O2A-a

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Author:
sookylala
ID:
159056
Filename:
O2A-a
Updated:
2012-07-22 01:07:50
Tags:
special techniques near add patient types integrating findings
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  1. How much vergence is induced at 6m?
    0.17D
  2. How much vergence is induced at 4m?
    0.17*6/4=0.26D
  3. Why is there a need for relaxation of accomodation
    • consulation anxiety in some px
    • induced vergence at 6m 
  4. What is the range of testing with the HIC?
    • sphere: normal chart
    • cyl: 2 vert fan charts
    • balance: isolate 6/9 letters
    • mono endpt 
  5. Vectographic graphs
    polarised material
  6. Raubitschek Chart?
    • Chevron=tips, blocks=wings and tips
    • add fog 
  7. Stenopaic slit
    • used for high cyl and keratoconous
    • long pinhole- blur circles contracted
    • fog, rotate for bv, reduce fog, rotate 90, reduce for bv deduce cyl
  8. how do cyclopegics work?
    paralyse ciliary muscle and iris constrictor papillae
  9. When would you use cyclopegics?
    •  px reports ast but no apparent rx
    •  unstable endpts in rx/ret
    • convergent strabismus
    • sig esophoria
    • low accom amp
    • obj more positive than sub 
  10. how much deviation of accom is ok before worrying?
    20% from expected amp
  11. cyclo results- what action should be taken when +0.50, +1.00?
    • 1. nothing
    • 2. psuedomyope/ latent hyp 
  12. What is the average result of cyclo? hyp/myp?
    • dry rx+0.50
    • more plus
    • more minus 
  13. what are some problems with cyclo?
    • increase aberrations
    • reduces dof
    • alters accom-conv
    • toxic/allergic effects
    • incon to px
    • lens prescribed cant be worn for long
  14. Tentative add at 20, 44, 60 yo?
    10, 4, 0 loss of 1D every 4  years
  15. For prolonged viewing how much amp is used?
    • normal- 1/2
    • young- 2/3
    • ill- <1/2 
  16. What lighting is used for FCC and UFCC and why?
    • room light/ no additional light- increase depth of focus= less blur
    • this is how they would read with at home
  17. Procedure for testing a presb patient
    • Entering vision: unaided VA/ habitual VA, habitual near VA, amp of accom
    • Obj Rx: ret
    • Subj Rx: refine sphere, cyl,  +1.00D test, balance
    • Near: UFCC, FCC, NRA, PRA, linear range of clear vision 
  18. At what cyl does spectacle effectivity change for near vision?
    >3.5DC
  19. Near cyl method?
    • reduced snellen chart+ JCC- clc retina- spher from FCC
    •  
  20. What is an adequate fog for near JCC on 20yo?
    +3.00
  21. what is UFCC?
    balance accom for near without convergence
  22. Value for UFCC in young adult?
    +1.00+/-0.50
  23. FCC?
    • established accom employed relative to testing distance (with convergence)
    • near base
  24. Value for FCC in young adult? why difference from UFCC?
    • +0.50+/-0.50
    • convergence acting, less accom required 
  25. NRA?
    • how much the px can relax their accom
    • elderly have none so no relaxing
    •  
  26. NRA norms in young adult?
    • +2.25+/-0.25
    • not +10 since that is monocular, cant get that much at 40cm
  27. PRA?
    How much accom can exert
  28. PRA norm in young adult?
    -3.00
  29. in a pre-presbyopic px, where is nra/pra taken from?
    distance sph
  30. in a presbyopic px, where is nra/pra taken from?
    FCC
  31. Linear range of clear vision?
    • dioptric midpoint
    • carried out last
    • chart out then in
  32. What caution should you take when prescribing a psuedomyope?
    • limit -ve lenses!
    • try an add instead! :)
    • review in 6 months 
  33. What clues are there to exposing a psuedomyope?
    • asthenopia more severe
    • intermittance distance blur
    • reduced/varible va
    • low amp accom fr age
    • more minus on subj/ret than normal 
    • ret fluctiations
    • minus lenses dont provide much clarity
    •  clinical history of anxiety
    • bv abnorm 
  34. what risks are there when it comes to hyperopes?
    • strabismus/ amblyopia in children
    • what stage should you prescribe? 
  35. What is the problem with hyperopic children and ast
    • low a causes more asthenopia
    • larger a= px gives up trying 
  36. Should 0.50DC be prescribed?
    • old- yeah may need it
    • if sphere is rly huge
    • must be able to improve vision couple of letters 
  37. never ______ prescrbie cyl!
    over, always lesser cyl value
  38. what counts as anisometropia in hyp/myp/ast?
    • >1
    • >2
    • >1.5 
  39. What considerations need to be amde for anisometropia?
    correct dominant eye to best va
  40. what is meant by the apparent early onset of pres?
    • latent hyp becoming manifset
    • only give px 'reading' glasses
    • do not over correct add 
  41. how to treat an amblyope?
    • aniso: fully correct good eye
    • and mpmva amb eye
    • BV training 
    • iso:
    • full rx BE goal in stages
    • BV training 
  42. Cutoff considerations for child age 1
    • myp: -3
    • hyp: +4.5
    • ast(no):2.5
    • aniso(hyp):2
  43. Cutoff considerations for child age 3
    • myp: -1.5
    • hyp: +3
    • ast(no):1.5
    • aniso(hyp):1
  44. Cutoff considerations for child age 5
    • myp: -1
    • hyp: +1.5
    • ast(no):1
    • aniso(hyp):1

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