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BINOCULAR DYSFUNCTION REMEDIATION I. ACCOMMODATIVE THERAPY. Accommodative Dysfunctions. Run along the vertical axis of the new fangled, BVA ‘O’ MATIC CHART Less severe: towards center More severe: towards periphery. AE. PCE 2ºAE. LOW/ NORMAL. HIGH/ NORMAL. CE. CI. LOW. HIGH. HIGH/
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BINOCULAR DYSFUNCTION REMEDIATION I ACCOMMODATIVE THERAPY
Accommodative Dysfunctions • Run along the vertical axis of the new fangled, BVA ‘O’ MATIC CHART • Less severe: towards center • More severe: towards periphery
AE PCE 2ºAE LOW/ NORMAL HIGH/ NORMAL CE CI LOW HIGH HIGH/ NORMAL LOW/ NORMAL PCI PCE 2ºAI AI
Accommodative Dysfunctions • Off vertical axis: increased vergence involvement • Left: PCI or CI • Right: PCE (secondary to accommodative excess or insufficiency)
AE PCE 2ºAE LOW/ NORMAL HIGH/ NORMAL CE CI LOW HIGH HIGH/ NORMAL LOW/ NORMAL PCI PCE 2ºAI AI
Accommodative Insufficiency (AI) • More severe at bottom edge • Vergence is a secondary modality to address • 5 accommodative activities first 2-3 sessions • Incorporate 2 vergence activities after 2rd session
Accommodative Excess (AE) • More severe at top edge • Usually expect smaller “gains” each week of Tx compared with insufficiency • Vergence is a secondary modality to address • 5 accommodative activities first 3-4 sessions • Incorporate 2 vergence activities after 3rd session
Accommodative Infacility (AInf) • Towards periphery (usually a older, more severe cases) • Top: “Classic” accommodative infacility • Diagnostic criteria for AE PLUS • Difficulty clearing MINUS (and plus) on monocular +/-2.00 facility • Takes longer to remediate than other accommodative Dx
Accommodative Infacility • Towards periphery (usually a older, more severe cases) • Bottom: accommodative infacility with accommodative insufficiency • Diagnostic criteria for accomm. insufficiency AND... • Difficulty clearing PLUS (and minus) on monocular +/-2.00 facility • Takes longer to remediate than AE and AI, but shorter than true infacility
Therapy Techniques for Accommodation Tx • Monocular Hart Chart Rock: • Monocular Lens Rock: • Monocular window screen rock: • Alternate occlusion methods (lens rock or far/near rock): • *Red/Red Rock: • *Binocular A/S Chart Rock:
Vergence Techniques for Accommodation Tx • Brock string: • Add ladybug vergence • Add BI/BO flippers • Add BOP/BIM
Vergence Techniques for Accommodation Tx • Vectogram: • Add spatial localization • Add BI/BO flippers • Add BOP/BIM • Eccentric circles: • Add spatial localization • Add BI/BO flippers • Add BOP/BIM