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OPTOM FASLU MUHAMMED
 It’s a haploscopic deviceIt’s a haploscopic device
 Consists of two tubes , having a rightConsists of two tubes , having a right
angled bend, mounded on a base havingangled bend, mounded on a base having
a chin rest and forehead resta chin rest and forehead rest
 Each tubes contain a light source forEach tubes contain a light source for
illumination of slides and a slide carrier atillumination of slides and a slide carrier at
the outer end, a reflecting mirror at thethe outer end, a reflecting mirror at the
right angled bend and an eye piece ofright angled bend and an eye piece of
+6.50D at the inner end+6.50D at the inner end
 Correction lenses can be inserted in theCorrection lenses can be inserted in the
lens holder if necessarylens holder if necessary
Elevtn & diprtnElevtn & diprtn
Horizontal vergenceHorizontal vergence
Tube lockingTube locking
Chin rest controlChin rest control Hand flashing switchsHand flashing switchs
Illumination controlIllumination control
Vertical divtnVertical divtn
handlehandle
MirrorEyepiece(+6.50DS)
Slide carrierDiffusing screen
Iris diaphram
Grades of Binocular VisionGrades of Binocular Vision
 Simultaneous Macular PerceptionSimultaneous Macular Perception
 FusionFusion
 StereopsisStereopsis
Simultaneous MacularSimultaneous Macular
PerceptionPerception
 Two dissimilar slides such as one having aTwo dissimilar slides such as one having a
picture of a lion and the other of the cage,picture of a lion and the other of the cage,
constitute a pair of SMP slides.constitute a pair of SMP slides.
 Each slides is presented separately to eachEach slides is presented separately to each
eye.eye.
 There are three gradesThere are three grades
1.1. Simultaneous foveal PerceptionSimultaneous foveal Perception slidesslides
Consists of small sized pictures, the images ofConsists of small sized pictures, the images of
which do not exceed the size of the foveawhich do not exceed the size of the fovea
2.2. Simultaneous Macular Perception slidesSimultaneous Macular Perception slides
In this pictures are slightly larger than those onIn this pictures are slightly larger than those on
the SFP slidesthe SFP slides
3.3. Simultaneous Para Macular PerceptionSimultaneous Para Macular Perception
Slides have the largest pictures and form theSlides have the largest pictures and form the
images that extends in to Para macularimages that extends in to Para macular
areasareas
Various varieties availableVarious varieties available
Fusion slidesFusion slides
 Consists of two dissimilar pictures each ofConsists of two dissimilar pictures each of
which is incomplete in small detailswhich is incomplete in small details
 There are two rabbits each lacking a tail orThere are two rabbits each lacking a tail or
bunch of flowersbunch of flowers
 In the presence of fusion a complete rabbitIn the presence of fusion a complete rabbit
holding a bunch of flowers will be seenholding a bunch of flowers will be seen
 In the presence of suppression either tailIn the presence of suppression either tail
or bunch of flowers will be missingor bunch of flowers will be missing
Various varieties availableVarious varieties available
Stereoscopic slidesStereoscopic slides
 Consists of two pictures of same objectsConsists of two pictures of same objects
which have been taken from slightlywhich have been taken from slightly
different angles, ie, picture for one eye isdifferent angles, ie, picture for one eye is
in part dissimilar from that for the otherin part dissimilar from that for the other
eyeeye
After imageAfter image
Haidinger
brushes
For measurement of angleFor measurement of angle
kappakappa
 A slide which consist of numbers andA slide which consist of numbers and
letters or animal pictures is usedletters or animal pictures is used
After image testingAfter image testing
 In this right fovea is stimulated withIn this right fovea is stimulated with
vertical and left with horizontal bright lightvertical and left with horizontal bright light
 Pt is asked to draw the position of afterPt is asked to draw the position of after
imagesimages
 A pt with NRC will draw a crossA pt with NRC will draw a cross
 An esotropic pt with ARC will draw verticalAn esotropic pt with ARC will draw vertical
image to the left of horizontalimage to the left of horizontal
 An exotropic pt with ARC will draw verticalAn exotropic pt with ARC will draw vertical
image to the right of horizontalimage to the right of horizontal
 Entoptic phenomenaEntoptic phenomena
 Operated by 2 on/off switches,2 speedOperated by 2 on/off switches,2 speed
control & 2 reversing switchescontrol & 2 reversing switches
 Active polarized light falling on maculaActive polarized light falling on macula
 Eccentric fixation & ARCEccentric fixation & ARC
HAIDINGER BRUSHES
 The pt who learns to recognize the brushThe pt who learns to recognize the brush
can be made aware of the spatialcan be made aware of the spatial
projection of the fovea and thus use theprojection of the fovea and thus use the
centre for fixation.centre for fixation.
