Podcast
Questions and Answers
What is the value subtracted from the sphere gross value for adults during the measurement process?
What is the value subtracted from the sphere gross value for adults during the measurement process?
- 0.50D
- 1.00D
- 1.25D (correct)
- 1.50D
Which age group has its sphere value modified by subtracting 1.00D?
Which age group has its sphere value modified by subtracting 1.00D?
- Children over 2 years (correct)
- Children over 5 years
- Children aged 2 to 3 years
- Children under 1 year
What factors can influence the modification of net sphere value according to age?
What factors can influence the modification of net sphere value according to age?
- Type of lens used
- Environmental light conditions
- Patient's emotional state
- Type of refractive error (correct)
For children under 2 years, how much is subtracted from the sphere?
For children under 2 years, how much is subtracted from the sphere?
What is the assumption made regarding tonic accommodation for adults during the measurement?
What is the assumption made regarding tonic accommodation for adults during the measurement?
What working distance is assumed in the measurement for adults?
What working distance is assumed in the measurement for adults?
What is one of the primary reasons for probing the areas in the case history?
What is one of the primary reasons for probing the areas in the case history?
Which of the following would be considered when assessing the severity of a complaint?
Which of the following would be considered when assessing the severity of a complaint?
What aspect does NOT directly aid in the diagnosis process?
What aspect does NOT directly aid in the diagnosis process?
How is the relief from symptoms assessed in the case history?
How is the relief from symptoms assessed in the case history?
When considering diplopia in a patient, which factor is crucial for establishing the type?
When considering diplopia in a patient, which factor is crucial for establishing the type?
What is an essential question to ask regarding the onset of symptoms?
What is an essential question to ask regarding the onset of symptoms?
Which symptom is least likely to be related to eye turn?
Which symptom is least likely to be related to eye turn?
What type of diplopia is described when there is confusion of images in both eyes?
What type of diplopia is described when there is confusion of images in both eyes?
Which of the following questions would NOT help determine aggravating factors during case history?
Which of the following questions would NOT help determine aggravating factors during case history?
What type of prism should be used for a patient with left esotropia before the right eye while scoping?
What type of prism should be used for a patient with left esotropia before the right eye while scoping?
For a 30 prism left eye exotropia, which prism should be used during retinoscopy?
For a 30 prism left eye exotropia, which prism should be used during retinoscopy?
When dealing with vertical deviations, what should be applied before the fixating eye?
When dealing with vertical deviations, what should be applied before the fixating eye?
In cases where horizontal deviations exceed 15 PD, what is the best practice for retinoscopy?
In cases where horizontal deviations exceed 15 PD, what is the best practice for retinoscopy?
What method is suggested for recording gross findings in near retinoscopy?
What method is suggested for recording gross findings in near retinoscopy?
Which prism should be used in retinoscopy for a patient with 15 right hypertropia while scoping the right eye?
Which prism should be used in retinoscopy for a patient with 15 right hypertropia while scoping the right eye?
What is recommended for patients who are young or have special needs during the retinoscopy process?
What is recommended for patients who are young or have special needs during the retinoscopy process?
What adjustments should be made to align Purkinje images when retinoscopy is performed?
What adjustments should be made to align Purkinje images when retinoscopy is performed?
For patients with esotropia during distant target fixation, what type of prism is suggested for the left eye correction?
For patients with esotropia during distant target fixation, what type of prism is suggested for the left eye correction?
How should gross findings be handled immediately after performing Mohindra retinoscopy?
How should gross findings be handled immediately after performing Mohindra retinoscopy?
How might symptoms of eye turn or diplopia vary in relation to time of day?
How might symptoms of eye turn or diplopia vary in relation to time of day?
Which factor could lead to the onset of eye turn or diplopia?
Which factor could lead to the onset of eye turn or diplopia?
What is a possible change in the symptoms of eye turn or diplopia over time?
What is a possible change in the symptoms of eye turn or diplopia over time?
Which of the following is least likely to be a contributor to eye turn or diplopia symptoms?
Which of the following is least likely to be a contributor to eye turn or diplopia symptoms?
How can patients potentially alleviate their eye turn or diplopia symptoms?
How can patients potentially alleviate their eye turn or diplopia symptoms?
