week 1 Flashcards
T/F: People with poor BV, accommodative, and oculomotor skills can be asymptomatic
True, probably avoiding tasks that would result in their symptoms showing up
Richman says “headache is more likely associated with ___ than with ___”
acc or vergence problems?
HA is more likely associated with accommodative dysfunction than w/ vergence problems (but could be either)
acc dysfunction was found in what % of those with binocular anom?
accommodative dysfunction in 60-80% of patients with binocular dysfunction
what % of non-presbyopes with acc dysfunction had acc insufficiency? acc infacility? acc spam?
- 2% =accommodative insufficiency
- 1% =accommodative infacility
- 5% =accommodative spasm
If there is variation by _ standard deviations or more in pt’s results vs norms, this may indicate an anomaly
2 SD
acc insufficiency test results: amp, lag or lead?, acc facility test?
amp: low
lag
acc facility test: trouble with minus
acc infacility test results: MEM/FCC, NRA/PRA, acc facility test?
MEM and FCC are normal to low
NRA/PRA reduced
acc facility test: trouble with plus and minus
acc excess test results: MEM/FCC, acc facility test?
MEM and FCC low
Facility: trouble with plus
2 tests for amp of acc?
1) Push Up
2) Minus lens to blur
Push up test: Norm vs min formula
Norm: 18.5-(0.3)age
Minimum: 15-(0.25)age
How do you calculate amp in minus lens to blur?
amount of minus in the phoropter (if an emmetrope)plus distance of target (in D) is amp
Ex: 10D of minus in phoropter and target is at 40cm (2.5)=12.5 D amp
D) patient has 12.5D amp
How do the amp results of minus lens to blur compare to push up?
2D less than the push-up method
expected findings for monocular acc facility testing: (with +/-2D flippers)
- age 6-7
- age 8-12
- age 13-30
6-7: 6 CPD +/- 2.5
8-12: 7 CPD +/- 2.5
13-30: 11 CPD +/-5
expected findings for binocular acc facility testing: (with +/-2D flippers)
- age 6-7
- age 8-12
- age 13-30
6-7: 3 CPD +/- 2.5
8-12: 5 CPD +/- 2.5
13-30: USE AMP SCALED
what is amp scaled binocular testing with flippers? what value flippers and what distance do you use?
what score is the cutoff for normal?
- Measure amp with push-up
- Use 45% of that dioptric value as testing distance
- Use 30% of that dioptric value as the lens flipper range
- Flipper used= range/2
Patient is likely to be symptomatic if the BAF score is <10 cpm
what kind of tests can measure lag of acc?
FCC, Knott ret, MEM ret, other near point/dynamic ret techniques (Bell and Book)
How do you calculate amount of lag using Nott Ret?
-see with motion, move back from target till you get neutrality
Lag = AS (in D) – AR (in D)
AS is between pt and target
AR is between pt and dr.
what are are the two most accurate and repeatable measures of the lag via retinoscopy techniques?
Nott and MEM
