Ocular Alignment & AC/A Ratio
During the Unilateral Cover Test, you observe the uncovered eye move to pick up fixation. What does this indicate?
tropia
This accommodative test, often used for children, involves starting a target at the upper lid and moving it away until the patient can identify it.
Pull-Away Amplitude
On a Worth 4 Dot test, the patient reports seeing 5 balls. What does this indicate?
Diplopia
The NSUCO (Maples) test scores patients in four specific areas. Name them.
Accuracy, Ability, Head Movement, or Body Movement
What must be completed and worn for at least 2-4 weeks before a binocular vision (BV) workup can be considered valid?
appropriate refractive correction (Best Correction)
A patient has a near phoria of 10 XP. When re-measured through -1.00 D lenses, the finding is 6 XP. What is the Gradient AC/A ratio?
4:1
If a patient fails both BAF and MAF, what system is likely the primary source of the problem?
accommodative system
If suppression is still present on W4D when the room lights are dimmed, how is the suppression classified?
Deep suppression
A patient has a normal vertical time on the DEM but a high horizontal time and a high ratio. What DEM Type is this?
Type 2, which indicates OMD (Ocular Motor Dysfunction) or a tracking problem.
A 10-year-old male with +2.50 D hyperopia and 6 EP’ at near has his symptoms resolved by glasses alone. Why was BV testing not helpful initially for the 11-year-old in Case
BV testing is not helpful without correction
This method of calculating AC/A is typically higher because it is impacted by proximal vergence.
Calculated AC/A
What does the mnemonic "BIM BOP" stand for in the context of Binocular Accommodative Facility (BAF)?
Base In Minus, Base Out Plus
In vergence testing, this specific point occurs when voluntary fusional vergence breaks down, leaving only accommodative vergence to keep the target clear.
Blur Point
Unlike the DEM, the King-Devick (KD) test is limited because it does not control for this factor.
Automaticity (or processing speed)
A 14-year-old male presents with a new-onset eye turn, a headache behind the ear, and nausea/vomiting at night. Why is this likely NOT a BV problem?
"red flags" (sudden onset, night vomiting, specific location) that may indicate a serious medical issue like a brain tumor
According to the "Rule of Thumb", what does a High AC/A (> 7:1) generally mean for a patient's alignment at near?
more eso or less exo
You observe "With Motion" while performing MEM Retinoscopy. What does this result represent, and what is the normal range?
Lag of accommodation, with a normal range of +0.25 to +0.75
Which vergence test indirectly evaluates Positive Fusional Vergence (PFV) by using plus lenses to relax accommodation?
NRA (Negative Relative Accommodation)
In the DEM test, if a patient skips a number, how should their horizontal time be adjusted?
adjusted time should get longer
According to the sources, what is the #1 method for measuring the accuracy of accommodation?
MEM Retinoscopy
When documenting a tropia, what are the four specific characteristics that must always be recorded?
1) Constant vs. Intermittent
2) Right vs. Left vs. Alternating
3) Eso vs. Exo
4) Tropia vs. Phoria
When performing Minus Lens to Blur amplitudes, what amount must be added to the final dioptric result to account for minification, and why?
+2.50 D must be added to account for the working distance in the phoropter
What is the standard prism setup and starting direction for testing Near Vergence Facility?
3 BI / 12 BO stacked prisms, always starting with BI (Base In)
This objective eye movement recording method is beneficial because it is not dependent on examiner skills and measures regressions and reading rates.
Visagraph or RightEye
In Book Retinoscopy, what does a dull, brick red reflex with high "with motion" signify?
Stage Four, representing noncomprehension or complete frustration