This document discusses accommodation and presbyopia. It begins by defining accommodation as the process by which the eye focuses on near objects. It then describes accommodation anatomy and the ranges and variation of accommodation with age. Presbyopia is introduced as a normal age-related condition where accommodation decreases. Theories of presbyopia are presented along with treatment options like glasses and contact lenses. Accommodative disorders like spasm and insufficiency are also summarized.
Presbyopia/ Methods of Presbyopic Addition Determination (healthkura.com)Bikash Sapkota
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Dear viewers Check Out my other piece of works at ❤❤❤ https://healthkura.com ❤❤❤
Presbyopia and techniques of measurement
A fantastic presentation in the topic "Presbyopia and techniques of measurement"
A detailed information about presbyopia, techniques of presbyopic add determination and different correction methods.
Informative slide presentation on presbyopia for ophthalmology residents, ophthalmologists, optometrists, ophthalmic assistants, ophthalmic technicians, ophthalmic nurses, medical students, medical professors, teaching guides.
Presentation Contents:
--Introduction to presbyopia
-Types of presbyopia
-Risk factors
-Symptoms and signs
-Refractive error and presbyopia
-Methods of determining near add.
-Management of presbyopia
In a nutshell..
- The evaluation and management of presbyopia are important because significant functional deficits can occur when the condition is left untreated
- Undercorrected or uncorrected presbyopia can cause significant visual disability and have a negative impact on the pt.'s quality of life
- Finally, every tentative addition should be adjusted according to the particular needs of the patient
For Further Reading:
-Clinical Procedures in Optometry by J.D. Bartlett, J.B. Eskridge, J.F. Amos
-Primary Care Optometry by Theodere Grosvenor
-Borish’s Clinical Refraction by W.J. Benjamin
-Clinical Procedures for Ocular examination by Carlson et al
-American Academy of Ophthalmology
-Optometric Clinical Practice Guideline by American Optometric Association
-Internet
Follow me to get in touch with optometric and ophthalmic updates.
Presbyopia/ Methods of Presbyopic Addition Determination (healthkura.com)Bikash Sapkota
DIRECT DOWNLOAD LINK ❤❤https://healthkura.com/presbyopia-near-addition/❤❤
Dear viewers Check Out my other piece of works at ❤❤❤ https://healthkura.com ❤❤❤
Presbyopia and techniques of measurement
A fantastic presentation in the topic "Presbyopia and techniques of measurement"
A detailed information about presbyopia, techniques of presbyopic add determination and different correction methods.
Informative slide presentation on presbyopia for ophthalmology residents, ophthalmologists, optometrists, ophthalmic assistants, ophthalmic technicians, ophthalmic nurses, medical students, medical professors, teaching guides.
Presentation Contents:
--Introduction to presbyopia
-Types of presbyopia
-Risk factors
-Symptoms and signs
-Refractive error and presbyopia
-Methods of determining near add.
-Management of presbyopia
In a nutshell..
- The evaluation and management of presbyopia are important because significant functional deficits can occur when the condition is left untreated
- Undercorrected or uncorrected presbyopia can cause significant visual disability and have a negative impact on the pt.'s quality of life
- Finally, every tentative addition should be adjusted according to the particular needs of the patient
For Further Reading:
-Clinical Procedures in Optometry by J.D. Bartlett, J.B. Eskridge, J.F. Amos
-Primary Care Optometry by Theodere Grosvenor
-Borish’s Clinical Refraction by W.J. Benjamin
-Clinical Procedures for Ocular examination by Carlson et al
-American Academy of Ophthalmology
-Optometric Clinical Practice Guideline by American Optometric Association
-Internet
Follow me to get in touch with optometric and ophthalmic updates.
