BV Quiz Questions

When you are prescribing for pt's with XT or orthophoria who are hyperopic, what is the most you would want to cut the plus?

+1.50 from the cycloplegic rx

Your pt has alternating ET of 15pd distance and near. Their IPD is 55 mm. What lens power would you use to help them fuse at their centration point?

+2.75

For children <13 yrs of age, what is the starting dosage for 1% atropine in treatment of moderate amblyopia?

1 drop of 1% atropine in sound eye qAM Saturday and Sunday

What level of anisometropia in a spectacle rx should you start to consider correcting for possible aniseikonia?

2.00 D of anisometropia

In the studies, in older children diagnosed with amblyopia, it was discovered that approximately _____% of children improved their acuity by 2 or more lines when prescribed spectacles alone.

25%

For participants in the study on anisometropia and amblyopia in 3 to <7 years of age, what was the upper limit, in # of weeks, where improvement of VA was seen?

30 weeks

In the PEDIG studies that evaluated the use of spectacles only as the initial tx of amblyopia, what percentage of children showed resolution of amblyopia?

33%

Your pt has alternating ET of 15pd distance and near. Their IPD is 55 mm. What working distance would you use to help them fuse at their centration point?

36 cm

According to the PEDIG studies, which of the following is the most appropriate time span to start with when initiating PTP for moderate and severe amblyopia? A. 2 hrs for moderate amblyopia, daily B. 2 hrs for moderate, every other day C. 2 hrs for moderate, at least once a week D. 2 hrs for moderate, 5 days a week

A. 2 hrs for moderate amblyopia, daily

Your pt with RIET (central fixation, NC) is having difficulty with fusing the Bagolini test. Which of the statements is correct concerning what you should do next in this siutation during this test battery? A. Add BO prism in front of R eye until they report fusion B. Since they are having trouble fusing, test is done and you report unable to fuse C. Add BI prism in front of L eye until they report fusion D. Quickly perform UCT, as they more than likely truly have AC

A. Add BO prism in front of R eye until they report fusion

Before starting a patient on BV therapy for ET the pt should have a certain clinical profile. Which of the following is NOT necessary for a pt to have before starting to develop peripheral fusion? A. Pt needs to be 20/20 in each eye B. Pt needs to have less than 2 pd of eccentric fixation in eye that is ET C. Pt needs to have normal correspondence D. Ideally the pt shows possible sensory fusion at <D

A. Pt needs to be 20/20 in each eye

Your patient with XT is undergoing Motor Stimulation Therapy for AC. What must the patient be able to do in order for you to transition to "traditional" therapy and start working on the motor component of the XT? A. Be able to covary B. be able to show NC when they are in exo posture and AC when they're in ortho posture C. be able to have AC only 1% of the time D. show NC at the objective angle

A. be able to covary

Your pt has been compliant with PTP 2 hr/day of their right eye. Before you started patching, his VA were 20/20 OD and 20/200 OS. You have seen him for f/u every 6-8 weeks, with following results: - Exam where PTP was started 20/20 OD and 20/200 OS -1st f/u: 20/20 OD, 20/200 OS -2nd f/u: 20/20 OD 20/200 OS Throughout the f/u period there has not been any change in CT or stereo. Which of the following is most appropriate for your pt? A. increase PTP to 6hr/day, RTC 6-8 weeks B. Switch to atropine 1% daily C. Start weaning pt off PTP, Reduce to 1 hr/day D. Continue PTP 2hr/day

A. increase PTP to 6hr/day, RTC 6-8 weeks

Your pt with constant XT is unable to fuse at ortho. You decide to start fusion activities around the objective angle. Which of the following methods will allow you to BEST complete therapy acitivities around the objective angle at distance? A. synoptophore B. Mirror stereoscope C. VTS-4 with the clown in the circle target at distance of 2 meters D. Vectograms with pt 1 m from slides

A. synoptophore

PEDIG performed a study on the rate of recidivism when amblyopia therapy was stopped. The study showed a percentage of pts did have recurrence. The highest number of pts with regression was during which time period? A. within the first 3 months following cessation of therapy B. Between 6-9 months C. Between 9-12 months D. Greater than 12 months

