Station 3: PD, Ret, Phoria, Accomm

Question 1

Entering the room

Answer 1

“Good morning Mr(s). Lee, I’m candidate 392”

• wash hands
• clean phoropter

Question 2

Retinoscopy

Answer 2

• measure and state PD
• set phoropter to PD

“The purpose of this procedure is to objectively determine your refractive error or glasses prescription. I’ll be waving a light back and forth in front of your eyes”

*ret and state findings

Question 3

Refraction

Answer 3

“The purpose of this procedure is to subjectively determine your refractive error or glasses prescription for distance”

*refract and state findings with BCVA

Binocular balance - state findings and BCVA again

Pt education on astigmatism/hyper/myopia

Question 4

Phoria and vergences

Answer 4

“The purpose of this procedure is to determine how well your eyes are aligned”

*12BI OD, 6BU OS

Phorias

• horizontal: buttons on t-shirt, BI/arrow towards nose is exo
• vertical: headlights on car, down arrow is left hyper, up arrow is right hyper

Vergences

• “I’m going to measure the __ vergence ranges at distance. I set the prisms at 0 prism diopters at __ degrees. I will adjust both eyes equally and at the same rate”
• state findings
• vertical: adjust OS only, supra = down, infra = up

Ed
-“the findings show that your eyes naturally tend to rest ___, but your eyes work together to keep you from having symptoms or discomfort”

Question 5

Accommodation

Answer 5

BCC

• “the purpose of this procedure is to test the focusing ability of your eyes. I’ll set the phoropter to the patient’s near PD”
• “where do you normally hold a book to read?”
• vertical = minus, horiz = plus
• stop if >-1.00
• state findings: lag of +__, plano, or lead of -__

NRA/PRA

• full room illumination and direct lighting on card
• take out +/-0.50s, use 20/40 target
• “as I change the lenses, I want you to let me know when you can no longer keep the letters clear. You can blink to try to clear them up. The near base being used is the BCC finding”
• “the NRA is __D relative to manifest refraction final rx”
• “the PRA is __D relative to manifest refraction final rx”

Ed on presbyopia, reading glasses around 40yo