Presbyopia

Question 1

At 40 cm, “add” for 40-45 years old

Answer 1

+0.75 to +1.00 add

Question 2

At 40 cm, “add” for 45-49 years old

Answer 2

+1.00 to +1.50

Question 3

At 40 cm, “add” for 50-54 years old

Answer 3

+1.50 to +2.00

Question 4

At 40 cm, “add” for 55-59 years old

Answer 4

+2.00 to +2.25

Question 5

At 40 cm, “add” for 60-65 years old

Answer 5

+2.25 to +2.50

Question 6

At 40 cm, “add” for over 65 years old

Answer 6

+2.50 or greater for mag

Question 7

A person with cataract surgery needs an “add”, what power do you give them? Why?

Answer 7

+2.50

They can’t accommodate fir the stimulus at 40 cm.

Question 8

2 most important things when determining add for presbyopes

Answer 8

1) Occupational demands

2) Near working distances

Question 9

True or False:

“Never cut the total near plus on a presbyope”

Answer 9

True

Question 10

True or False:

FCC usually works better for older or more established presbyopes.

Answer 10

True

Question 11

Purpose of NRA/PRA Balance (Middle third method)

Answer 11

Puts the patients accommodation in the middle of the PRA/NRA range, with the nets being equal.

Question 12

What is the minimum plus method to 20/20 to find the patient’s near lens?

Answer 12

Add plus lenses until they can just barely read the 20/20 line. Then give them an extra +0.50D for good measure.

Question 13

What does FCC test measure for presbyopes?

Answer 13

Add power

Question 14

Why might a presbyope not report the vertical lines as darker when doing the FCC test?

Answer 14

You may not have blurred them enough. Older patients may need close to 2.50D of blur instead of 1.25D (5 clicks)

Question 15

If you do near retinoscopy at 67 cm, what must you add or subtract to find their prescription at near?

Answer 15

Since retinoscopy is -1.50D working distance and their accommodation at 40 cm is +2.50, it would result in them needing 1.00D of accommodation

SO….

Add +1.00D on their retinoscope rx.

Question 16

If a presbyope has been using a +3.00D add and you retest their manifest, run the FCC, and get their add to be +2.00D, what do you prescribe them?

Answer 16

You give them a +3.00D add because you never cut plus on a presbyope unless they complain of holding object too close.

Question 17

If a patient has a lower add, they will have a _______ range where they can see clearly at near.

Answer 17

larger

Question 18

If a patient has a high add, they will have a _______ range where they can see clearly at near.

Answer 18

shorter

Question 19

With a patients near ranges, if they can read closer in more easily than further out, the add is too much _____.

Answer 19

plus

Question 20

With a patients near ranges, if they can read further out more easily than closer in, the add is too much _____.

Answer 20

minus