 This method is employed in treatment ofThis method is employed in treatment of
amblyopiaamblyopia
 Therapeutic usesTherapeutic uses
 Diagnostic usesDiagnostic uses
 Measurement of IPDMeasurement of IPD::
>To measure the IPD arms of the synaptophore are>To measure the IPD arms of the synaptophore are
placed at 0 and the pt is instructed to look at centerplaced at 0 and the pt is instructed to look at center
of the picture in the right hand tube with right eye .of the picture in the right hand tube with right eye .
>The examiner aligns the central white line of the tube>The examiner aligns the central white line of the tube
with the reflection of the light on center of the ptswith the reflection of the light on center of the pts
pupilpupil
 Measurement of objective angle ofMeasurement of objective angle of
deviation:deviation:
>>SMP slides are used .SMP slides are used .
>the pt is asked to look at the pictures and then>the pt is asked to look at the pictures and then
the arm controlling the picture in front of thethe arm controlling the picture in front of the
deviating eye is moved by the examiner untildeviating eye is moved by the examiner until
there is no movement of either eye on a coverthere is no movement of either eye on a cover
test, performed by alternatively turning of thetest, performed by alternatively turning of the
lightlight
 Measurement of OA for near fixationMeasurement of OA for near fixation
>A -3.00D lens is inserted in the lens holder>A -3.00D lens is inserted in the lens holder
situated infront of eyepiece lenssituated infront of eyepiece lens
 Measurement of SA of deviationMeasurement of SA of deviation
>the pt is asked to move the handle controlling>the pt is asked to move the handle controlling
the picture in front of the non fixating eyethe picture in front of the non fixating eye
until he sees the 2 pictures superimposeduntil he sees the 2 pictures superimposed
 Measurement of cyclodeviationMeasurement of cyclodeviation
>>SMP slides are used.SMP slides are used.
>in presence of cyclodeviation the image>in presence of cyclodeviation the image
appears tilted .appears tilted .
 Measurement of angle kappaMeasurement of angle kappa
>the pt is asked to focus the zero mark of>the pt is asked to focus the zero mark of
the slide , while the examiner looks for thethe slide , while the examiner looks for the
corneal reflex.corneal reflex.
>if the corneal reflex is on the nasal side of>if the corneal reflex is on the nasal side of
the center of pupil the angle is positivethe center of pupil the angle is positive
>if it is on the temporal side it is negative>if it is on the temporal side it is negative
>the pt is then asked to look in turn either>the pt is then asked to look in turn either
one letter or number until the reflex isone letter or number until the reflex is
centeredcentered
>the degree of deviation corresponding to>the degree of deviation corresponding to
the letter is then recordedthe letter is then recorded
 To estimate the presence of suppressionTo estimate the presence of suppression
>SMP slides and fusion slides can be used .>SMP slides and fusion slides can be used .
>In the presence of suppression pts sees only one>In the presence of suppression pts sees only one
image .image .
 To detect ARCTo detect ARC
>>OA & SA of deviation are measured .OA & SA of deviation are measured .
>If the angles are equal NRC is present>If the angles are equal NRC is present
>If the OA>SA ARC is present.>If the OA>SA ARC is present.
 Measurement of range of fusionMeasurement of range of fusion
>Deviation is determined using SMP slides .>Deviation is determined using SMP slides .
> Then the fusion slides are introduced and blocks> Then the fusion slides are introduced and blocks
the arms at the objective angle .the arms at the objective angle .
