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Z. Vision Therapy — Class Final > OMD > Flashcards

OMD Flashcards

1
Q

A sensorimotor deficit of the visual system characterized by poorly executed and inaccurate eye movements

A

OMD

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2
Q

Sx of OMD (5)

A

While reading…
1. Head movement
2. Use of fingers
3. Skipping words
4. Slow reading speed
5. Poor comprehension

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3
Q

Reading involves what two ocular movements

A
  1. Fixations
  2. Saccades
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4
Q

Irregular, involuntary flicks of fixation off a target, followed by saccade onto target

A

Saccadic Intrusion

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5
Q

Saccadic intrusion is associated with what severity of OMD?

A

Moderate to severe

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6
Q

Small SI may be found in… (4)

A
  1. Elderly
  2. Strabismus
  3. Dyslexia
  4. Extreme fatigue
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7
Q

Large SIs are associated with… (2)

A
  1. Cerebellar disease
  2. Multiple sclerosis
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8
Q

Congenital vs. Acquired: which type of Nystagmus is MORE concerning?

A

Acquired

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9
Q

Congenital vs. Acquired: which type of Nystagmus is LESS concerning?

A

Congenital

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10
Q

Congenital Nystagmus is associated with… (3)

A
  1. Albinism
  2. Achromotopsia
  3. Leber’s
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11
Q

Acquired nystagmus is associated with… (6)

A
  1. Stroke
  2. Multiple Sclerosis
  3. Head trauma
  4. Parkinson’s
  5. Brain Tumor
  6. Cerebellar Disease
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12
Q

Pendular vs Jerk: bidirectional, slow/equal in both directions

A

Pendular

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13
Q

Pendular vs Jerk: slow phase, followed by a fast phase

A

Jerk

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14
Q

Jerk nystagmus is named after the ___ (fast/slow) phase

A

FAST

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15
Q

Jerk Nystagmus: slow to the left, fast to the right would be called

A

RIGHT jerk nystagmus

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16
Q

Jerk Nystagmus: slow to the right, fast to the left would be called

A

LEFT jerk nystagmus

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17
Q

FUNBLOCS is associated with…

A

Congenital Nystagmus

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18
Q

Pendular Nystagmus is associated with:

A
  1. Albinism
  2. Achromotopsia
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19
Q

FUNBLOCS stands for

A

Fixation —> worsens nystagmus
Upgaze —> remains horizontal
Null point exists
Bilateral & conjugate
Latent component
OKN not superimposable
Convergence —> dampens
Symptomless (no oscillopsia)

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20
Q

Treatment for Nystagmus (7)

A
  1. Correct RE
  2. Promote convergence (BO prism, closer working distance, surgery)
  3. Position to null point (yoked prism, surgery)
  4. Feedback (tactile — e.g. CL, auditory, visual)
  5. VT
  6. Low vision aids
  7. Pharm injections
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21
Q

In Acquired Nystagmus, what occurs in upgaze?

A

Converts to upbeat

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22
Q

Defective pursuits in elementary aged pts can be attributed to lack of… (3)

A
  1. Development
  2. Attention
  3. Experience
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23
Q

Defective pursuits in adults pts can be attributed to: (5)

A
  1. Neurological dysfunction
  2. Drugs
  3. Fatigue
  4. Emotional stress
  5. Test anxiety
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24
Q

Defective pursuits in adults pts can be attributed to: (5)

A
  1. Neurological dysfunction
  2. Drugs
  3. Fatigue
  4. Emotional stress
  5. Test anxiety
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25
Q

Monocular eye movement is also known as

A

Ductions

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26
Q

Binocular eye movement is also known as

A

Versions

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27
Q

Objective assessments of fixation (2)

A
  1. Visagraph
  2. RightEye
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28
Q

A normal/expected result for fixation would be:

A

Stability x 10 sec

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29
Q

In Gross Observation of Pursuits, the Wolff wand should be moved:

A

Horizontally, vertically, and in circular motions

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30
Q

In the NSUCO evaluation of Pursuits, the Wolff wands…

A

Are rotated CW x2 and CCW x2

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31
Q

When evaluating NSUCO for pursuits, we should also check for _____ (e,g, rolling tongue, moving eyebrows, etc)

A

Motor Overflow

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32
Q

Following normal NSUCO Pursuits, it should be repeated with…

A

Cognitive Loading (simple questions asked simultaneously)

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33
Q

What should be ruled out in the assessment of saccades?

A

Uncorrected RE and poor attention

34
Q

Developmental Eye Movement Test (DEM) is used to evaluate ___ and ___ of fine saccades

A

Accuracy and speed

35
Q

Developmental Eye Movement Test (DEM) is used to identify ___ and/or ___

A

OMD and/or learning-related automaticity deficits

36
Q

The norms for DEM test are for _____ (age range)

A

6y0m — 13y11m (but can be performed on pts >14)

37
Q

The norms for DEM test are for _____ (age range)

A

6y0m — 13y11m (but can be performed on pts >14)

38
Q

T/F: The pt is permitted to use their fingers during the pre-test (during DEM test)

A

TRUE

39
Q

DEM: A substitution error indicates that a number was ___ and is signified by a ___ symbol

A

Misnamed; “/“

40
Q

DEM: An omission error indicates that a number was ___ and is signified by a ___ symbol

A

Skipped; circle (circle the letter skipped)

41
Q

DEM: An addition error indicates that a number was ___ and is signified by a ___ symbol

A

Added; “+”

42
Q

DEM: A transposition error indicates that a number was ___ and is signified by a ___ symbol

A

Read out of sequence; arrow

43
Q

DEM: Vertical time score is calculated by:

A

Adding Test A and Test B time

44
Q

DEM: What is the “essence” of DEM?