What aspect of medical history is crucial to understanding eye conditions?
What aspect of medical history is crucial to understanding eye conditions?
Which of the following factors is the least relevant when assessing the severity of eye turn?
Which of the following factors is the least relevant when assessing the severity of eye turn?
What maternal factor is critical in the prenatal period related to eye conditions in a child?
What maternal factor is critical in the prenatal period related to eye conditions in a child?
Which of the following is considered a recommended practice in managing pupil eye conditions?
Which of the following is considered a recommended practice in managing pupil eye conditions?
What aspect of infant health could impact the likelihood of future eye conditions?
What aspect of infant health could impact the likelihood of future eye conditions?
What is the primary purpose of using prism in retinoscopy for strabismic patients?
What is the primary purpose of using prism in retinoscopy for strabismic patients?
Which of the following best describes a goal of vision therapy?
Which of the following best describes a goal of vision therapy?
What might be a reason for assessing a child's developmental history in relation to their visual needs?
What might be a reason for assessing a child's developmental history in relation to their visual needs?
When evaluating a child's academic history, which factor is most important?
When evaluating a child's academic history, which factor is most important?
Why is compliance with recommendations significant in therapy programs?
Why is compliance with recommendations significant in therapy programs?
In the context of eye surgeries, which factor is essential for evaluating success?
In the context of eye surgeries, which factor is essential for evaluating success?
Which aspect is important when assessing allergies in relation to medications?
Which aspect is important when assessing allergies in relation to medications?
What is a common reason for children to be included in special classes or tutoring?
What is a common reason for children to be included in special classes or tutoring?
What might be assessed regarding medications during a visual evaluation?
What might be assessed regarding medications during a visual evaluation?
What is a key consideration when determining a child’s visual needs in relation to their career aspirations?
What is a key consideration when determining a child’s visual needs in relation to their career aspirations?
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Study Notes
Case History
- Establishing the diagnosis and prognosis is essential in evaluating patient complaints.
- Frequency, duration, quality, location, and onset of symptoms are critical characteristics to document.
- Chief complaints may include issues like diplopia, asthenopia, or failed screenings.
- Assessing patient awareness of eye turns and potential double vision is vital, including identifying if it’s monocular or binocular.
- Timing of symptoms—persistent or sporadic—can lead to insights about potential triggers and viewing conditions.
- Understanding any modifying factors or actions the patient employs to alleviate symptoms offers additional context.
Onset and Patient Medical History
- Important to note the onset of symptoms, including age of first notice and circumstances surrounding the event (e.g., injury or illness).
- Changes over time regarding symptoms should be tracked, including any improvements or deteriorations in severity or frequency.
- Review overall general health status, including historical illnesses and prenatal, perinatal, and postnatal factors.
Patient Eye History
- Prior evaluations, treatments, and compliance with prescribed interventions (glasses, patching) must be recorded.
- Success of treatments and any alternative therapies applied should be documented.
- Assess vision therapy involvement, goals, length, and efficacy on both short and long-term outcomes.
Developmental and Academic History
- Document milestones in motor and language development, alongside current academic standing.
- Identify any learning difficulties or areas of academic struggle impacting the patient.
Family Eye/Medical History
- Review family history for any eye conditions or related medical issues, such as binocular vision problems.
- Understanding familial patterns can help inform diagnosis and treatment planning.
Goals of Patient/Parent
- Clarify expectations for outcomes from evaluation or treatment, including functional, aesthetic, or other specific health objectives.
Assessing Refractive Status
- Use of retinoscopy on strabismic patients involves specific techniques to capture accurate findings while engaging the patient's focus.
- Horizontal deviations require specific prism applications (BI for exotropia, BO for esotropia).
- Vertical deviations call for neutralizing prisms to ensure the fixating eye can properly view the distance target.
Clinical Pearls for Retinoscopy
- For significant deviations (>15 PD), it may be more effective to perform exams out of phoropter for greater alignment with the patient's gaze.
- Young or special needs patients may benefit from retinoscopy performed outside the phoropter for easier handling.
Near Retinoscopy
- Record gross findings on the optical cross, adjusting values based on the patient’s age and expected levels of accommodation.
- Understand subtractions for sphere gross values based on age to accurately assess refractive error.
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