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OTM2 Exam With Complete Solutions 100% Verified
determines the closest point to the patient at which single vision can be maintained -ANSWER NPC
the distance from the patient's corneal plane (or spectacle plane) to the target -ANSWER Break measurement
after obtaining your break point, while moving the target back from the patient. you seethe eye turn and fixate. what kind of measurement is this - ANSWER objective
if the patient reports double or single vision during NPC, what type of measurement isthis - ANSWER subjective
the distance from the patient's corneal plane (or spectacle plane) to the single target -ANSWER recovery measurement
what should you record if the patient never reports doubling of the target? - ANSWERsuppression
if examiner was able to move target to the bridge of the nose without the patient losingfixation or reporting doubling of the target then record - ANSWER TTN
normal break point NPC - ANSWER 3-5 cm abnormal break is recorded as greater than - ANSWER 12 cm "normal" recovery is within - ANSWER 3 cm of break point
assess the presence and measure the magnitude of a heterophoria or a heterotropia -ANSWER Cover test
waiting 3 seconds after uncovering one of the eyes during UCT allows for the patient toattempt to - ANSWER recover BV after uncover
endpoint of prism neutralization is where - ANSWER no movement is seen (can split thedifference if more than one power)
movement is observed in ACT but no movement is seen in UCT - ANSWER phoria movement is seen in both the ACT/UCT - ANSWER tropia no movement is seen in either UCT or ACT - ANSWER ortho if VA is unequal, then prism bar should be placed over the - ANSWER better seeing eye(usually non-deviating)
neutralizes ESO movements - ANSWER base OUT neutralizes EXO movements - ANSWER base IN Morgan's Norms for Distance - ANSWER 1 ESOphoria -- 2 EXOphoria morgan's norm's for near - ANSWER ortho-- 6 exophoria literature cites this amount as required for comfortable near work - ANSWER 4-6 PDexophoria
"important" - ANSWER objective an accommodative target is generally used for - ANSWER pre-presbyopes BOTH an accommodative target and a non-accommodative target - ANSWER fixationstick
transilluminator target generally used for - ANSWER presbyopes if TTN then no - ANSWER recovery an entrance test that determines the patient's resting position of their eyes (whendissociated) - ANSWER cover test
cover test measures tonic - ANSWER convergence at distance excessive tonic convergence = - ANSWER eso deficient tonic convergence = - ANSWER exo measures: -tonic convergence-accommodative convergence -proximal convergence at near - ANSWER Cover test ONLY looking at ____ eye for both UCT + ACT - ANSWER uncovered During ACT, you should move the occluder directly across to maintain - ANSWER
dissociation UCT; as soon as you see movement = - ANSWER tropia if you notice movement after removing the occluder, is this a tropia? - ANSWER no! what is the MOVEMENT of the eyes? - ANSWER IN, OUT, UP, DOWN if patient is orthophoric... - ANSWER neutralize with base in/base out and check for firstsign of movement, the middle point is your magnitude
when covering the trope eye, what will happen to the other eye if still fixating on target -ANSWER no movement
L. esotropia cover OD (fixating eye)Os will move ___ to re-align to its image - ANSWER out
in this procedure, the patient is fogged in both eyes and has to compare the degradationin acuity between the two. (not a true binocular test) - ANSWER successive alternate occlusion successive alternate occlusion: present an isolated line of letters; typically ____ worse than BCVA - ANSWER 3 lines if one eye is only fogged by +0.50 to +1.00, foveal vision is - ANSWER suspended in thateye
acuities? - ANSWER Humphriss Immediate Contrast test what does RAMGAP stand for? - ANSWER red add minusgreen add plus
purpose of binocular balance - ANSWER Equalize the stimulus to accommodationbetween the two eyes
true or false: Binocular balance purpose includes equalizing the visual acuity between the two eyes. -ANSWER false!
