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CLI PEDIA M2 > M4 > Flashcards

M4 Flashcards

1
Q

4 Types of Visual Acuity

A

Detection (minimum visible)
Resolution(minimum resolvable)
Recognition (minimum recognizable)
Hyperacuity (minimum discriminable)

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2
Q

Detection

A

(minimum visible)

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3
Q

Resolution

A

(minimum resolvable)

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4
Q

Recognition

A

(minimum recognizable)

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5
Q

Hyperacuity

A

(minimum discriminable)

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6
Q

refers to the smallest test object that can be detected

A

Detection (minimum visible)

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7
Q

Stycar Balls and ‘Hundreds and Thousands’

A

Examples of Detection (minimum visible)

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8
Q
  • Detection tasks are often less affected by visual impairment than complex acuity tasks
A

Detection (minimum visible)

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9
Q
  • may grossly overestimate VA in visually impaired children
A

Detection (minimum visible)

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10
Q
  • Motor problem reducing control of fine hand movements rather than the inability to detect the targets could cause failure to the test.
A

Detection (minimum visible)

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11
Q

measures the smallest angular separation between adjacent targets than can be resolved

A

Resolution (minimum resolvable)

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12
Q

PL tests and VEP

A

Examples of Resolution (minimum resolvable)

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13
Q
  • more useful and sensitive measure of VA than detection tests.
A

Resolution (minimum resolvable)

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14
Q
  • can be succesful in estimating acuity in infants from birth
A

Resolution (minimum resolvable)

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15
Q
  • refers to the ability to identify a form or its orientation
A

Recognition (minimum recognisable)

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16
Q

Snellen chart, acuity tests that use both letters or other optotypes

A

Examples of Recognition (minimum recognisable)

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17
Q
  • children from about 2.5 years of age can be tested successfully
A

Recognition (minimum recognisable)

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18
Q

*larger target size
*less degraded in peripheral retina, stimulates parafoveal area
*not affected by contour interaction

A

RESOLUTION

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19
Q

*smaller target size
*more degraded in peripheral retina, does not stimulate parafoveal areas
*affected by contour interaction - crowding phenomenon

A

RECOGNITION

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20
Q

ability to determine differences between two stimuli (size, orientation and position)

A

Hyperacuity (minimum discriminable)

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21
Q

limited less by optical and retinal factors

A

Hyperacuity (minimum discriminable)

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22
Q

believed to reflect cortical processing

A

Hyperacuity (minimum discriminable)

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23
Q

vernier acuity and stereoacuity

A

Examples of Hyperacuity (minimum discriminable)

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24
Q
  • monitor visual development in children
  • we can detect children with reduced binocular acuity * detect interocular acuity difference
  • need to test VA monocularly otherwise amblyopia will not be detected
  • a VA test with both eyes open only represents the VA in the good eye
  • to monitor the treatment efficacy (change in acuity resulting in spectacle Rx)
  • disease progression
A

Why is VA test necessary?

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25
Q

Screening Test for Young Children and Retardates

A

STYCAR GRADED BALL TEST

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26
Q
  • Age: 3 months to 2 years
  • Test target: white balls with diameter ranging from 3mm - 6.16cm
A

STYCAR GRADED BALL TEST

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27
Q
  • The child watches as the balls are presented (rolled or mounted on stick) against a black screen by the hidden examiner.
  • The examiner observes the child’s responses to successively smaller balls. The smallest ball fixed is recorded as estimate of child’s acuity
A

STYCAR GRADED BALL TEST

28
Q

sprinkles are held in the palm of the hand are used to gain attention for infants over 6 months old

A

Hundreds and Thousands

29
Q
  • At 9 months: baby may prod the decorations
  • at 1 year old: baby may attempt to pick them up
A

Hundreds and Thousands

30
Q

principle: a child will prefer to look at an object with visual interest (grating) rather than a plain field of the same luminance

A

Preferential Looking

31
Q
  • used from birth and most appropriate acuity test for children under 2.5 years
A

Preferential Looking

32
Q
  • when the grating is too narrow to be differentiated, the child will gaze randomly at one side or the other
A

Preferential Looking

33
Q

alternating black and white lines of equal thickness and length

A

Square-wave gratings

34
Q

use pictures constructed of black and white lines

A

Vanishing optotypes

35
Q

Keeler Acuity System (UK)
Teller acuity cards (US)
Lea paddles

A

Square-wave gratings

36
Q

Cardiff acuity test

A

Vanishing optotypes

37
Q

*Test Distance: 40 cm
* Cardiff: 1m or 50cm

A

Preferential Looking

38
Q

Procedure:
* A gross target is presented first
* Cards are presented (unseen by the optom)
* Optom watches the infant through the peephole
* A judgement must be made by the optom if child is fixating to
right or left/up or down (force-choice)
* VA is estimated as the highest spatial frequency (finest grating)
the child was able to see.