>Amplitude of divergence and convergence are>Amplitude of divergence and convergence are
measured with break and recovery pointmeasured with break and recovery point
NORMAL VALUES(NORMAL VALUES(IN PRISAMIN PRISAM
DIOPTERSDIOPTERS))
 In adductionsIn adductions
DistanceDistance NearNear
BlurBlur 12-1612-16 20-2820-28
BreakBreak 18-2218-22 26-3426-34
RecoveRecove
ryry
14-1814-18 22-3022-30
 In abductionIn abduction
DistanceDistance NearNear
BlurBlur NANA 6-106-10
BreakBreak 6-126-12 12-1812-18
RecoveryRecovery 4-84-8 8-148-14
 Fusion Vergence exercisesFusion Vergence exercises
 Management of suppression-Management of suppression-
antisuppression exercisesantisuppression exercises
 Eccentric fixation & ARCEccentric fixation & ARC
 Amblyopia therapy usingAmblyopia therapy using
H.brushesH.brushes
Proficiency testProficiency test
 The power of eye piece lensThe power of eye piece lens
1.1. +6.50D+6.50D
2.2. +6.00D+6.00D
3.3. +5.00D+5.00D
4.4. +6.25D+6.25D
 Principle of synaptophorePrinciple of synaptophore
1.1. Haploscopic PrincipleHaploscopic Principle
2.2. Polarization PrinciplePolarization Principle
3.3. Equal image size and variable object sizeEqual image size and variable object size
4.4. DiffractionDiffraction
 Which slide is used in objective angleWhich slide is used in objective angle
measurementmeasurement
1.1. FusionFusion
2.2. SMPSMP
3.3. Steriopsis slideSteriopsis slide
4.4. After image slideAfter image slide
 Principle of haidinger brushesPrinciple of haidinger brushes
1.1. PolarizationPolarization
2.2. ReflectionReflection
3.3. DiffractionDiffraction
4.4. interferenceinterference
 Normal range of break point in adductionNormal range of break point in adduction
for distance isfor distance is
1.1. 18-22PD18-22PD
2.2. 12-16PD12-16PD
3.3. 6-12PD6-12PD
4.4. 8-4PD8-4PD
Synoptophore 2

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Synoptophore 2

  • 2.  It’s a haploscopic deviceIt’s a haploscopic device
  • 3.  Consists of two tubes , having a rightConsists of two tubes , having a right angled bend, mounded on a base havingangled bend, mounded on a base having a chin rest and forehead resta chin rest and forehead rest  Each tubes contain a light source forEach tubes contain a light source for illumination of slides and a slide carrier atillumination of slides and a slide carrier at the outer end, a reflecting mirror at thethe outer end, a reflecting mirror at the right angled bend and an eye piece ofright angled bend and an eye piece of +6.50D at the inner end+6.50D at the inner end  Correction lenses can be inserted in theCorrection lenses can be inserted in the lens holder if necessarylens holder if necessary
  • 4. Elevtn & diprtnElevtn & diprtn Horizontal vergenceHorizontal vergence Tube lockingTube locking Chin rest controlChin rest control Hand flashing switchsHand flashing switchs Illumination controlIllumination control Vertical divtnVertical divtn handlehandle
  • 6. Grades of Binocular VisionGrades of Binocular Vision  Simultaneous Macular PerceptionSimultaneous Macular Perception  FusionFusion  StereopsisStereopsis
  • 7. Simultaneous MacularSimultaneous Macular PerceptionPerception  Two dissimilar slides such as one having aTwo dissimilar slides such as one having a picture of a lion and the other of the cage,picture of a lion and the other of the cage, constitute a pair of SMP slides.constitute a pair of SMP slides.  Each slides is presented separately to eachEach slides is presented separately to each eye.eye.  There are three gradesThere are three grades 1.1. Simultaneous foveal PerceptionSimultaneous foveal Perception slidesslides Consists of small sized pictures, the images ofConsists of small sized pictures, the images of which do not exceed the size of the foveawhich do not exceed the size of the fovea
  • 8. 2.2. Simultaneous Macular Perception slidesSimultaneous Macular Perception slides In this pictures are slightly larger than those onIn this pictures are slightly larger than those on the SFP slidesthe SFP slides 3.3. Simultaneous Para Macular PerceptionSimultaneous Para Macular Perception Slides have the largest pictures and form theSlides have the largest pictures and form the images that extends in to Para macularimages that extends in to Para macular areasareas
  • 9.