A. within the first 3 months following cessation of therapy

VT can be an effective therapy option for amblyopia. Which of the following circumstances would it NOT be appropriate to start VT for an amblyopia pt? A. Pt is currently undergoing PTP 2hr/day and is compliant B. Pt is currently undergoing tx with weekend atropine, as long as in-office visits were on Wednesday C. Pt who was switched from atropine to PTP because of significant issues with compliance and is currently only patching 30 mins a day D. PTP has been increased to 6hr/day due to plateau of VA

B and C

Your pt has IXT where the IXT control scale results are listed as distance 2, near 1. On her worth dot, she was able to fuse the dots into 4. Based upon this control scale and worth dot response, which of the following could be used to measure their vergence ranges? A. Need to create a composite score given the high frequency of the IXT for the pt B. You can use the phoropter for measurement since the frequency of eye turn is low C. Should not use the phoropter given the eye frequency scores and only perform out of instrument ranges D. Need to use the synoptophore to measure vergence ranges around the subjective angle E. Need to use the synoptophre to measure the vergence ranges around the objective angle

B. You can use the phoropter for measurement since the frequency of eye turn is low

Atropine 1% is a viable option for amblyopia. The prescriber needs to educate the parents and children on the safety profile. Which of the following SE is more commonly seen in pts while using 1% atropine? A. increase in strabismus by 20pd B. photophobia C. agitation D. seizures

B. photophobia

Dismissal of the patient from prism therapy can include ____________. A. switching from overcorrective to inverse prism B. referral for surgical consult C. needing to decrease the overcorrective prism for a patient with ET, because the overcorrected XT is increasing in magnitude D. having the pt switch from overcorrective prism to Ludlam's procedure

B. referral for surgical consult

Prism therapy can be used in the tx of AC. What is the goal of this therapy? A. allow pt to fuse in order to have them move the fovea to the anomalous point B. to disrupt the AMF and subsequently the AC C. to see double all day so they suppress the strabismic eye more frequently D. to allow the patient to deepen the anomalous point in order to have good quality fusion.

B. to disrupt the AMF and subsequently the AC

Which of the following statements about the clinical research performed on PTP and atropine 1% is/are true? A. Pts who do PTP for 2 hrs daily recieve equivalent therapeutic results as those children who receive weekend 1% atropine for the treatment of moderate amblyopia B. 6 hrs of daily PTP is equivalent to 2 hrs of daily PTP for the treatment of moderate amblyopia C. When prescribed initially 2 hrs of PTP, each day, is equivalent to prescribed daily 1% atropine for treatment of moderate amblyopia D. All the above E. None of the above

C.

Your pt with ET is getting ready to start working on peripheral fusion. This is their first in-office session with you. Which of the following targets would be most appropriate to start with? A. Quoits vectogram B. Tranaglyph (large rabbit slides) C. Large lion and cage targets on synoptophore D. Opaque lifesaver cards

C. Large lion and cage targets on synoptophore

Which of the following is not a test method to measure a pt's sensorimotor ability? A. worth 4 dot B. major amblyoscope C. MEM D. synoptophore E. vergence ranges behind the phoropter

C. MEM

You have diagnosed a new pt who is 8 yrs old with refractive amblyopia. They are not currently wearing glasses. Fixation testing showed central fixation in each eye, CT was ortho, NC. Her best corrected VA were 20/20 OD and 20/200 OS. Based upon the above info, which of the following tx plans is most appropriate? A. Specs for FTW. Start PTP 2-4 hrs a day. RTC 6-8 weeks for f/u B. Specs for FTW. Start Atropine 1% qAM on Saturdays and Sundays. RTC 6-8 weeks for f/u C. Specs for FTW. RTC 6-8 weeks for f/u D. Specs for FTW. Start PTP 2-4 hrs a day or Atropine 1% weekend AMs, given parental preference. RTC 6-8 weeks.