accommodation is more relaxed in the - ANSWER binocular state the patient can accommodate different amounts in the _____ state - ANSWER monocular Binocular = - ANSWER both eyes open, ONE image seen one image seen with both eyes open = - ANSWER binocular both eyes open, TWO images seen = - ANSWER biocular changes the focal point without lenses (only brings focal point forward) - ANSWERaccommodation
only for patients with equal VA's; allows for successive comparison - ANSWER alternateocclusion
during alternate occlusion, you will add +0.25 to the - ANSWER clearer seeing eye alternate occlusion: you add +0.25 to the clearer seeing eye (let's say OD) now they report equality what should you do next? - ANSWER add +0.25 to OD to check for reversal. pt should now report OS is clearer Alternate occlusion:once balanced appropriately, come out of the fog _____ to BCVA OU - ANSWER binocularly a disadvantage of this test includes: a high heterophoria makes comparison moredifficult due to movement of letters - ANSWER alternate occlusion
disadvantages of alternate occlusion: - ANSWER -more difficult to make successivecomparison than a simultaneous one -high heterophoria makes comparison more difficult -undesirable to teach patient's to compare VAs in each eye simultaneous-comparison test - ANSWER vertical prism dissociation patient sees two images at the same time and compares
goal of duochrome binocular - ANSWER red and green wavelengths appear equidistantfrom the retina
chromatic abberation is more noticable with - ANSWER larger pupils (why we doduochrome in the dark)
simultaneous comparison test; not based on visual acuity - ANSWER duochrome duochrome test: -fog OD +0.75-looking at the top line, on which side can you expect the patient to report the letters blacker/sharper or more distinct? - ANSWER red side (OD fogged, moves in front ofretina)
this test provides an indication of the accommodative status of your patient whileviewing a near target. this test contributes to a functional analysis when over- or under- accommodation at near is suspected (younger patients) and used to find a tentative addfor a presbyope. - ANSWER FCC
when nearing the spherical endpoint during duochrome, an eye that reports the letterson the red background to be slightly clearer/darker with more defined borders may be slightly - ANSWER residually myopic (focus is in front of the retina) vergences at distance: purpose includes being able to measure through the applicationof prism, the patient's ability to use horizontal vergences to maintain - ANSWER binocular fusion duochrome test: what does it mean if the patient reports there is no change no matter what type andamount of lenses you add? - ANSWER suppression
when measuring vergences at distance: prisms, which induce retinal disparity, are gradually increased in power, forcing thepatient's ____ system to compensate for the disparity - ANSWER vergence
where to leave the person who never reports equal during duochrome? - ANSWERyoung patients : first GREEN
older pre-presby/presbyopes: last RED represents the point at which the patient has used all of their vertical vergence and canno longer maintain single vision - ANSWER break point
why do we leave older pre-presbyopes/presbyopes on the last red during duochrome ifthey do not report equal? - ANSWER helps to preserve accommodation
indicates that the retinal disparity induced by the prisms has been decreased to thepoint at which the patient can access the vertical vergence system and regain single vision - ANSWER recovery point in theory, you *CAN use the duochrome test on "color blind" individuals but you should -ANSWER use the words "left and right" instead of red and green
duochrome: some people with nuclear sclerotic cataracts will exhibit - ANSWER red bias NPC testing has the ability to evaluate both the - ANSWER convergence +accommodative system
duochrome: if green is clearer = - ANSWER patient is overminused
maximum amplitude of accommodation formula: - ANSWER 25- 0.4 (age) average amplitude of accommodation formula: - ANSWER 18.5 - 1/3 (age) minimum amplitude of accommodation formula: - ANSWER 15 - 1/4 (age) accommodative response is dependent on the patient's - ANSWER -interpretation of blur -ability to converge-criteria for clarity -ability/willingness to put in effort -depth of focus excessive room illumination during Donder's push up will - ANSWER increase depth offocus
donder's push up target - ANSWER group of 20/30 vertical letters on fixation stick at40cm
donder's push up: begin moving the fixation stick towards the patient until they report - ANSWER firstsustained blur
donder's push up: OU results are usually greater due to - ANSWER fusional convergence retinal image size ___ as a target gets closer - ANSWER increases
donder's push up method usually generates results that are - ANSWER higher donder's pull away:put the target next to the patients eye at the vertex distance and pull away until they first report - ANSWER object is clear donder's pull away method is mainly performed on - ANSWER children those who do not understand the push up method target for minus lens to blur method - ANSWER one line above patient's best VA final results of the minus lens to blur method would be the measurement with the -ANSWER amount of minus lenses added + 2.50 needed to focus at 40cm
