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Orthoptic evaluation 1
Orthoptic evaluation examines eye alignment, eye movement, and binocularity using various tools. It involves assessing convergence, accommodation, and binocular single vision. Clinical signs of convergence and accommodation dysfunction include diplopia, headaches, and blurred vision. Treatment may include prism exercises, accommodative therapy, and vision therapy. The orthoptist plays a key role in diagnosing and providing non-surgical treatment for conditions like amblyopia and strabismus.
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Orthoptic evaluation 1
- 1. ORTHOPTIC EVALUATION DR. VARSHINI SHANKERDR. PUSHKAR DHIR
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- 4. • Diplopia • Pullingsensation • Poor Concentration • Headache • Over the eyes • Strain
- 5. DR / DA PMT (2-4PM,ALL DAYS EXCEPT SATURDAY)
- 6. AIM OF PRESENTATION Importance of knowing Orthoptics Overview of Sports Vision N new fascinating stuff Jinx of AC/A ratio measurement Synaptophore – made easy.
- 7. WHAT ARE WEEVALUATING?? Ortho = Straight Opticas = Vision Orthoptics Orthoptics = literally means "straightening of the eyes", dates back to the 1850s limited in scope to eye-muscle training and the cosmetic straightening of eyes. Vision therapy = includes Orthoptics + include training and rehabilitation of the eye-brain connections involved in vision.
- 8. ORTHOPTIST :- They specializein study of ocular motility & visual development & master themselves in non –surgical treatment. ORTHOPTIST + OPHTHALMOLOGIST :- Diagnose visual system dysfunction (Vision (lazy eye) , Eye Movement (Versions & Vergences , Eye Alignment (Squints) , Binocularity (BSV) ORTHOPTICS :- Focuses on NON- SURGICAL treatment of Amblyopia ,Strabismus , Diplopia
- 9. WHAT ALL WECHECK IN ORTHOPTICS? 1. CONVERGENCE 2. ACCOMODATION 3. BSV ( SMP/ FUSION/ STEREOPSIS)
- 10. TOOLS FOR OBJECTIVEORTHOPTIC EVALUATION • a
- 11. •Convergence is abilityto move eyes inside B/L •Driven by 3 things – Accommodation , Fusion , Proximity. •* Whenever there is pathology in either 3, NPC will be reduced. •C/F:- Blurred Vision , Diplopia , Brow Pain CONVERGENCE
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- 15. CLINICAL FEATURES &TYPES Convergence Dysfunction Accomodative Insufficiency Ill sustained accomodation Accomodative infacility / inertia Spasm of Accommodation Accomodation Paralysis Accommodative Dysfunction C/F:- Headache, Poor Concentration Blurred Vision after near work C/F:- Diplopia Eye Brow Pain Swimming of letters Heavy Lid Blurred Vision Convergence Insufficiency Divergence Excess (>10 pd difference b/w near & distance) Divergence Insufficiency Convergence Excess
- 16. FUSION Ability to MaintainFusion B/L with Accomodation Kept Constant It comes from Retinal Correspondence Concept of Break Point & Recovery Point. Checked with Prism Bars & Not with synaptophore fusion slides
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- 20. IPD MEASUREMENT SUBJ. &OBJECTIVE ANGLE OF DEVIATION PRIMARY & SECONDARY DEVIAITON ANGLE OF DEVIATION IN 9 GAZES STATUS OF BINOCULAR VISION (S.Perception / Fusion / Stereopsis ) MEASUREMENT OF VERTICAL & CYCLO-DEVIAITION AFTER IMAGE TEST FOR NRC & ARC MACULAR FUNCTION WITH H.B ANGLE ALPHA MEASUREMENT ANTI SUPPRESSION EXERCISES IN ARC CONVERGENCE DEFICIENCY EXERCISES RELAXATION EXERCISES FUSIONAL EXERCISES PLEOPTIC TREATMENT
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- 22. WHITE BINDING •Original MaddoxSeries / Torsions • Labelled with prefix A YELLOW BINDING • Stereoscopic • Labelled with D RED BINDING •Simultaneous Perception •Labelled with G or H GREEN BINDING •Fusion Series •(Sensory & motor fusion) •Labelled with F BLUE BINDING • Special Purpose Slide (after image, HB slides) • Labelled with S • Mayou Series of 8 slides
- 23. SLIDE SIZE ANGLESUBTENDED FOVEAL 1 ° MACULAR 1-3° PARAMACULAR 3-5° PERIPHERAL >5°
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- 27. Orthoptic Tools -Therapeutic • a Less Than 20 Pd Exophoria /Tropia Base Out Prism Exercise + Dot Card Exercises +/- Fusional exercises on Synaptophore or Cat Card
- 29. Orthoptic Tools - Therapeutic •a • Near Point of Accomodation if > 10cms. • Accomodative Infacility / Inertia < 10 cps. Brock string Flippers Jump Convergence
- 30. VISION THERAPY Orthoptic Therapy AccomodationTherapy Visual-Attention Therapy (Vapor Strobes) Eye Hand Coordination Therapy Peripheral Area Therapy Visual-Perception Therapy Visual-Vestibular Therapy Visual Auditory Integration Therapy
- 33. REFERENCES • American OptometryAssociation CPG-18 • Dos Slides on Orthoptics by Dr.Wangchuk Doma. • Practical Orthoptics inTreatment of squint – T.Kenneth Lyle. • Discussion with Dr. Varshini Shankar & one on one discussion with Mr.Krishna(Opto Venu) & Ms.Nikita. • Haag Streit Manual of Major Amblyoscope. • Synaptophore Guide by Haag Streit. • For Videos and Pics ,mail me.
- 34. • THANK YOUEVERYONE FOR PATIENTLY LISTENING TO THIS SEMINAR & • REQUEST U FOR NET NEUTRALITY • For feedbacks & brickbats plz mail at • ykush@yahoo.co.in./drdhir2014@gmail.com TELL ME AND I FORGET, TEACH ME AND I MAY REMEMBER, INVOLVE ME AND I LEARN