or gradient method), fixation disparity fusional vergence amplitudes, vergence facility, accommodative lag

36
Q

What are three standard methods for evaluating binocular data?

A

sheard’s, percival’s and morgan’s

37
Q

What is sheard’s criterion?

A

for comfortable BV, fusional reserve= 2x demand (phoria), useful for prescribing prism, especially with exo

38
Q

What is percival’s criterion?

A

patient’s data should be in the middle third of their vergence range (phoria between BO and BI), useful for prescribing prism, especially eso

39
Q

What are morgan’s norms?

A

compare patient’s test results to the expected findings, note there is an average and an expected range of normal

40
Q

What happens when findings are outside of normal?

A

there is a possibility for a diagnosis

41
Q

What is the maximum amp Hofstetter formula?

A

25 - (2/5 x age)

42
Q

What is the average amp Hofstetter formula?

A

18.5 - (1/3 x age)

43
Q

What is the minimum amp Hofstetter formula?

A

15 - (1/4 x age)

44
Q

Which is the most important Hofstetter’s formula?

A

minimum expected amplitude

45
Q

What is the AC/A ratio?

A

tells how much accommodative convergence there is for a given amount of accommodation

46
Q

T/F AC/A is different than PFV

A

true

47
Q

When is the AC/A ratio useful?

A

when considering refractive correction and especially near adds

48
Q

What is the CA/C ratio?

A

tells how much convergence accommodation there is for a given amount of convergence

49
Q

T/F CA/C is the same as blur-driven accommodation

A

false

50
Q

Why is CA/C rarely used clinically?

A

there is no set accepted testing protocol, may be used with TBI patients

51
Q

What are the six areas of data where we look for trends?

A

PFV, NFV, accommodative system, vertical fusional vergence, oculomotor system, motor alignment and interaction

52
Q

How do we evaluate PFV? (7)

A

smooth and step vergence, PFV facility, NRA, BAF with plus lenses, NPC, MEM retinoscopy, FCC

53
Q

How does NRA evaluate PFV?

A

plus lenses OU relaxes accommodation and therefore vergence relaxes, patient uses PFV to prevent diplopia

54
Q

How do we evaluate NFV? (6)

A

smooth and step vergences, NFV facility, PRA, BAF with minus lenses, MEM retinoscopy, FCC

55
Q

How do we evaluate accommodation? (5)

A

monocular and binocular accommodative amp, MAF/BAF with +/- lenses, MEM, FCC, NRA/PRA

56
Q

How do we evaluate vertical fusional vergence?

A

supravergence, infravergence, fixation disparity

57
Q

How do we evaluate oculomotor ability?

A

fixation status, NSUCO saccades and pursuits, DEM, K-D, visagraph/readalyzer

58
Q

How do we evaluate motor alignment and interaction?

A

cover test, phorias, fixation disparity, AC/A ratio, CA/C ratio

59
Q

What are the three classical categories of visual skills conditions?

A

BV conditions, accommodative conditions, oculomotor conditions

60
Q

What are BV conditions?

A

Duane White: CI, CE, DI, DE, + fusional vergence dysfunction, basic exophoria, and basic esophoria

61
Q

What are accommodative conditions?

A

accommodative insufficiency/paresis, accommodative excess/spasm and accommodative infacility

62
Q

What are oculomotor conditions?

A

saccadic deficiency, pursuit deficiency, and oculomotor dysfunction

63
Q

What is vergence dysfunction?

A

involves disjunctive eye movements in which the visual axes convergence or diverge, resulting in ability of the eyes to accurately fixate and stabilize a retinal image

64
Q

What is accommodative dysfunction?

A

interferes with ability of the eyes to focus clearly on objects at various distances, resulting in lack of clear retinal images

65
Q

What are four possible goals of treatment?

A

to assist the patient in functioning efficiently, to relieve ocular physical and/or psychological symptoms, to rehabilitate the patient following injury, or to enhance athletic performance

66
Q

What are methods of treatment?

A

traditional VT, lenses/prism, surgery

67
Q

What is traditional VT?

A

accommodative therapy to increase the amplitude, speed, accuracy and ease of accommodative responses; vergence therapy to enhance sensorimotor fusion

68
Q

What is prism therapy?

A

horizontal prisms to eliminate symptoms of asthenopia and reduce fusional vergence demand of vergence dysfunction; vertical prisms to eliminate vertical imbalance

69
Q

What is surgery for?

A

to decrease the size of a deviation

70
Q

What is lens therapy?

A

plus lenses to reduce the motor demand on either accommodative or vergence systems

Vision Therapy (21 decks)

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