To know Humphrey visual field analyser
To know about various types of perimetry
To identify field defect
To recognize that field defect is due to glaucoma or neurological lesion
To know that field defect is progressive or not
Interpretation of HVFA
Interventions to Reduce Myopia Progression in Children (Journal Club) (health...Bikash Sapkota
DIRECT DOWNLOAD LINK ❤❤https://healthkura.com/reduce-myopia/❤❤
Dear viewers Check Out my other piece of works at___ https://healthkura.com
Interventions to Reduce Myopia Progression in Children (Journal Club)
Objectives:
- To discuss about the different interventions to reduce myopia progression in children
- To determine the effectiveness of different interventions to slow down the progression of myopia in children
Interventions to Reduce Myopia Progression:
Environmental Considerations
- Time Spent Outdoors
- Near-Vision Activities
Spectacles & Contact Lenses
- Gas-Permeable Contact Lens Wear
- Bifocal & Multifocal Spectacles
- Soft Bifocal Contact Lenses
- Orthokeratology
Pharmacological Therapies
- Antimuscarinic Agents: Atropine & Pirenzepine
Under Correction of Myopia
To know Humphrey visual field analyser
To know about various types of perimetry
To identify field defect
To recognize that field defect is due to glaucoma or neurological lesion
To know that field defect is progressive or not
Interpretation of HVFA
Interventions to Reduce Myopia Progression in Children (Journal Club) (health...Bikash Sapkota
DIRECT DOWNLOAD LINK ❤❤https://healthkura.com/reduce-myopia/❤❤
Dear viewers Check Out my other piece of works at___ https://healthkura.com
Interventions to Reduce Myopia Progression in Children (Journal Club)
Objectives:
- To discuss about the different interventions to reduce myopia progression in children
- To determine the effectiveness of different interventions to slow down the progression of myopia in children
Interventions to Reduce Myopia Progression:
Environmental Considerations
- Time Spent Outdoors
- Near-Vision Activities
Spectacles & Contact Lenses
- Gas-Permeable Contact Lens Wear
- Bifocal & Multifocal Spectacles
- Soft Bifocal Contact Lenses
- Orthokeratology
Pharmacological Therapies
- Antimuscarinic Agents: Atropine & Pirenzepine
Under Correction of Myopia
250+ High Frequency MCQs in Optometry and OphthalmologyRabindraAdhikary
The collection of high-ranked, top-rated high frequency multiple-choice questions suitable for any examination of optometry, ophthalmology and ophthalmic sciences with their answers for FREE. No Log in, No Pay!!
Contact lens care and maintenance
RGP care
Soft Contact lens care
Silicon Hydrogel Care
Contact Lens Disinfection
Thermal disinfection
Chemical Disinfection
Oxidative chemical disinfection
Troubleshooting bifocals and Market Availability in Nepal
Bifocals in Anisometropia
Prismatic Effect in Bifocal
Bifocal Prescription
Bifocals in High Astigmatism
Variables: Types and their Operational Definitions
Unit III: Problem identification formulation of research objectives and hypothesis (as part of M.Optom Curriculum of Pokhara University, Nepal)
Cholinergic agent: Autonomic Drugs
According to the M. Optom curriculum, we have prepared a concise presentation on Cholinergic or parasympathomimetic or cholinomimetic drugs
Multiple Choice Questions (MCQs) for Masters of Optometry Entrance Examinatio...RabindraAdhikary
Multiple Choice Questions (MCQs) for Masters of Optometry Entrance Examination, Pokhara University NEPAL
MCQs Optometry Nepal
Here we have included syllabus of entrance examinations for Master of Optometry in Pokhara University, entry requirements of candidate for the master of optometry course and multiple choice questions that appeared in the entrance examinations of 2019.
Prepared by: Rabindra Adhikary
for more MCQs:
http://ravinems.blogspot.com/2019/05/multiple-choice-questions-mcqs-for.html
Visual Implication in Diabetes Mellitus
These slides talk in detail about the visual implications of Diabetes Mellitus and how to address them systematically
Systemic Diseases and the Eye
Various systemic diseases affect the eye and it's functioning. Here we present those common systemic diseases that are responsible to cause effects in the eye.
What are the diseases that affect eye?
Eye is affected by the following diseases:
Systemic Hypertension (Increased blood pressure of the body)
Diabetes Melitus (Increased blood sugar level)
Systemic Lupus Erythromatosus (SLE)
AIDS and other Venereal Diseases like Syphilis
Sickle Cell Anemia,
Eales Disease and many more.
