Misc - Luviano

Question 1

Acquired Myopia - globe/cornea/ciliary power & shift

Answer 1

Globe (increased AL)- posterior staphyloma, congenital glaucoma, scleral buckle, ROP, progressive myopia

Cornea (INCREASED K POWER) - keratoconus, laser surgery, cornea ectasia, CL warp, congenital glaucoma

Ciliary power - excess accomodation, antihistamine

Ciliary shift - sulfa medications, topomax, toxemia of
pregnancy, miotics, tetracycline

Question 2

Acquired Myopia - lens/drugs

Answer 2

Lens - (INCREASED lens power), cataract, anterior lenticonus, anterior dislocation, diabetes, galactosemia, uremia, sulfonamides

Drugs - Miotics (like pilocarpine), CAIs, topomax, antihistamines, tetracycline

Question 3

Acquired Myopia - congenital/systemic/trauma

Answer 3

Congenital - glaucoma, ROP
Systemic - diabetes, pregnancy, Marfan’s syndrome, tumors
Trauma - anterior dislocation of lens, scleral buckle

Question 4

Calculating bifocal power - table of Donder’s method

Answer 4

Before 40 yo, accommodation decreases 1 D q4years
@ 40 yo: accommodation = 6D
s/p 40 yo: accommodation decreases 1.5 D q4years
s/p 48 yo: accommodation decreases 0.5 D q4years

Question 5

Calculating bifocal power - amplitude method of spheres

Answer 5

M.D. gives patient 1/2 of their amplitude as add power
Obain BCVA @ 40 cm (write prescription)
Add minus power until letters are blurred (write this prescription)
Next add plus power until letters are blurred (write this prescription)
Dioptric difference between the two written prescriptions = amplitude range

Question 6

Calculating bifocal power - prince rule method

Answer 6

M.D. gives patient 1/2 of their amplitude as add power:
Add +3.00 to the patient’s distance BCVA (brings near to 33 cm)
Measure length of how close the card can be moved to patient
Convert this distance to diopters
Amplitude = difference from far point to near point

Question 7

Calculating bifocal power - clinical method

Answer 7

M.D. adds plus power with phoropter until patient is able to read comfortably at 33 cm

Question 8

Acquired hyperopia - globe/cornea/ciliary power & shift

Answer 8

globe (DECREASED AL) - retrobulbar tumor/ mass, silicone oil, choroid hemorrhage or tumor,

cornea - refractive surgery, flat cornea 2/2 CL,
conductive keratoplasty

ciliary power - tonic pupil (poor accommodation), CN3 palsy, posterior rotations

Question 9

Acquired hyperopia - lens/retina/drugs

Answer 9

Lens (DECREASED refractive power) - presbyopia, refractive, lens posteriorly dislocated, aphakic

Retina - fluid, trauma, central serous retinopathy

Drugs - marijuana, antihistamines, chloroquine, benzodiazepines

Question 10

Acquired astigmatism

Answer 10

Lid lesion (tumor, chalazion, ptosis)

Pterygium, limbal dermoid, K degeneration/ectasia

Surgery (cornea, cataract)

Lenticular

Ciliary body tumor