Suppression Tests: worth 4 dot and 4BO test Flashcards

(28 cards)

1
Q

what is Worth’s 0 degree of fusion

A

no sensory fusion- suppression/monocular vision (may also have diplopia)

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2
Q

What two tests can be used when central suppression scotoma is suspected

A

Worth a-Dot and 4-Prism Base Out tests

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3
Q

what is Worth’s 1st degree of fusion

A

simultaneous fusion- diplopia/confusion

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4
Q

what is Worth’s 2nd degree of fusion

A

flat fusion/superimposition- no diplopia, no stereo, has motor fusion

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5
Q

what is Worth’s 3rd degree of fusion

A

stereopsis (highest degree)- ultimate sensory fusion

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6
Q

how do you test for the highest level of stereopsis (degree 3)

A

use Randot (VAC) stereo test

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7
Q

what is suspected if the patient has less than 40 sec of arc on the Randot stereo test

A

suspect suppression or a central scotoma

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8
Q

what test is used for flat fusion (degree 2)

A

the Worth 4 Dot test

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9
Q

what must the patient have in order to do the Worth 4 Dot test

A

flat fusion at 40cm

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10
Q

what does the Worth 4 Dot test for

A

binocular central suppression scotoma

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11
Q

when do you stop moving away from the patient with the Worth 4 Dot test

A

when there is a change in the number of dots seen or 3m

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12
Q

what happens if the patient covers one eye and the dots reappear

A

the patient has a scotoma under binocular conditions

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13
Q

what happens if the patient covers one eye and the dots do not reappear

A

the scotoma is under monocular conditions of the eye uncovered (check both eyes separately)

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14
Q

how many dots should the patient be able to see with only the OD

A

2 red

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15
Q

how many dots should the patient be able to see with only the OS

A

3 green

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16
Q

what does the patient have if they see 2 red dots binocularly

A

they are suppressing OS

17
Q

what does the patient have if they see 3 green dots binocularly

A

suppressing OD

18
Q

what does the patient have if they see 5 dots binocularly

A

not fusing images - diplopia

19
Q

what does the patient have if they see 5 dots and the red dots are to their right

A

uncrossed diplopia (ESO deviation)

20
Q

what does the patient have if they see 5 dots and the red dots are to their left

A

crossed diplopia (EXO deviation)

21
Q

what does the patient have if they see 5 dots and the red dots are below the green dots

A

Right hyper-deviation

22
Q

what does the patient have if they see 5 dots and the red dots are above the green dots

A

left hyper-deviation

23
Q

what 3 things do you record for the Worth 4 Dot test

A

test distance, fusion or suppression, and Exo, Eso, R hyper or L hyper

24
Q

what are 4 situations you would want to use the Worth 4 Dot test

A

determine suppressing eye (less than 40 sec arc), differential diagnosis of unilateral decreased VA (NIPH), detect small unilateral central scotomas, and preschool children

25
when would you use a 4BO prism test
to check for central scotomas (slightly reduced VA, mildly reduced stereo (30-80 sec arc), small angle strabismus, and macular diseases)
26
what type of target does the patient look at during the 4BO prism test
a single letter one line above better seeing eye
27
what is a normal response to the 4BO prism test
version and vergence on both eyes (separately)
28
what is an abnormal response to the 4BO prism test
neither eye moves in response to the prism (the eye that doesn't move = suppressing eye because no diplopia occurred)