C. Specs for FTW. RTC 6-8 weeks for f/u

Which of the following tx options is considered the primary tx option for amblyopia? A. Atropine B. VT C. Spectacles D. PTP E. Monitoring

C. Spectacles

For the treatment of strabismus, the primary goal is to achieve a functional cure. Which of the following statements is NOT consistent with the idea of a functional cure? A. To be considered a functional cure the patient should be able to have clear, single, comfortable vision B. An example of a functional cure is a patient with ET who has undergone VT, requires +1.00 bifocal to increase comfort while working on computer C. To be considered a functional cure, the patient cannot have additional prismatic correction in their SpRx D. Typically diplopia should not occur more than 1% of the time daily

C. To be considered a functional cure, the patient cannot have additional prismatic correction in their SpRx

Which of the following statements comparing PTP, VT and atropine is correct? A. PTP has better compliance compared to atropine B. If VT is chosen, the pt must have measurable stereo C. VT can be performed while PTP, but not while they are using atropine D. PTP can be used in treating moderate and severe amblyopia while atropine can only be used in severe

C. VT can be performed while PTP, but not while they are using atropine

Which of the following is true when you are using the synoptophore for measurements of vergence ranges? A. only use the simultaneous perception targets when attempting to measure vergence ranges B. cannot use the synoptophore for this type of testing, it's only for AC measurement C. You'll be able to use flat fusion targets while measuring vergence ranges D. if you do not have a synoptophore, you can use a mirror stereoscope as long as the angle is less than 45 pd

C. You'll be able to use flat fusion targets while measuring vergence ranges

Which of the following patient factors will allow for a better prognosis when having a patient work on the synoptophore for VT? A. UAC will react better than HAC B. Smaller angles will more likely improve towards NC C. Children <4 will do better than older children due to AC point not setting in yet D. A constant deviation that is comitant will do better than a noncomitant deviation

D. A constant deviation that is comitant will do better than a noncomitant deviation

You have a 4yo pt who you diagnosed with accommodative ET (Dist 10XT, Near 25XT). You are at the stage where you are considering prescribing a bifocal for this pt, you previously prescribed his first pair of glasses 8 weeks ago. Given the pt's age and type of ET, which of the following is best method for prescribing the bifocal? A. PAL of +2.50 with fitting cross set 2mm higher than typical adult position B. PAL of +2.50 with fitting cross at the typical adult position C. Flat top +2.50 with line at lower lids D. Flat top +2.50 with line bisecting the pupils

D. Flat top +2.50 with line bisecting the pupils

Throughout working near fusional ranges you will move the pt from peripheral to central targets . In order to see the images clearly, the pt must be able to show __________. A. ability to have appropriate vergence ranges B. less than 10% suppression C. normal saccadic response D. appropriate monocular accommodative skills

D. appropriate monocular accommodative skills

Which of the following phases is the foundation to the VT plan for XT? A. being able to not suppress during initial therapy B. Having the pt gain ability to fuse in free space C. being able to wean the pt off weekly in-office therapy D. having a strong accommodation convergence response

D. having a strong accommodation convergence response

Which of the following is an ideal clinical characteristic a patient would have before starting VT for XT? A. being symptom free B. being treated for amblyopia with atropine C. having local stereo D. having global stereo

D. having global stereo

As moving through the VT program, the goal after peripheral fusion is that the pt will be able to obtain central and foveal fusion. Which of the following can be a limitation to the pt being able to gain central/foveal fusion? A. Ambylopia B. Eccentric fixation C. Accommodative issues D. Amblyopia and EF E. All the above

E. All the above

Performing the sensorimotor exam will enable you to. better which of the following therapy plans? A. monitoring or educating the pt and their family B. Spectacle correction C. VT D. Need for surgical referral E. All the above

E. all the above

T/F: Home therapy is an integral part to the overall XT therapy plan?

True

T/F: In the clinical research studies, it was discovered that pts were more compliant with PTP when compared to using atropine 1%.

false

Before truly establishing normal peripheral fusion the patient needs to show the ability to have _______________?

gross convergence

___________________ ET can be associated with a wide range of magnitudes and sensory abnormalities. It will typically occur before the age of 1 in patients. A common differential is pseudostrabismus.

infantile

What part of the eye is covered in binasal occlusion?

nasal retina from fovea to almost the z-point

What is the upper age limit for pt with amblyopia to potentially be treated and have improvement in their VA?

no upper age limit

What is one of the potential SE of using binasal occlusion as a tx option for ET that you need to educate your patient on and have them RTC if noticing?

significant head turn in an attempt to enlarge their visual field

__________________ constant angles of ET are more difficult to treat because they can be associated with more sensory anomalies, such as suppression, amblyopia and AC.

smaller

What is the upper age limit to treating Xt through surgical means?

there is no upper age limit as long as the pt can handle the anesthesia component