Block 16 > BV: BV Testig Basics > Flashcards

BV: BV Testig Basics Flashcards

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1
Q

Expected findings for BO distance vergences

A

9/19/10

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2
Q

Expected findings for BI distance vergences

A

X/7/4

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3
Q

Expected findings for BO near vergences

A

17/21/11

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4
Q

Expected findings for BI near vergences

A

13/21/13

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5
Q

NRA and BAF (plus lenses) indirectly tests ______

A

PFV

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6
Q

PRA and BAF (minus lenses) indirectly tests ____

A

NFV

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7
Q

Assume an AC/A ration of 7:1, when a patient is presented with +2.00 lenses, what happens?

If PFV of X/16/10 enough?

A

14 prism diopters change if exo so PFVs must be used

Yes, patient will not report blur or break

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8
Q

Assume an AC/A of 8:1, when a patient is presented with -2.00 lenses, what happens?

Is NFV of 10/12/8 enough?

A

16 prism diopters change so eso must use NFV

No, patient will report blur or break

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9
Q

In cases where a patient is exophoric only, sheard’s criterion states that the fusional reverse amount should be _____ the fusional demand (phoria)

A

Twice

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10
Q

A patient with a 6pD exophoria should ahve at least ____pD PFV blur

A

12

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11
Q

In cases where a patient is esophoric only, a separate equation may be used called the one-to-one (1:1) rule. This rules states that the opposite ______ should be at least as great as the amount of phoria that you are concerned with.

A

Recovery

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12
Q

A patient with a 10 pD esophoria shows should have at least a ____ pD NFV recovery

A

10

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13
Q

Look at all the examples throughout the lecture

A

Yes bella I’m serious actually do it

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14
Q

3 direct tests of PFV and NFV

A

Smooth Vergence
Step Vergence
Vergence facility

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15
Q

4 indirect tests of PFV and NFV

A

NPC
NRA/PRA
BAF
MEM/FCC

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16
Q

Monocular plus and minus is looking only at the __________ system

A

Accommodative system

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17
Q

Binocular plus and minus will affect both the _______ and ______ system

A

Accommodative and Vergence system

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18
Q

Name the direct and indirect tests of PFV

A

-smooth and step vergences (BO prism)
-Vergence facility (12 pD BO)
-NRA
-BAF (+ lenses)
-NPC
-MEM and FCC (low to lead)

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19
Q

Name the direct and indirect tests of NFV

A

-smooth and step vergences (BI prism)
-vergences facility (3pD BI)
-PRA
-BAF (- lenses)
-MEM and FCC (high lag)

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20
Q

Negative fusional vergences measures __________

Concerns for _____ patients

Directly measured using ______

Indirectly tested utilizing binocular ________

A

Divergence power/reverses

ESO

Base IN

MINUS

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21
Q

Positive fusional vergences measures __________

Concerns for ____patients

Directly measured using _______

Indirectly testes utilizing binocular _______

A

Convergence power/reverses

Exo

Base OUT

PLUS

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22
Q

What does NPC measure?

A

Convergence amplitude or the closest point to a persons face where he eyes can maintain single vision

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23
Q

NPC is a test of _____ fusional vergence

A

PFV

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24
Q

What 4 targets can be used for NPC?

A

Accommodative target
Transilluminator
Transilluminator with red lens
Ligth with red/green lens