  • 10. Various varieties availableVarious varieties available
  • 11. Fusion slidesFusion slides  Consists of two dissimilar pictures each ofConsists of two dissimilar pictures each of which is incomplete in small detailswhich is incomplete in small details  There are two rabbits each lacking a tail orThere are two rabbits each lacking a tail or bunch of flowersbunch of flowers  In the presence of fusion a complete rabbitIn the presence of fusion a complete rabbit holding a bunch of flowers will be seenholding a bunch of flowers will be seen  In the presence of suppression either tailIn the presence of suppression either tail or bunch of flowers will be missingor bunch of flowers will be missing
  • 12.
  • 13. Various varieties availableVarious varieties available
  • 14. Stereoscopic slidesStereoscopic slides  Consists of two pictures of same objectsConsists of two pictures of same objects which have been taken from slightlywhich have been taken from slightly different angles, ie, picture for one eye isdifferent angles, ie, picture for one eye is in part dissimilar from that for the otherin part dissimilar from that for the other eyeeye
  • 15.
  • 16.
  • 17.
  • 19. For measurement of angleFor measurement of angle kappakappa  A slide which consist of numbers andA slide which consist of numbers and letters or animal pictures is usedletters or animal pictures is used
  • 20. After image testingAfter image testing  In this right fovea is stimulated withIn this right fovea is stimulated with vertical and left with horizontal bright lightvertical and left with horizontal bright light  Pt is asked to draw the position of afterPt is asked to draw the position of after imagesimages  A pt with NRC will draw a crossA pt with NRC will draw a cross  An esotropic pt with ARC will draw verticalAn esotropic pt with ARC will draw vertical image to the left of horizontalimage to the left of horizontal  An exotropic pt with ARC will draw verticalAn exotropic pt with ARC will draw vertical image to the right of horizontalimage to the right of horizontal
  • 21.  Entoptic phenomenaEntoptic phenomena  Operated by 2 on/off switches,2 speedOperated by 2 on/off switches,2 speed control & 2 reversing switchescontrol & 2 reversing switches  Active polarized light falling on maculaActive polarized light falling on macula  Eccentric fixation & ARCEccentric fixation & ARC HAIDINGER BRUSHES
  • 22.  The pt who learns to recognize the brushThe pt who learns to recognize the brush can be made aware of the spatialcan be made aware of the spatial projection of the fovea and thus use theprojection of the fovea and thus use the centre for fixation.centre for fixation.  This method is employed in treatment ofThis method is employed in treatment of amblyopiaamblyopia
  • 23.  Therapeutic usesTherapeutic uses  Diagnostic usesDiagnostic uses
  • 24.  Measurement of IPDMeasurement of IPD:: >To measure the IPD arms of the synaptophore are>To measure the IPD arms of the synaptophore are placed at 0 and the pt is instructed to look at centerplaced at 0 and the pt is instructed to look at center of the picture in the right hand tube with right eye .of the picture in the right hand tube with right eye . >The examiner aligns the central white line of the tube>The examiner aligns the central white line of the tube with the reflection of the light on center of the ptswith the reflection of the light on center of the pts pupilpupil
  • 25.  Measurement of objective angle ofMeasurement of objective angle of deviation:deviation: >>SMP slides are used .SMP slides are used . >the pt is asked to look at the pictures and then>the pt is asked to look at the pictures and then the arm controlling the picture in front of thethe arm controlling the picture in front of the deviating eye is moved by the examiner untildeviating eye is moved by the examiner until there is no movement of either eye on a coverthere is no movement of either eye on a cover test, performed by alternatively turning of thetest, performed by alternatively turning of the lightlight
  • 26.  Measurement of OA for near fixationMeasurement of OA for near fixation >A -3.00D lens is inserted in the lens holder>A -3.00D lens is inserted in the lens holder situated infront of eyepiece lenssituated infront of eyepiece lens  Measurement of SA of deviationMeasurement of SA of deviation >the pt is asked to move the handle controlling>the pt is asked to move the handle controlling the picture in front of the non fixating eyethe picture in front of the non fixating eye until he sees the 2 pictures superimposeduntil he sees the 2 pictures superimposed  Measurement of cyclodeviationMeasurement of cyclodeviation >>SMP slides are used.SMP slides are used. >in presence of cyclodeviation the image>in presence of cyclodeviation the image appears tilted .appears tilted .
