Part 2 Exam Techniques Flashcards
common CC: Infants
- eye turn
- excessive tearing
- monocular lid closure
- red eye
- not common but important: shaking eyes, white pupil, not responding to light
common CC: Preschool
- squinting
- avoiding reading/near activities
- closing eyes in sunlight (photophobic)
- rubbing eyes
- head tilts
- eye turns
- clumsy
common CC: School Aged
(same as preschool) +
- can’t see board at school/kindergarten
- failed school screening
VAs from easiest to hardest
- informal tests (fix and follow, resistance to occlusion, fixation preference)
- OKN drum
- Teller acuity (preferential looking)- Gold standard for infants
- Cardiff (preferential looking)
- LEA: 2 alt.forced choice, matching, naming (recognition acuity
- Directionality charts (recognition acuity and directionality)
- HOVT: matching naming (recognition)
- Snellen (recognition acuity)
who is fixation preference most sensitive to
-strabs and anisometropic ambyopes
what age is fixation preference best for and what prism do you use?
< 3 years
10pd vertical prism
when are the preferential looking acuities good to use (Teller and Cardiff)?
6months- 3 years
for Teller acuity, what working distance changes do you have with what ages?
for < or = 6 months= 33cm testing distance
for > 6 months = 55cm testing distance
Cardiff:
- how many cards are there per acuity level
- how many cards do you show at threshold
- test distance
- 3 cards per acuity level
- 2/3 or 3/4 for threshold
- 50cm testing distance
Isometropic potentially amblyopia numbers
astigmatism > 2.50
hyperopia > 5
myopia > 8
anisometropia potentially ambylogenic numbers
astigmatism > 1.50
hyperopia > 1
myopia > 3
what are some options for contortion fields on kids
from easiest to hardest
- non-seeing to seeing, object presentation (binocular)
- non-seeing to seeing, object presentation (monocular)
- FTFC (sticker on nose, for older kids)
ocular deviation tests from lowest to highest level
- gross observation
- Bruckner
- Hirshberg/Kappa/Krimsky
- Cover Test
on the Bruckner test, what can be causes of the brighter eye reflex
- Strabismus (strab eye)
- Anisometropia (higher RE)
- pathology (larger pupil, leukocornia, other)
- false positive (from media opacities)
Bruckner sensitivity/sensitivity shows you:
-pretty good at telling you there is something if there is, but not good at telling you if there is for sure something or not
(specificity better than sensitivity)
