Vision Therapy Evaluation

Question 1

What are some tests to measure Amplitude of Accommodation

Answer 1

Minus Lens Method ( functional Amps)
Push Up method
Pull Away Method

Question 2

How do you do the Minus lens method Amplitude of Accommodation test

Answer 2

pt in phoropter, measurements done at 40 cm ; minus lenses added until it blurs; add 2.50 D to the amt of minus lens added ( working distance)

Question 3

what are some probs with push up amp method

Answer 3

overestimates the amps and sometimes kids don’t understand the directions

Question 4

Describe Accommodative Facility Test

Answer 4

distance: Harmons Distance ; Purpose: test the pts focusing flexibility ; Method: Monocular first and then Binocular performance, Use 20/30 words on rock card, use +2/-2 flippers ; divide the number by 2 to get cpm; when performing binocularly you must control for suppression ( using R/G or polaroid glasses - score of the binocular should be lower than the monocular due to the demand )

Question 5

How do you perform Bell Retinoscopy

Answer 5

Distance : 20 inches, hold wolf wand from above , pt keeps their eyes on their reflection in the ball, scope pts eye ( will see “ with “ motion while moving ball towards pt ) and reflex will change to against motion - note this distance. Move wand away from the pt and note the distance when “with” motion is noted again ; convert each measurement to Diopters, the diff between thet wo is the lag

Question 6

what are the direct measures of accommodation

Answer 6

amplitude of accommodation, accommodative facility, MEM , Bell retin.

Question 7

What are the indirect measures of accommodation

Answer 7

NRA/PRA

Question 8

What is an example test of free space testing

Answer 8

NSUCO

Question 9

How do you perform NSUCO

Answer 9

distance : 40 cm ; methods: pt stands feet shoulder width apart, wolf wands held 20 cm apart for saccades /pursuiits; for saccades pt switches gaze back and forth between the silver wand and the gold wand ( only test horizontal for 5 cycles) ; for pursuits you only need one wand, pt follows one of the wands while you make an imaginary circle with the wand. make 2 circles CW and 2 CCW

Question 10

How do we score NSUCO

Answer 10

for each test we judge the pts ability, accuracy, head movements, and body movements,

Question 11

Which two tests use psychometric testing ( instruments used depend on the response from the pt )

Answer 11

King Devick and Developmental Eye Test

Question 12

How do we perform the King Devick Test

Answer 12

Purpose: tests fine saccades ; gives insight on what happens to reading eye movements over time ; test has early exit pts ; tests for concussions in athletes
Method: Binocular, there are three cards with numbers arranged horizontally with increasing difficulty pt reads them off as fast as they can

Question 13

How do we perform the Developmental Eye Test

Answer 13

Purpose: tests for RAN and saccadic function;
method: Binocular test plate to make sure pt know their numbers, two plates with vertically arranged numbers and a horizontal plated test ; Zscores calculated

Question 14

Which test is an electrodiagnostic test ( objective, accurate measurements of eye movements)

Answer 14

Readalyzer/ Visagraph

Question 15

How do you perform the Readalyzer

Answer 15

Purpose: analyzes a pts reading based on eye movements ;
Method: pt wears goggles while they read , reading level is set two levels below the grade level ; after reading pt answers 10 questions related to the topic

Question 16

How do we perform vergence facilities

Answer 16

distance : 40 cm; Purpose: works on the speed and accuracy of the fast vergence response and endurance ; we expect 8 cpm when done with 8 BI/BO;
methods: use “ look here” card ; time for 60 sec and hold the prisms in front of the pts eyes and start the timer for 60 sec and count they cycles ; Ask the pt when it becomes double and single ; flip the prisms when the object become single and clear - don’t need RG or polaroids bc the pt goes double anyways

Question 17

When do we perform Worth 4 Dot

Answer 17

When stereopsis is below 40 sec of arc

Question 18

what are the 5 major areas we test for a VT evaluation

Answer 18

Visual acuity D/N, Chair Skills, Accommodation, Oculomotility, and Binocularity