Look at the slides.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
DISSERTATION on NEW DRUG DISCOVERY AND DEVELOPMENT STAGES OF DRUG DISCOVERYNEHA GUPTA
The process of drug discovery and development is a complex and multi-step endeavor aimed at bringing new pharmaceutical drugs to market. It begins with identifying and validating a biological target, such as a protein, gene, or RNA, that is associated with a disease. This step involves understanding the target's role in the disease and confirming that modulating it can have therapeutic effects. The next stage, hit identification, employs high-throughput screening (HTS) and other methods to find compounds that interact with the target. Computational techniques may also be used to identify potential hits from large compound libraries.
Following hit identification, the hits are optimized to improve their efficacy, selectivity, and pharmacokinetic properties, resulting in lead compounds. These leads undergo further refinement to enhance their potency, reduce toxicity, and improve drug-like characteristics, creating drug candidates suitable for preclinical testing. In the preclinical development phase, drug candidates are tested in vitro (in cell cultures) and in vivo (in animal models) to evaluate their safety, efficacy, pharmacokinetics, and pharmacodynamics. Toxicology studies are conducted to assess potential risks.
Before clinical trials can begin, an Investigational New Drug (IND) application must be submitted to regulatory authorities. This application includes data from preclinical studies and plans for clinical trials. Clinical development involves human trials in three phases: Phase I tests the drug's safety and dosage in a small group of healthy volunteers, Phase II assesses the drug's efficacy and side effects in a larger group of patients with the target disease, and Phase III confirms the drug's efficacy and monitors adverse reactions in a large population, often compared to existing treatments.
After successful clinical trials, a New Drug Application (NDA) is submitted to regulatory authorities for approval, including all data from preclinical and clinical studies, as well as proposed labeling and manufacturing information. Regulatory authorities then review the NDA to ensure the drug is safe, effective, and of high quality, potentially requiring additional studies. Finally, after a drug is approved and marketed, it undergoes post-marketing surveillance, which includes continuous monitoring for long-term safety and effectiveness, pharmacovigilance, and reporting of any adverse effects.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
2. Borish’s clinical refraction
Duke-Elder’s practice of refraction
Principal of optics and refraction by Lalit P.
Agrawal
Binocular vision and ocular motility-Gunter
K Von noorden
Clinical management of strabismus-
Elizabeth
Optics and refraction by A.K khurana
Anatomy physiology by A.K khuran
Internet
3. The process by
which the dioptric
power of eye
changes so that an
infocus retinal
image of an object of
regard is obtained
and maintained at
high resolution at
fovea.
4. Brief anatomy of lens
Transparent,biconvex
Anterior surface is is
less convex(abt10mm)
Posterior surface more
curved(6mm)
Refractive index=1.39
5.
6.
7. Punctum proximum-
Punctum remotum-
Ranges of accommodation-
Amplitude of accommodation-
Variation with refractive error???
12. Presbyopia –not a disease
Age of onset depends on
sex,race and occupation.
Why ?????
Helmhotz –Hess
Gullstrand theory
Donder Duane
fincham theory
14. Symptoms –
Small print become indistinct in dim
illumination.
Hand short for reading
15. Glass..near glass,bifocal glass.progressive
addition lens,monovision glasses
Contact lens option
Distance single vision CL and near glasses
Monovision CL
Bifocal /multifocal CL
Non refractive bifocal
Weakest glass which are compatible with good
vision????
16. A general rule an individual require 1D at 40 and in
every 5 yrs ,increases by 1D until 55 then stabilizes.
Considering amplitude of accommodation
-RAF ruler
-Donder's table
-hoffsteter’s formula
-Dynamic retinoscopy
Binocular cross cylinder test-
17. Negative relative accommodation (NRA)and
positive relative accommodation(PRA)-
Addition-NRA+1/2 relative amplitude of
accommodation
Eg if PRA is –0.50 Ds and NRA is +2.00
Amplitude of accommodation=+2.50
Addition==2.00-1/2*2.50=+0.75Ds
18. Surgical procedure
Made artificially anisometropic
New advancement in surgical process
19. Ciliary body is supplied by both sympathetic
and parasympathetic supply.