  • 27.  Measurement of angle kappaMeasurement of angle kappa >the pt is asked to focus the zero mark of>the pt is asked to focus the zero mark of the slide , while the examiner looks for thethe slide , while the examiner looks for the corneal reflex.corneal reflex. >if the corneal reflex is on the nasal side of>if the corneal reflex is on the nasal side of the center of pupil the angle is positivethe center of pupil the angle is positive >if it is on the temporal side it is negative>if it is on the temporal side it is negative >the pt is then asked to look in turn either>the pt is then asked to look in turn either one letter or number until the reflex isone letter or number until the reflex is centeredcentered >the degree of deviation corresponding to>the degree of deviation corresponding to the letter is then recordedthe letter is then recorded
  • 28.  To estimate the presence of suppressionTo estimate the presence of suppression >SMP slides and fusion slides can be used .>SMP slides and fusion slides can be used . >In the presence of suppression pts sees only one>In the presence of suppression pts sees only one image .image .  To detect ARCTo detect ARC >>OA & SA of deviation are measured .OA & SA of deviation are measured . >If the angles are equal NRC is present>If the angles are equal NRC is present >If the OA>SA ARC is present.>If the OA>SA ARC is present.  Measurement of range of fusionMeasurement of range of fusion >Deviation is determined using SMP slides .>Deviation is determined using SMP slides . > Then the fusion slides are introduced and blocks> Then the fusion slides are introduced and blocks the arms at the objective angle .the arms at the objective angle . >Amplitude of divergence and convergence are>Amplitude of divergence and convergence are measured with break and recovery pointmeasured with break and recovery point
  • 29. NORMAL VALUES(NORMAL VALUES(IN PRISAMIN PRISAM DIOPTERSDIOPTERS))  In adductionsIn adductions DistanceDistance NearNear BlurBlur 12-1612-16 20-2820-28 BreakBreak 18-2218-22 26-3426-34 RecoveRecove ryry 14-1814-18 22-3022-30
  • 30.  In abductionIn abduction DistanceDistance NearNear BlurBlur NANA 6-106-10 BreakBreak 6-126-12 12-1812-18 RecoveryRecovery 4-84-8 8-148-14
  • 31.  Fusion Vergence exercisesFusion Vergence exercises  Management of suppression-Management of suppression- antisuppression exercisesantisuppression exercises  Eccentric fixation & ARCEccentric fixation & ARC  Amblyopia therapy usingAmblyopia therapy using H.brushesH.brushes
  • 32.
  • 33. Proficiency testProficiency test  The power of eye piece lensThe power of eye piece lens 1.1. +6.50D+6.50D 2.2. +6.00D+6.00D 3.3. +5.00D+5.00D 4.4. +6.25D+6.25D
  • 34.  Principle of synaptophorePrinciple of synaptophore 1.1. Haploscopic PrincipleHaploscopic Principle 2.2. Polarization PrinciplePolarization Principle 3.3. Equal image size and variable object sizeEqual image size and variable object size 4.4. DiffractionDiffraction
  • 35.  Which slide is used in objective angleWhich slide is used in objective angle measurementmeasurement 1.1. FusionFusion 2.2. SMPSMP 3.3. Steriopsis slideSteriopsis slide 4.4. After image slideAfter image slide
  • 36.  Principle of haidinger brushesPrinciple of haidinger brushes 1.1. PolarizationPolarization 2.2. ReflectionReflection 3.3. DiffractionDiffraction 4.4. interferenceinterference
  • 37.  Normal range of break point in adductionNormal range of break point in adduction for distance isfor distance is 1.1. 18-22PD18-22PD 2.2. 12-16PD12-16PD 3.3. 6-12PD6-12PD 4.4. 8-4PD8-4PD