A

Compare vertical time with horizontal time

45
Q

DEM: How do you calculate Horizontal Adjusted Time?

A

Time x (80/(80 - o + a))

46
Q

DEM: “Ratio” refers to

A

Horizontal Adj. TIme/Vertical Adj. Time

47
Q

DEM: vertical columns are mainly used to determine a pt’s

A

Rapid automatized naming (RAN)

48
Q

DEM: horizontal columns are used to

A

Simulate usual reading demands

49
Q

DEM: what is the following outcome?
Horizontal — increased
Vertical — normal

A

OMD dysfunction

50
Q

DEM: what is the following outcome?
Horizontal — increased
Vertical — normal

A

OMD dysfunction

51
Q

DEM: what is the following outcome?
Horizontal — increased
Vertical — increased
*approximately the same

A

RAN deficit

52
Q

DEM: what is the following outcome?
Horizontal — increased (more than vertical)
Vertical — increased

A

OMD dysfunction + RAN deficit

53
Q

Generally, a score at least ___ SD away from the norm usually indicated deficiencies

A

One

54
Q

Generally, a score at least ___ SD away from the norm usually indicated deficiencies

A

One

55
Q

DEM: what percentile is considered significant?

A

≤ 16%

56
Q

Percentile considered:
Above average — ?
High average — ?
Average — ?
Low average — ?
Poor — ?

A
57
Q

T/F: King Devick is better for older children/adults

A

FALSE

58
Q

T/F: King Devick can differentiate between OMD and RAN deficits

A

FALSE

59
Q

The visagraph is used to determine ___

A

Reading efficiency

60
Q

Advantages of Visagraph? (3)

A
  1. Objective measurement
  2. Permanent recording
  3. More sophisticated information
61
Q

Visagraph should be performed at what reading level?

A

One grade below reading level (based on case history or practice)

62
Q

What types of questions are asked after a paragraph is read on a visagraph?

A

True/False Questions

63
Q

Visagraph: how many questions correct to be considered valid?

A

7 out of 10

64
Q

Visagraph: if reading difficulty is decreased but efficiency does not improve, ___

A

OMD

65
Q

Visagraph: if reading difficulty is decreased and efficiency improves, ___

A

Reading Problem

66
Q

Principles of Oculomotor Therapy (3)

A
  1. Visual motor support (using a pointer)
  2. Visual motor integration (motor task while reading, eg. Michigan Tracking)
  3. Cognitive Loading (adding distractors; simulates real world scenario)
67
Q

What is the FIRST thing to do when training saccadic eye movements?

A

Ensure pt is able to maintain fixation on a stationary target

68
Q

Which is easier and thus should be trained first, when training saccadic eye movements: gross or fine saccades?

A

GROSS

69
Q

Which is easier and thus should be trained first, when training saccadic eye movements: slow or fast saccades?

A

SLOW

70
Q

When training saccadic eye movements, it is best to start: monocularly or binocularly? How do you know when to move on to the other?

A

Train monocularly until both eyes are trained equally

71
Q

One general approach in saccadic training is to develop _____ saccades, which means that eye movements should not be more difficult with cognitive loading

A

Automated

72
Q

In saccadic training, what should be eliminated if possible? (4)

A
  1. Overshoots
  2. Undershoots
  3. Regressions
  4. Inefficient return sweeps
73
Q

When training pursuit eye movements, to increase difficulty, how could you increase vergence demand?

A

Add prism

74
Q

How to increase difficulty with Four Corner Saccades (4)

A
  1. Move pt farther from wall (decrease saccades)
  2. Perform in random pattern
  3. Increase speed
  4. Incorporating cognitive loading
75
Q

How to decrease difficulty with Four Corner Saccades (4)

A
  1. Move pt closer to wall (makes saccades larger)
  2. Follow a CW or CCW pattern
  3. Decrease speed
  4. Allow use of pointer
76
Q

Oculomotor Training Techniques: Basic (4)

A
  1. Thumb Rotator
  2. 4 Corner Saccades
  3. Flash Light Tag
  4. Marsden Ball (Follow)
77
Q

Oculomotor Training Techniques: Intermediate (4)

A
  1. Keystone/Pegboard Rotator
  2. Hart Chart Saccades
  3. Large Michigan Tracking
  4. Marsden ball (catch/hit w/ hand)
78
Q

Oculomotor Training Techniques: Advance (4)

A
  1. Rotator w/ loading
  2. Hart Chart Saccades w/ loading
  3. Smaller Michigan Tracking
  4. Marsden ball bunt w/ loading
79
Q

How to increase difficulty with Hart Chart saccades? (3)

A
  1. Move pt further from wall (smaller saccade)
  2. Read lines closer together (eg columns 4 & 7)
  3. Add loading
80
Q

How to decrease difficulty with Hart Chart saccades? (3)

A
  1. Move pt closer to wall (larger saccades)
  2. Have to read lines further apart (eg columns 1 & 10)
  3. Allow use of pointer

Z. Vision Therapy — Class Final (7 decks)

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