Sympathetic receptor include alpha and beta
Parasympathetic include muscarinic receptor
M1,M2,M3
22. Insuffeciency of accommodation-
Accommodative power is consistently poor
than what may be considered as normal at that
age.
Etiology…..
· General debility
· Malnutrition
· Anaemia
Glaucoma (?)
23. Cause is treated
If not treatable,symptom relieving majors…
Optical treatment-1st
choice
Accommodation therapy…
24. Accommodative
response is smaller
than accommodative
demand.
Causes asthenopic
symptoms.
Can be found by
dynamic
retinoscopy ,jackson
cross cyl method.
Corrected by giving
25. Normal accommodative lag in Nepalese
population-Dhungana Purushottam
151 patient were examined out of which
88(58%) were female,63(42%)male.
He found normal accommodative lag increase
with age and ranges from 1.004-1.33(16-
35yrs)in monocular fixation and 0.915-1.116(16-
35yrs)in binocular condition.
26. Accommodation lag in entire Nepalese
population found to be increase with age
Myope showed lag towards higher
side,hyperope towards lower side.
Normal lag 1.174(+/-0.17) monocular
fixation,0.998(+/-0.003)binocular condition.
27. Accommodation is normal initially but can not
be maintained over length of time.
Initial stage of true insufficiency
Convalescent period from debilitating illness
Tiredness
· refractive status
relationship with convergence
29. Difficulty is experienced in altering the range
of accommodation .
Measurement of quality of the eye ability to
smoothly and efficiently change the amount of
accommodation
Cycles per minute by flipper
30.
31. Monocular distribution of monocular
accommodative measurement using +/-2 Ds
for 100 eyes,12-14 cycles constitute about 50
eyes.(asymptomatic)
Binocular accommodative facility measurement
using +/-2Ds,8-14 constitute about 50 percent
total screened(asymptomatic)
32. Disease affecting cranium and oculomotor
nerve
Paralytical mydriasis
If accommodation paralysis is isolated cause,-it
is cortical in origin
Other cause include encephalitis,anterior
poliomyelitis,TB,syphilis etc
37. Tone of ciliary muscle is increased,inducing
pseudomyopia.
Symptoms
· Blurred vision depending on patient’s
refractive status
· Macropsia
· Asthenopia during close work
· Pain (brows/headache)
· Poor concentration
Miosis
Convergence anomalies (excess or
insufficiency)
40.
Functional spasm
A response to over fatigue and "eye strain".
Precipitated by 3 factors:
· Bad visual hygiene e.g., poor lighting,
glare unaccustomed work
· Optical or ocular motor difficulties e.g.,
anisometropia, early presbyopia,
convergence anomalies
psychological factors
41. Irritation of parasympathetic system
Aetiology
· Ciliary spasm
- drug induced e.g., physostigmine, pilocarpine,
morphine, digitalis
- lesions of brain stem
· Inflammation
e.g., anterior uveitis
Trigeminal neuralgia
42. Reversible or irreversible….
Reversible then + lens
Irreversible than – lenses
43. Can be due to ciliary muscle weakness or
decrease in elasticity of lens capsule..
Other causes include amblyopia,unilateral
sclerosis..
45. To improve accommodative amplitude
,facility ..
Principle is to alter the stimulus for
accommodation by glasses or changing
distance
Initially therapy is performed monocularly so
that vergence system does not influence.
46. Hart chat push up(push up paddle)
Hart chat distance near facility
Lens flippers
Loose minus lens rock
Split pupil rock
47.
48. Accommodative anomaly is one of the most
common cause of asthenopic symptom
presenting to optometrist.
So all patient should undergo tests for
refractive error,muscle imbalance and
convergence and accommodation anomaly
should not be forgotten.
49. HEADACHE
Patch eye and do near work
Headache persists Headache subsides
Binocular problem
Accommodative Refractive error