Lecture 9-10 Flashcards

You may prefer our related Brainscape-certified flashcards:
1
Q

what are the characteristics of normal correspondence on the retina?

A

highly stable, not altered by image luminance, contrast, color, size or orientation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is anomalous retinal correspondence (ARC)?

A

the centers of the fovea have different visual direction (oculocentric direction) - new corresponding points = fovea of straight eye and peripheral retina point in turned eye

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

is ARC the same thing as eccentric fixation?

A

no - EF is monocular and usually much smaller in size than ARC (ARC may be present with or without EF)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

why does a patient develop ARC?

A

anti-diplopia sensory adaption if onset before age 6 - able to preserve rudimentary binocular vision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

if a strabismic patient develops ARC - can they be cured?

A

less than 50/50 change of cure (if constant ET without ARC then 50/50 chance of cure)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

in ARC, what is point z called?

A

zero measure point of the turned eye (sometimes the same as point a to restore single vision)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

in ARC, what is point a called?

A

the PVD of the turned eye has moved to a non-foveal point (anomalous point) a and has the same oculocentric visual direction as the fovea of the straight eye

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what does the displacement of point a from the fovea represent?

A

typically related to the size of the strabismus and “a” location usually co-varies with strabismic fluctuation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is ARC influenced by?

A

luminance and contrast (unlike normal correspondence) - the more natural the test environment the more likely ARC will be found

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is angle H in ARC? how do you measure it?

A

the horizontal objective angle of the deviation - how much the eye is physically turned, measured by CT and prism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is angle S in ARC? how do you measure it?

A

the subjective angle of directionalization - perceived angle of diplopia and measured by maddox rod, red lens test, or synoptophore

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is angle A in ARC? how do you measure it?

A

angle of anomaly - amount of shift of correspondence from fovea, it is measured by afterimage test or angle H - angle S

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

how are angles H (objective angle) and angle S (subjective angle) related in normal correspondence?

A

they are equal

H = S

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

how does a synoptophore (major amblyoscope) measure the subjective angle S?

A

present different images to each eye in stereoscope, the turned eye’s image is moved in until it is aligned with the other image of straight eye = angle S

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what does a person with normal correspondence see in the synoptophore?

A

two diplopic images are separated by the same angle as the angle of esotropia (H = S) so anomaly A is zero (point a corresponds with f)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is harmonious ARC?

A

sensory adaptation A completely compensates for angle of strabismus H and there is no subjective angle S (a coincides with zero point z)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what type of ARC does a patient have if they have 20PD RET on cover test and 10PD displacement on the synoptophore (angle S)?

A

unharmonious ARC

Angle A = 20PD - 10PD = 10PD (S < H and will have diplopia)

18
Q

what type of correspondence will a patient have with angle S = 0, and A = H?

A

harmonious ARC

19
Q

what type of correspondence will a patient have with angle A = 0 and H = S?

A

Normal correspondence

20
Q

what does the Hering-Birlschowski afterimage test measure?

A

a direct measurement of angle A for ARC

21
Q

how does the afterimage test work?

A

a horizontal afterimage is flashed for the straight eye and vertical for deviated eye - the position of the images doesn’t depend on whether the eyes are straight or crossed (test depends on fixation behavior - NRC vs. ARC)

22
Q

what side will the vertical line be if the patient has left ET with HARC?

A

the afterimage will be seen to the right side of the horizontal line

23
Q

what side will the vertical line be if the patient has a left XT with HARC?

A

the afterimage will be seen to the left side of the horizontal line

24
Q

what will the afterimage look like if a patient has a right ET with NRC? (or adult onset)

A

crossed lines

25
Q

if a patient has eccentric fixation and ARC, what will their afterimage look like?

A

a perfect cross (angle E or angle of EF = angle A)

26
Q

what can you use the Maddox rod to measure?

A

the subjective deviation - angle S (crossed = EXO and uncrossed = ESO)

27
Q

how will someone with HARC see the maddox rod?

A

as the red line going through the white light

28
Q

what do the bagolini lens test?

A

suppression and subjective deviation

29
Q

which direction are the bangolini lenses usually placed?

A

45 degrees OD and 135 degrees OS (from doctors perspective)

30
Q

what type of correspondence will see a perfect cross of lights in the bangolini test?

A

NRC, HARC, or small angle (monofixation syndrome)

31
Q

how will the lights look with bangolini lenses in exo deviation?

A

“A” pattern

32
Q

how will the lights look with bangolini lenses in eso deviation?

A

“V” pattern

33
Q

which test has the most dissociation? which had the least amount?

A
most = afterimage 
least = bangolini
34
Q

what happens to suppression as dissociation increases?

A

amount of suppression decreases

35
Q

what is a flom notch?

A

seen in early onset constant ET patients - irregular shape in a specific area on the identical visual direction horopter

36
Q

what does the peripheral horopter look like with a flom notch?

A

periphery looks like someone who has NRC

37
Q

your patient has 28PD LET and maddox rod = vertical line to right of white light but neutralized by 28PD BO, does this patient have ARC?

A

no (angle H = S and angle A = 0)

38
Q

your patient has 28PD LET and maddox rod = vertical line to right of white light but neutralized by 28PD BO, what will their afterimage look like?

A

no ARC - so a perfect cross

39
Q

your patient has 28PD LET and maddox rod = vertical line to right of white light but neutralized by 28PD BO, what will the bangolini test show?

A

“V” pattern or suppression of the left eye

40
Q

your patient has 16PD LET and maddox rod = vertical line passes through white light, does the patient have ARC?

A

yes - harmonious ARC

41
Q

your patient has 16PD LET and maddox rod = vertical line passes through white light, what will the bangolini test show?

A

a perfect cross

42
Q

your patient has 16PD LET and maddox rod = vertical line passes through white light, what will the afterimage results be?

A

the vertical line will be to the right of the horizontal line (crossed)