Lecture 3- Ret on schematic eye

Question 1

To use minus cylinder lenses, you must have ___ in one meridian and ____ in the other meridian

Answer 1

neutral; against

Question 2

Hyperopia results when the eye has ____ refractive power for its axial length, and is a ____ discrepancy for BLOAD

Answer 2

insufficient; minus

Question 3

what is the definition of hyperopoia

Answer 3

parallel light rays enter the eye and come to a focus behind the retina when accomodation is relaxed

Question 4

what are ex of pathological hyperopia

Answer 4

1. diabetic macular edema
2. cystoid macular edema
3. orbital tumors

Question 5

Accommodation is the eyes ability to temporarily ___ power by increasing the power of the crystalline lens. A lot of Native america, african americans and pacific islanders are hyperopic

Answer 5

increase

Question 6

why do patients seem to get more hyperopic as they get older?

Answer 6

1. the increase in hyperopia with age is associated with the loss of the ability to compensate for the hyperopia by active accommodation.
2. There is some anatomic change in the eye which has not been identified.

Question 7

how is hyperopia classified as

Answer 7

1. manifest; hyperopia measured by relaxation of accommodation with the addition of plus lenses during the refraction. DRY; no drops
2. latent: the portion of the total hyperopia compensated for by the tonicity of the ciliary muscle .the amt of hyperopia revealed on top of the manifest hyperopia using cyclopegic drops to simulate an eye at rest.

Question 8

manifest + latent hyperopia = ____hyperopia. This will equal the amount of hyperopia revealed with the “wet” refraction

Answer 8

total

Question 9

wet refraction - dry refraction = _____ hyperopia

Answer 9

latent

Question 10

____hyperopia can be overcome or “self corrected” by accommodation. The VA at distance without correction will be 20/20

Answer 10

facultative

Question 11

_____ hyperopia cannot be overcome or compensated by accommodation; pt doesnt have enough amplitude of accommodation to self correct the discrepancy

Answer 11

absolute

Question 12

A pt will be comfortable if he uses no more than ___ of his amplitude of accommodation

Answer 12

half

Question 13

what is the demand at distance for a hyperope?

Answer 13

infinity (6m)

Question 14

for a hyperope, how much accommodation occurs at infinity

Answer 14

depends upon the amount of hyperopia

Question 15

with an increase in age, the amplitude of accommodation decreases, therefore, ____ hyperopia decreases and ____ hyperopia increases

Answer 15

facultative; absolute

Question 16

Infants with moderate to high hyperopia are up to 13 times more likely to develop ____ by 4 years of age if left uncorrected. They are also 6 x more likely to have reduced VA than infants with low hyperopia or emmetropia

Answer 16

strabismus

Question 17

There is a strong association between modest hyperopoia and infantile ____

Answer 17

esotropia

Question 18

In hyperopia, it only takes ____D of anisometropia to be a risk factor for amblyopia

Answer 18

1

Question 19

Accommodative ET treatment is most successful with _____

Answer 19

spectacles

Question 20

whats amblyopia

Answer 20

a pt whose vision is not corrected to 20/20 and no eye disease; nothing

Question 21

what is refractive amblyopia

Answer 21

one eye is + 1.00 and one eye -4.00

1. high amts of astigmatism

Question 22

what are signs of moderate to high hyperopia

Answer 22

1. amblyopia: refractive or strabismic
2. esotropia/esophoria
3. narrow angle glaucoma

Question 23

hyperopes tend to have ____ eyes with narrow anterior chamber angles; use caution when dilating hyperopes check the angles carefully.

Answer 23

smaller

Question 24

what are techniques used to control the refraction of hyperopes?

Answer 24

1. Fogging
2. Three eyed method of retinoscopy
3. delayed subjective
4. cyclopegic “wet” refraction: near retinoscopy

Question 25

what is delayed subjective; when is it most useful?

Answer 25

to maximally relax a patients accommodation and subsequently stimulate the acceptance of plus at distance

• latent hyperopia
• accommodative spasm

Question 26

what is cyclopegic refraction; when do you use it?

Answer 26

wet refraction

• latent hyperopia is suspected
• strabismus (esotropia)
• accommodative spasm during ret or subjective
• variable refraction
• near point symptoms greater than what the refractive findings would indicate

Question 27

what is downside to cyclopegic refractions

Answer 27

1. lasts 24 hours
2. dilated pupil makes ret more difficult
3. patients with DS or cerebral palsy have a higher reaction to the drops.

Question 28

what are prescribing considerations for infants

Answer 28

1. no full plus for babies due to emmetropization during the first 36 months of life.

Question 29

what are prescribing considerations for hyperopes

Answer 29

1. near vision only spectacles
2. OTC readers
3. contacts
4. multifocals

Question 30

what is the goal of treating physiological hyperopia

Answer 30

reduce accommodative demand and to provide clear, comfortable binocular vision