A

Preferential Looking

39
Q
  • examiner should be unaware of the position of the stimulus when presenting to avoid bias
  • judgements must be based on eye movements rather than pointing/verbal response
  • cards are presented atleast twice for a definite response.
A

Reminders for PL

40
Q

Optotype-matching and naming tests

A

Recognition

41
Q
  • letters or picture-matching or naming tests
  • Optotypes: isolated (uncrowded) or linear (crowded)
    Test distance: 3m or 6m
A

Matching and naming

42
Q

Procedure:
* Examiner presents the letter or picture targets * Child chooses a match from the key card
* Older children can name the picture or letter

A

Matching and naming

43
Q
  • 2-3 years of age
  • single picture - Snellen format
    ⚬ 3/3 (6/6) - 3/30 (6/60)
  • Crowded version - LogMAR
    ⚬ 1.0-0.1
A

Kay Picture Test

44
Q
  • Lea shapes: square, circle, house and apple (heart)
  • single and crowded format
  • 2-3 years
  • unlike Kay, symbols are
    uniform in detail, line width and size
A

Lea Symbols

45
Q
  • 2.5-3yearsofage
  • optotype: single letters
  • no crowded version
  • disadvantage: may overestimate acuity in amblyopia
A

Sheridan-Gardiner Test

46
Q

Sonksen-Silver Acuity System

A
  • 3.5 years of age
  • uses Sheridan-Gardiner letters but presents letters in linear format
47
Q
  • contains contour interaction to elicit crowding phenomenon
  • also uses Sheridan Gardiner letters
  • the child has to identify the letter surrounded by four others
A

Cambridge Crowding Cards

48
Q
  • previously known as Glasgow Acuity Cards
  • applies the Bailey-Lovie test
  • letter size decreases in logarithmic
    fashion
  • scoring system: each letter is scored
    0.025
    Versions:
  • uncrowded (2.5 - 3 years)
  • crowded version (3.5 - 4 years)
A

LogMAR Acuity Test

49
Q
  • children have ample accommodation and few near vision problems when distance EOR is corrected
  • those with neurological impairment or LV may have reduced acc
A

Near Vision Testing

50
Q
  • PL tests tend to overestimate VA (amblyopic eyes)
  • It is important that the testing environment be quiet and free from distraction
  • Young children tire quickly and lose motivation
  • A lot of information about a child’s acuity can be gathered by simply observing them interacting with their environment
  • Always end on a good note
A

Clinical pearls

51
Q

-crucial for children with visual impairment / defects

A

Contrast Sensitivity

52
Q

Hiding Heidi
Cardiff Contrast Test

A

Contrast Sensitivity

53
Q
  • important for career related decisions
  • school related activities
A

Color Vision

54
Q
  • most commonly used
  • red-green color deficiency screening test
  • do not screen for blue-yellow defects
A

Ishihara Test

55
Q
  • 75cm
  • 1st plate is visible to all regardless of CV status
  • 14 plate edition: px must get 10 correct to pass
  • 24 plate edition: plates 1-17 are administered to children who can recognize numbers
    ⚬ 13 out of 17 is required to pass
    ⚬ 18-24- if px cannot identify numbers-traceable curving lines
A

Ishihara Test

56
Q
  • CV test that does not classify type or severity
  • only normal vs abnormal CV
  • 12-14 plate pseudoisochromatic test
  • 3-5 years
  • 75cm
A

Color Vision Testing Made Esay

57
Q
  • Part 1: circle, square and star targets
  • Part 2: boat, house, dog
  • 1st plate is test plate and visible to all
A

Color Vision Testing Made Esay

58
Q
  • can detect and classify R-G defects & B-Y defects
  • helpful in identifying congenital and acquired CV defects
  • child friendly shapes and mini paint brush
A

Hardy-Rand-Rittler (HRR)

59
Q
  • first 4 plates are demonstration plates to confirm child’s understanding of the test
  • the next 6 plates are used to separate normal from those with defective CV
  • if the child fails demo plates –>px may be malingering or not cooperating, stop the test
A

Hardy-Rand-Rittler (HRR)

60
Q
  • if px completes demo plates, continue with remaining
  • if child fails the 6 screening plates, there are 14 subsequent plates to diagnose extent and type of defect
    ⚬ if plates 5-6 are missed: B-Y defect is suspected
    ⚬ show plates 21-24
    ■ if error in 5-6 but no error in 21-24: mild defect
    ■ 21-22, no error in 23-24: moderate defect
    ■ 23-24 error: severe defect
A

Hardy-Rand-Rittler (HRR)

61
Q
  • 7-10 error: R-G defect suspect
    ■ only plates 11-20 are shown to concentrate on R-G defects
    ■ 11-15: defect is mild
    ■ 16-18:defect is moderate
    ■ 19-20: defect is severe
A

Hardy-Rand-Rittler (HRR)

62
Q

px is asked to arrange 15 colored discs in order of hue and intensity

A

Farnsworth D-15

63
Q
  • It is important to identify children with CV defect as early as possible
  • if child fails an initial CV screening test, it is beneficial to repeat testing in order to confirm deficiency
  • it is equally important to educate pxs, teachers and parents regarding potential limitations in school or in future career paths
A

Clinical pearls

64
Q
  • directed towards cc (for px with short attention)
  • older child: slit lamp
  • younger / uncooperative child: hand held slit lamp
    ⚬ indirect ophthalmoscope with 20D or 28D lens
A

Ocular Health External

65
Q
  • Lids and Lashes
  • Bulbar Conjunctiva
  • Palpebral Conjunctiva
  • Cornea
  • Ant. Chamber Angle
  • Iris
  • Lens
A

Evaluation of ocular anterior segment/adnexa

66
Q
  • Cup/Disc Ratio
  • A/V Ratio
  • Vessel
  • Venous Pulse
  • Foveal Reflex
  • Macula
  • Vitreous
  • Peripheral fundus
A

Evaluation of ocular posterior segment

CLI PEDIA M2 (4 decks)

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