By Carole Bowden, Simmons, Norris, Joanne Masters, Noble, Cunliffe, Richard R. Suminski, Jack J. Kanski, Anne Bolton, Ettinger, R. Muller, Roger, Devinksy
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Extra resources for Binocular Vision & Orthoptics
There are several methods of calculating the ACj A ratio. The heterophoria/tropia. gradient and the fixation disparity methods are the most common calculations used (see Chapter 5). In all of these methods, convergent (esophoric) values are taken as positive values and divergent (exophoric) as negative values. 1). Using this method, the normal values range from 4: 1 to 7: 1. Thegradientmethod of calculating the ACj A ratio is by determining the effect of spherical lenses on convergence. It can be measured either at distance or near.
Other antisuppression exercises include uniocular reading with the suppressing eye or. for children. using a red filter over the non-suppressing eye and a red pen while colouring in letters or pictures. Improve the convergence. Give pencilto-nose exercises using an accommodative target. and ensure that diplopia is appreciated at the break point. If the patient has reasonable convergence, a better exercise is one employing physiological diplopia. Using a dot card from the tip of the nose. two lines of dots are seen, which will automatically cross at the point of fixation.
The symptoms are aggravated by poor health, anxiety or by a lack of sleep. Secondary convergence insufficiency may be secondary to: • intermittent exophoria/tropia of divergence-excess type (divergence greater at distance); true or pseudo • exophoria/tropia of convergenceweakness type (divergence greater at near) with/without a low AC/A ratio • vertical muscle defect • misuse of the accommodative convergence mechanism, for example in uncorrected high myopia, high hypermetropia. e. ability to change accommodative demand), or accommodative insufficiency • poor general health (also associated with loss of accommodation) • paresis.
Binocular Vision & Orthoptics by Carole Bowden, Simmons, Norris, Joanne Masters, Noble, Cunliffe, Richard R. Suminski, Jack J. Kanski, Anne Bolton, Ettinger, R. Muller, Roger, Devinksy