OTM II Final - Prescribing Guidlines

Anisometropia

Significant difference in refractive error between the eyes (2.00D)

Antimetropia

Opposite signs in refractive error between the two eyes.

Aniseikonia

the perception of different image sizes between the two eyes resulting from different refractive errors leading to unequal magnification of images.

obtain pertinent information

do no harm

dont rock the boat

carefully follow rules of thumb

four practical principles of refractive care

age

incidence of myopia increase with..

2-3 D

Avoid correcting myopia in infants if it is less than

1-1.50 D

Correct myopia in toddlers if it is more than

Congenital myopia

myopia that is present at birth that persists through infancy and childhood. Often large magnitudes greater than 5 D. Prevalence is only about 1-2%.

Youth onset myopia

the most common presentation of myopia. Onset is around 5 years to teenage years. Magnitude increases throughout adolescence via myopic progression

20/40

Children entering school should have acuity ___ or better

0.50

Recommend an Rx change for a myope when there is ____ D change in refraction.

0.75

Patients who are over minused do not tolerate a decrease in minus power greater than ____ D

Pseudomyopia

overactive accommodation or difficulty relaxing accommodation results in minus power refraction in emmetropic or low hyperopic patients. Can be confirmed via cycloplegia refraction which will show plano or plus correction instead of minus.

Manifest hyperopia

the amount of hyperopia that you can identify through manifest refraction and binocular balance with no cycloplegic agent.

Absolute hyperopia

the amount of hyperopia that your patient cannot compensate for by using accommodation. Patient has decreased acuity and needs to wear plus lenses to achieve best VA. More common in adult patients

Facultative hyperopia

the amount of hyperopia that is discovered by manifest refraction on young patients with normal uncorrected distance acuity. Despite clear distance VA, the patient accepts plus lenses. Patient complains of visual discomfort rather than problems with clarity. May noticed blurred distance VA after prolonged near work.

Latent hyperopia

additional hyperopia that can only be uncovered by a cycloplegic agent, during a "wet" refraction.

strabismus

Correct hyperopia in children under 3 years of age if _____ present.

hyperope

If there are no symptoms of vision clarity or comfort, do not prescribe for a _____ regardless of the amount of refractive error.

Donders rule

rule applied for patients resisting a bifocal correction. Helps determine the add for a full time single vision correction. Manifest + 0.25 (latent)

Amblyopia

failure of the eye to develop the ability to see clearly

Strabismic amblyopia

amblyopia occurring as a result of the loss of binocular interaction.

Refractive amblyopia

amblyopia caused by high refractive error. Blurred retinal image fails to provide an appropriate visual stimulus for the eye to develop good visual acuity.

Isometric amblyopia

bilateral refractive amblyopia. Is more common in high hyperopic corrections than myopic.

Anisometric amblyopia

amblyopia that develops because of a refractive difference between the eyes. Each ametropia has different amounts of anisometropic amblyogenic factors.

0.50, 15

Astigmatism correction shows adaptation problems with a power change greater than ___ or an axis change of greater than ____ degrees

higher power

Changes in cylinder power axis is more noticeable with

toward

An axis change (toward or away) from 90 or 180 is more tolerable