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25
Which NPC target can help monitor suppression?
Light with red/green glasses
26
Correction and room illumination for NPC
Habitual/near correction Normal room illumination with stand lamp
27
What two things are measured in NPC?
Break point Recovery point
28
What is the point when the patient reports diplopia or the examiner notices a break in fusion?
Break point
29
What is the point at which an individual regains fusion after fusion has been lost?
Recovery point
30
Repeated testing in NPC suggests first using an _______ target and then using a _________ or ________
Accommodative target Transilluminator or penlight with red/green glasses
31
In NPC, a recovery point greatly different from the break indicates what?
Greater convergence problems
32
NPC recording is in ____
Cm
33
What about the break in NPC should be recorded?
If the break is because of diplopia or suppression
34
If no break is noted on NPC, what should be recorded?
TTN or BON
35
What is the expected value with an accommodative target?
5cm / 7 cm
36
What does vergence facility measure?
vergence flexibility or ability to make rapid repetitive vergence changes over an extended period of time
37
What equipment is used for near vergences facility testing?
3 pD BI / 12 pD BO for near
38
What is recorded in vergence facility?
Number of cycles in one minute
39
1 cycle in vergence facility = clearing both the ______ and _____ sides
BI and BO
40
Vergence facility expected findings
15 cpm +/- 3 cpm 12 cycles per min is the MINIMUM
41
What other than CPM should be recorded with vergences facility testing?
If difficulty is noted on the BI or BO
42
Accommodative amplitude tests what?
How much accommodation the patient has
43
Which tests measure accommodative amplitudes?
Minus to blur Push-up test Pull-away test
44
Accommodative response testing measures what?
How accurate the accommodation is
45
Which tests measure accommodative response?
FCC MEM
46
Accommodative facility testinf measures what?
How flexible the patients accommodation is
47
Which tests measure accommodative facility?
BAF MAF
48
Accommodative amplitudes measures a patients ability to accommodate or focus in ______
Diopters
49
Accommodative amplitudes are measured monocularly or binocularly? At distance or near?
Monocularly at near
50
Why accommodative amplitudes not measured binocularly ?
Because binocularly brings in the influence of NFV and PFV and is no longer solely looking at accommodation
51
Is the patient correct when measuring accommodative amplitudes?
Yes
52
Target for accommodative amplitudes testing
1-2 lines above BCVA of poorer seeing eye at near
53
Accommodative amplitudes are most important to _____________ patients in determine whether their accommodation is sufficient for their age
Non-presbyopic
54
Minimum expected amplitude hofstetter formula
15-0.25(age)
55
Average expected amplitude hofstetter formula
Average = 18.5-0.3 (age)
56
Maximum expected amplitude hofstetter formula
Maximum= 25-0.4(age)
57
Which of hofstetters formulas is used when assessing accommodative dysfunction?
Minimum expected amplitude
58
Which if the hofstetters formulas is used when setting goals for treatment?
Average expected amplitude
59
Purpose of push-up test?
Measure a patients ability to accommodate ( how much )
60
Is push-up to pull-away monocular or binocular?
Monocular
61
Target for push up and pull away tests
Accommodative target 1-2 lines above BCVA of poorer seeing eye
62
How is push-up test performed?
Slowly move this letters closer to the patient until the patient reports a blur
63
How is diopters for accommodative amplitudes determined from the push up test?
1/cm
64
Recording from the push up and pull away method of accommodative amplitudes measures should be what?
Diopters for each eyes
65
How is th pull-away method performed?
Similar to push up but you start with the target close and pull it away
66
What test of accommodative amplitudes measures measures by using minus to stimulate accommodation?
Minus lens to blur
67
Target and room illumination for minus lens to blue test
Letters or block of letters 1-2 lines above the BCVA of the poorer seeing eye Normal room illumination with a stand lamp
68
What should the patient instructions for minus lens to blur?
Tell the patient to keep the letters on the card clear
69
Minus lens to blur procedure
Set up and then add in -0.25 one click at a time until sustained blue is reached Complete for both eyes To calculate the amplitude, count the number of clicks to blue and then add +2.50 to account for the 40cm target distance
70
End point for minus lens to blur
First sustained blur
71
What should;d be recorded in minus lens to blur testing?
Absolute change in lenses +2.50
72
Expected minus lens to blur findings
At least hofstetters minimum for age
73
The point in space conjugate to the retina when the eye is not accommodated
Far point
74
Closest distance at which the human eye can maintain a sharply focused image on the retina
Near point
75
Accommodative response assesses how _______ the patient is using their accommodation
Accurately
76
LAG of accommodation
Underaccommodatinfg to the stimulus and eyes are focused behind the target
77
LEAD of accommodation
Overaccommodating to the stimulus and the eyes is focuses IN FRONT OF the target
78
Purpose of monocular estimation method
To evaluate he accuracy of the accommodative response
79
How is room illumination in MEM?
Normal
80
What distance is MEM performed at?
Harmon’s dostance = distance from the patients elbow to the middle knuckle
81
How is MEM performed?
Retinoscopy with MEM card
82
Should patient wear correction when testing MEM?
Yes
83
How are poor NFVs related to lag of accommodation?
Under-accommadation occurs rather than using NFVs since they are poor
84
How are poor PFV related to lead of accommodation?
Over-accommodation occurs rather than using PFVs since they are poor
85
Lead of accommodation is associated with exophoria or esophoria?
Exophoria
86
Lag of accommodation is associated with exophoria or esophoria?
Esophoria
87
MEM is a test of accommodative response but also ____ test of convergence and divergence (PFV and NFV)
Indirect
88
Expected value for MEM:
+0.25 to +0.75 lag of accommodation
89
FCC purpose
Evaluate the accuracy of the accommodative response
90
FCC can be used to determine a patients _______ point
Binocular near point
91
What else can FCC determine?
A tentative near add power
92
How should th phoropter be set up for FCC?
A tentative near add power
93
How should the phoropter be set up for FCC?
Manoifect refraction in phoropter Set to near PD Sphere wheel on the phoropter should be set to +/- 0.50
94
FCC lighting
DIM lighting
95
Target for FCC
Cross grid on the rotary chart set at 40 cm
96
What should you ask when the patient when performing FCC?
Which lines appear darker and sharper? Up and down or side to side?
97
An initial indication of vertical lines being darker on FCC means what?
LEAD in accommodation
98
An initial indication of horizontal lines being darker on FCC means what?
LAG in accommodation
99
If vertical lines are darker, add _________ until you reach the endpoint
Minus
100
What is the endpoint for FCC/
Horizaontla nd vertical lines equally dark or first horizontal line that’s is darker/sharper
101
Purpose of accommodative facility tests like BAF and MAF/
Test a patients ability to make rapid and accurate accommodative changes under monocular and binocular conditions
102
Accommodative facility is used to differentiate between what two abnormalities?
Vergence (BAF) and accommodative (BAF and MAF)
103
Room illumination and target for BAF and MAF are performed using _______ flippers
+/- 2.00
104
What should you instruct the patient to do on BAF and MAF?
Report when the letters are clear and single
105
Procedure for accommodative facility testing
Place the +2.00 lens in front of both eyes Patient should let you know when the letters are single and clear, the clinician should then flip the lenses to the -2.00 D side and wait for the same response. Continue to flip between the +2 and -2. Coun the number of clear cycles teh patient is able to complete in 1 minute
106
What is recorded for accommodative facility?
Number of cycles completed in one minute
107
If the patient is only able to complete less than 8 cycles and/or notable difficulty is observes on BAF, what should be done?
Occlude one eye at a time and repeat for each eye individually
108
Because MAF only evaluates accommodative function, the patient should be instructed to let the clinician know when the print is ______
Clear
109
Expected accommodative facility findings for adults /13 years and up?
8 cpm BAF 11 cpm MAF
110
Calculated AC/A ration
AC/A = PD + NFD (Pn - Pd) ESO +, EXO -
111
Gradient AC/A ratio
AC/A = pD in phoria / pD in accommodation
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