for the minus lens to blur method; with presbyopes you will generally need to - ANSWERadd + over the distance rx so that patient can see the target clearly
minus lens method is approx. _____ _____ than donder's push up method - ANSWER 2DLESS
Donders (binocular), donder's(monocular) and minus lens all average ____ at age 10 -ANSWER 12-14D
a patient should not use more than ___ of their amplitude for near work - ANSWER half inaccurate accommodation responses can lead to - ANSWER asthenopic complaints under accommodation = - ANSWER lag
ANSWER the patient was initially UNDERaccommodating (LAG) adding +1.50 in front of younger patients during FCC.. you have essentially just donewhat - ANSWER moved both the vertical and horizontal focal lines in front of the retina
stimulating accommodation = - ANSWER PRA if you had a high NRA value, and a low PRA value, what does this mean for the patient? -ANSWER the patient would not be able to bring anything too close, only bring it farther back. what would happen to the NRA/PRA values if you performed NRA/PRA over your FCC? -ANSWER NRA would be lower PRA would be higher (by the amount of the FCC) NRA/PRA is done with both eyes, testing how well you can relax/stimulate youraccommodation while maintaining your _____ - ANSWER vergence system
the ability of your eyes to converge - ANSWER positive relative vergence NRA relaxes accommodation and decreases - ANSWER accommodative convergence(eyes diverge)
NRA relaxes accommodation therefore your eyes will diverge so you need ____ toconverge the eyes to look at the target - ANSWER PRV
NRA depends on - ANSWER -AC/A ratio (how much you accommodate/converge) -PRV
-Latent hyperopia a latent hyperope that is not cyclopleged is essentially - ANSWER overminused if you perform NRA on a latent hyperope (who is essentially overminused), what type ofvalue will you get - ANSWER a much higher NRA value
as +0.25D is added to the distance rx, the stimulus to accommodation - ANSWERdecreases
relax accommodation, then you relax - ANSWER convergence AC/A ratio - ANSWER measurable change in the patients deviation as you change thestimulus to accommodate
the ratio/amount the convergence/accommodative system relaxes = - ANSWER AC/Aratio
the ability to turn the eyes in to maintain single vision - ANSWER PFV a patient with a low PFV will report - ANSWER diplopia what does the brain do with BV issues that cause you to see double? like patients withtropias? - ANSWER suppression ---> amblyopia
the patient will no longer relax accommodation once - ANSWER PFV is reached once PFV is reached the patient will - ANSWER no longer relax accommodation(vergence has stopped!)
vergence to keep things single. - ANSWER negative low PRA, occlude an eye. Pt reports target is now clear meaning which system failed? -ANSWER diverging system
low PRA, occlude an eye. pt reports still blurry meaning the - ANSWER accommodationsystem failed
expected morgan's norms for NRA - ANSWER +2.00D +- 0. if NRA value > +2.50, this could indicate - ANSWER -latent hyperope-overminused
if NRA value < +2.50 then maybe the patient has - ANSWER -poor ability to relaxaccommodation -limited PFV True or False: theoretically, if the patient has normal accommodation and normal NFV, then you shouldbe able to continuously keep stimulating accommodation indefinitely. - ANSWER true
if PRA value < -1.37/-1.50 then - ANSWER -reduced amplitude-reduced NFV
if the patient has the ability to accommodate more than -3.00D binocularly, and hasadequate NFV, what would their PRA value look like? - ANSWER > -3.
presbyopes will probably have a reduced NRA or PRA value? - ANSWER PRA
range of accommodation = - ANSWER near point measurement to your far pointmeasurement
range of accommodation is performed to determine if a patient's - ANSWER WD is withintheir range of clear vision (visual needs are being met!)
if a patient can bring material very close, but cannot bring it out very far, what do youwant to do to their ADD to fix it? - ANSWER lower the ADD
if you have a high EXOphoria, what system is functioning superiorly to keep this latent? -ANSWER converging system
if you have a high converging ability, you will always have ___ with both eyes open -ANSWER fusion
disjunctive eye movement that resolves retinal disparity - ANSWER fusional vergencesystem
the upward or downward movement of one eye RELATIVE to the other in order to fusean object in the vertical direction - ANSWER supra/infravergence
supra/infra vergence correct what type of phorias? - ANSWER vertical total breakdown of BV system = - ANSWER manifest deviation (tropia) in order to dissociate the patient under Von Graefe testing, we need a prismcombination that... - ANSWER is impossible for the patient to fuse
phoropter configuration for Von Graefe testing: - ANSWER 15 BI and 6BU
