Lecture 10 accommodation

Question 1

Should you use WNL when recording accommodation?

Answer 1

NO we never looked!

Question 2

is the process whereby the dioptric power of the crystalline lens changes so that an in-focus retinal image can be maintained on the fovea
–describes (normal/abnormal) accommodation?

Answer 2

normal

Question 3

Accommodation is (non/consensual) and usually (unequal/equal)

Answer 3

consensual, equal

Question 4

What is part of the near triad in accommodation?

Answer 4

convergence, miosis, accommodation

Question 5

-Tension on ciliary muscle released
-Capsule flattened
-Decrease in dioptric power
describes (negative/positive) accommodation

Answer 5

negative

Question 6

PSNS stimulated
A. Ciliary contraction
B. Ciliary body moved forward
C. Ligament tension released
D. Lens becomes more convex
Increase in dioptric power
describes (negative/positive) accommodation

Answer 6

positive

Question 7

invertebrates have (no/positive/negative) accommodation

Answer 7

no

Question 8

amphibians have (no/positive/negative) accommodation

Answer 8

positive

Question 9

fish (no/positive/negative) accommodation

Answer 9

negative

Question 10

humans have (no/positive/negative) accommodation

Answer 10

both positive and negative

Question 11

T/F birds have much better accommodation than humans

Answer 11

T

Question 12

-Depends on the tone of the ciliary body
Strongly controlled by convergence and fusion
-Darkness removes the appreciation of blur
-Somewhat controlled by the shift of spectral sensitivity and chromatic aberration
-“Standby” position of the lens in the dark
-Night myopia or empty field myopia

is which kind of accomodation:
A)Reflex accommodation
B)Tonic Accommodation
C)Convergence-Accommodation
D)Psychic or Near Accommodation

Answer 12

tonic accommodation

Question 13

• Stimulated by the quality of retinal images
• Blur signals or defocus signals
• PSNS pathway: CN 3 to short posterior ciliary nerves to the ciliary body, increases power of lens

is which kind of accomodation:

A)Reflex accommodation
B)Tonic Accommodation
C)Convergence-Accommodation
D)Psychic or Near Accommodation

Answer 13

reflex accommodation

Question 14

• Also known as relative accommodation
• As the convergence angle is changed, the accommodation must increase to see a target nearer and nearer
• Ratio of Convergence Accommodative to -convergence: CA/C
• Low illumination and low CA/C ratio are strong drivers for near work induced myopia*

is which kind of accomodation:

A)Reflex accommodation
B)Tonic Accommodation
C)Convergence-Accommodation
D)Psychic or Near Accommodation

Answer 14

convergence accommodation

Question 15

-Accommodation induced by the awareness of -nearness of target
-Microscopes
-Auto-refractor
-Eyestrain
-Charts less than 20ft
is which kind of accomodation:

A)Reflex accommodation
B)Tonic Accommodation
C)Convergence-Accommodation
D)Psychic or Near Accommodation

Answer 15

psychic accommodation

Question 16

T/F when accommodation is changed , convergence is also changed

Answer 16

T

Question 17

When measuring accommodation you use (minus/plus) lenses to induce accommodation

Answer 17

minus

Question 18

When measuring accommodation you use (plus/minus) lenses to relax accommodation

Answer 18

plus

Question 19

(lead/lag) is slighly more than is needed when measuring accuracy of accommodation

Answer 19

lead

Question 20

(lag/lead) is slighly less than is needed when measuring accuracy of accommodation

Answer 20

lag

Question 21

Most normal people show a (lead/lag) of about +0.50D

Answer 21

lag

Question 22

T/F in normal accommodation sustained reading of about 40 cm should be at least 2 hours

Answer 22

T

Question 23

T/F In normal accommodation it is expected for there to be a intermittent accommodation at 5-8’’ for short periods of time

Answer 23

T

Question 24

T/F in donders table there is a increase in amplitude of accommodation with increase in age

Answer 24

F There is a decrease in amplitude of accommodation with increase in age

Question 25

``` At age 40 their is an expected amount of amplitude of accommodation of __ A)15 B)6.5 c)4.5 d) 7.5 ```

Answer 25

4.5

Question 26

Hofstetter's formuli | is the _(average/maximum/minimum)__ expected accommodative amplitude:18.5-(0.30)(age)

Answer 26

Average

Question 27

- average expected accommodative amplitude - Maximum expected accommodative Amplitude - Minimum expected accommodative amplitude a.18.5-(0.30)(age) b.15-(0.25)(age) c.25-(0.40)(age) match them to correct formula

Answer 27

Maximum expected accommodative Amplitude= 25-(0.40)(age) Minimum expected accommodative amplitude= 15-(0.25)(age) Average expected accommodative amplitude= 18.5-(0.30)(age)

Question 28

Hofstetter's formuli | is the _(average/maximum/minimum)__ expected accommodative amplitude:25-(0.40)(age)

Answer 28

maximum

Question 29

Hofstetter's formuli | is the _(average/maximum/minimum)__ expected accommodative amplitude: 15-(0.25)(age)

Answer 29

minimum

Question 30

when using +/- 2.00 flipper you want to note how many ____ per minute the pt can see (with/wihtout) blur

Answer 30

cycles, without

Question 31

If less than 8cpm with flipper of +/-2.00 that the pt can see without blur you want to repeat test(binocularly/monocularly)

Answer 31

monocularly

Question 32

__ flips equals 1 cycle

Answer 32

2

Question 33

Inability to relax from the accommodative lead, some of which is experienced by the patient as an interference with distance vision --describes what accommodative (excess/spasm/insufficiency)

Answer 33

spasm

Question 34

``` Children 8-12 years old will have a __ cpm binocularly/ __cpm monocularly A)5 -7 B)6-8 c)4-5 d) 7-8 ```

Answer 34

5-7

Question 35

``` Adults 13-30 y: __ cpm binocularly/__ cpm monocularly A)10-11 B)11-13 c)4-5 d) 7-8 ```

Answer 35

10-11

Question 36

``` Monocular findings should be within __cpm for each eye. A)5 B)6 c)4 d) 7 ```

Answer 36

4

Question 37

-The lag is abnormally high - e.g. 5D accommodation is required, yet 4D is the accommodative response (less) (1/5=.20 1/4= .25) -The response is reduced for the patient’s age - Clearing additional minus power at near is difficult for this patient - -describes what accommodative (excess/spasm/insufficiency)

Answer 37

Accommodative Insufficiency

Question 38

Abnormally high lead, e.g. 5D accommodation required, yet the accommodative response is (more) 5.75D. Usually seen in younger patients. Clearing additional plus lens power is difficult for this patient.

Answer 38

Accommodative Excess