Psychogenic Amblyopia Flashcards
what are the different types of psychogenic amblyopia
- hysterical amblyopia: associated with stress
- malingering: faking it
- Streff syndrome: bilateral juvenile amblyopia; stress trigger
What tricks can you use for malingering amblyopia?
- Use disassociated prisms so they can observe that you changed something.
- give them a strong rx in the horopter so they see blurry.
- use stereo or CS to determine rough VA
What are key findings of streff syndrome
- Distance VA is 20/25 or worse
- Near VA is worse than distance
- They have a really close working distance
- Stereo is reduced
- Tubular VF (VF is the same even when WD is changed- lazy focus)
- Female prevalance 2:1
- Bilateral
- Difficulty in school
- possible clumsiness
How do you treat streff syndrome?
+0.25 - +0.50 lenses for FTW to magnify their F and enhance the ground (periphery) and dorsal pathway (where)
-Depending on the reason for onset of streff, you may want to refer to psychologist even when VA is improved.
What is the critical period?
0-3 years old
What is the sensitive period?
3-6 years old
T/F With strabismus, stereo and color will still be intact
true
T/F Bc you have improved VA, it does not mean you will have improved stereo
true; stereo is due to binocularity
T/F if a patient has central steady fixation and see 20/100 their prognosis to correct VA is much more less.
true; make sure they do the task with amblyopic eye fixating
What are two main objectives in treatment of functional amblyopia
- Establish steady central fixation
2. attain maximum VA
what are other things we hope to accomplish in treating functional amblyopia
- normal oculomotor function
- normal accommodative function
- normal binocularity
- normal spatial and visual information processing ability
What is the treatment sequence
- Optimum refractive correction
- base on cycloplegic refraction and based on improvement in performance and behavior, not by the VA chart.
- full correction of aniso/astigmatism - Behavioral lens prescription
- refractive compensation based upon minimal compensation to achieve desired results
- If you need to cut plus, to it equally.
- undercompensate until fixation is steady and centric
T/F If aniso is > -2D or +1D consider CL
true
