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Ophthalmology

The Preliminary Examination and Assessment of Visual Acuity

Built from Strabismus Simplified, Second Edition

What’s inside

9 sections · 110 slides

  1. 01

    Overview

    • Scope of the preliminary examination

    1 slide

  2. 02

    History

    • Value of the history in strabismus
    • Common presenting complaints
    • Uniocular versus binocular asthenopia
    • Symptoms of recent onset squint
    • Weighing the cosmetic complaint
    • Age of onset and duration as prognostic factors
    • Precipitating, antenatal and perinatal factors
    • Characterising the deviation on history
    • Head posture and old photographs
    • Treatment history to be elicited

    10 slides

  3. 03

    Refraction

    • Cycloplegic refraction before any measurement
    • Atropine cycloplegia protocol
    • Atropine safety and parental counselling
    • Sedation and prescribing under cycloplegia
    • Interval between glasses and measuring deviation
    • Emmetropisation and the schedule for repeat refraction

    6 slides

  4. 04

    Anterior and posterior segment examination

    • Anterior segment and pupillary examination
    • Fundus findings that precede occlusion therapy
    • Sites of fixation
    • Eccentric fixation on the fundus
    • Prognostic value of the fixation pattern
    • Bilateral eccentric fixation
    • Fundus torsion: the normal landmark
    • Intorsion and extorsion on the fundus
    • Torsional assessment on the fundus

    9 slides

  5. 05

    Visual acuity: principles and charts

    • Standard distance acuity testing in adults
    • Snellen distance acuity chart
    • LogMAR charts for academic and research use
    • LogMAR acuity chart
    • Organic basis of visual acuity
    • Angular subtense of the Snellen optotype
    • Optotype construction and crowding surrounds
    • Types of visual acuity
    • Detection acuity tests
    • Recognition acuity tests: direction identification
    • Recognition acuity tests: letters and pictures
    • Resolution acuity tests
    • Limitations shared by detection and resolution tests
    • Estimating acuity from object size and distance

    14 slides

  6. 06

    Vision testing in infancy

    • Catford drum test
    • Catford drum
    • Reliability of the Catford drum
    • Related drum tests
    • Preferential looking tests
    • Personnel required for the original preferential looking system
    • Teller acuity cards: the card set
    • Cycles, octaves and half octave steps
    • Teller acuity card screen and grating aperture
    • Contrast and illumination requirements for Teller cards
    • Teller acuity card testing in progress
    • Conversion of cycles per centimetre to Snellen equivalents
    • Conversion of cycles per centimetre to Snellen equivalents (continued)
    • Testing distance by age for Teller acuity cards
    • Indications and drawbacks of Teller acuity cards
    • Teller card acuity in normals compared with amblyopes
    • OKNOVIS
    • Cardiff acuity cards
    • Visually evoked response: principle and stimulus
    • Interpreting the P-100 and the two recording modes
    • Reliability and value of VER estimates
    • Sweep-VEP
    • Reflex responses as indirect evidence of vision
    • Development of fixation
    • Fixation pattern and the visual acuity it implies
    • Age of children and expected visual acuity
    • Behavioural signs accompanying visual attention
    • Fixation preference and resentment of occlusion
    • Fixation preference test
    • Induced prism test
    • Follow movements
    • Two phases of visual development
    • Factors in maturation of vision
    • Functions correlating with visual maturation
    • Visual milestones by age
    • Visual milestones by age (continued)

    36 slides

  7. 07

    Age-appropriate vision tests

    • Vision tests at 1 to 2 years
    • Vision tests at 2 to 3 years
    • Tumbling E test
    • Tumbling E optotypes
    • Crowding phenomenon and single letter acuity
    • Landolt's C, Sheridan and HOTV letter tests

    6 slides

  8. 08

    Hyperacuity and stereoacuity

    • Hyperacuity
    • Vernier acuity testing
    • Gratings and Vernier gratings
    • Stereoacuity in infancy and preschool screening
    • Principles of clinical stereotests
    • Tests using no dissociating glasses
    • Randot stereotest
    • TNO test
    • Frisby stereotest
    • Distance stereopsis testing
    • Frisby Davis distance test
    • Distance Randot test
    • Normal stereoacuity values
    • Gross stereopsis: the two-pencil test
    • Two-pencil test for gross stereopsis

    15 slides

  9. 09

    Summary

    • Key points: history and refraction
    • Key points: examination and acuity
    • Key points: paediatric testing and stereopsis
    • References
    • Strabismus Simplified

    5 slides