Course Code: Clinical Optometric Practice 1

Module #8

Name: RANON, LYAN ANACLETO Q

DAY 8 AFTERNOON SESSION:

Lesson 8- Part 8Title: FUNCTIIONAL TESTS BY VON GRAEFEOR THE OPTOMETRIC
EXTENSION PROGRAM TESTS (OEP)
Lesson Objectives:
1. To be able to perform correctly the Functional tests.
2. To be able to determine the cause of the visual problem of the Px whether it be accommodative,
refractive or binocularvision problem.

Activity 1: What I Know Chart, part 1 (3 mins)

WHAT I LEARNED QUESTIONS: WHAT KNOW (ACTIVITY 4)

#4 Static Retinoscopy
# 5 Dynamic Retinoscopy@ 20 in# 6
Dynamic Retinoscopy @ 40 in # 7
Distant Subjective Test
# 14 A Dissociated Cross Cyl Test # 14
B Binocular/ Fused Cross Cyl.
Test
# 19 A & B Amplitude of
Accommodation
# 20 Positive Relative
Accommodation
# 9 True Adduction @ Far#
10 Convergence @ Far # 11
Abduction @ Far
# 16 A Positive Relative
Convergence
# 16 B Positive Fusional Reserve#
17 A Negative Relative
Convergence
# 17 B Negative Fusional Reserve
# 3 Habitual Phoria @ Far
# 13 B Habitual Phoria @ near# 8
Induced Phoria @ Far/
# 13 B Induced Phoria @ near#
13 B + 1.00 Gradient
#15 A Induced Phoria Thru
Unfused Cross Cyl.
# 15 B Induced Phoria Thru Fused
Cross Cyl.
1. Give the tests for #4 Static Retinoscopy
accommodation # 5 Dynamic Retinoscopy@ 20 in# 6
system? Dynamic Retinoscopy @ 40 in # 7
Distant Subjective Test
# 14 A Dissociated Cross Cyl Test # 14
B Binocular/ Fused Cross Cyl.
Test
# 19 A & B Amplitude of
Accommodation
# 20 Positive Relative
Accommodation
2. Give the tests for # 9 True Adduction @ Far#
vergence system ? 10 Convergence @ Far # 11
Abduction @ Far
# 16 A Positive Relative
Convergence
# 16 B Positive Fusional Reserve#
17 A Negative Relative
Convergence
# 17 B Negative Fusional Reserve
3. Give the Lateral # 3 Habitual Phoria @ Far
phoria tests ? # 13 B Habitual Phoria @ near# 8
Induced Phoria @ Far/
# 13 B Induced Phoria @ near#
13 B + 1.00 Gradient
# 15 A Induced Phoria Thru
Unfused Cross Cyl.
# 15 B Induced Phoria Thru Fused
Cross Cyl.
 Course Code: Clinical Optometric Practice 1
Module #8

Name: RANON, LYAN ANACLETO Q

Activity 3: Create your own mnemonics that will help you remember the following:

1. Equipment used test # 21

 P - Phoropter head
 O - Overhead Lamp
 P - Plus lenses
 NPC - Near point card or reduced Snellen
 NPR - Near point rod

2. Give the setup of test # 20SET

UP:

 Px is seated comfortably on the phoroptor chair

 Gently place the phoropter head in front of the Px’s face
 Adjust the forehead rest
 Adjust the near PD of the PX
 Adjust the LP depends upon the case
HE 7 - Hyperope or emmetrope - # 7 findings
MOR - Myope – Old Rx
P14B - Presbyope - Net # 14B

3. Steps on test # 20
TD – 16 inches
PD – near PD
TT – (NPC) near point card or Reduced Snellen CardLP -
depends upon the case
HE 7 - Hyperope or emmetrope - # 7 findings
MOR - Myope – Old Rx
P14B - Presbyope - Net # 14B
Instructions:
 Instruct the Px to fixate on the reading card and to report if the targets willbe become
blur
 And to report if the targets will be clear.
 Course Code: Clinical Optometric Practice 1
Module #8

Name: RANON, LYAN ANACLETO Q

Activity 5: Check for Understanding (5 mins)

A. What is the test target in test #20?

 Reduced Snellen

B. Give the equipment’s used in test # 20?

 Phoropter head
 Overhead Lamp
 Minus lenses
 Near point card or reduced Snellen
 Near point rod

C. Give the equipment’s used in test # 21?

 Phoropter head
 Overhead Lamp
 Plus lenses
 Near point card or reduced Snellen
 Near point rod

D. Give the method of test 20?

METHOD

 Introduce “Minus “lenses over & above the LP until the Px reports blurring
 Take note of the power on the phoroptor when the Px reports blurring and
the power of the LP for this will be recorded as “to blur “
 Clue: Like signs “Subtract” Unlike signs” Add” g) Reduce the minus lens until the Px
reports clear of target, this will have recorded as “to clear”. This is a specific lens reading
from the phoroptor
 Get the Phoria as the Lens to clear as the lens in place.
 Course Code: Clinical Optometric Practice 1
Module #8

Name: RANON, LYAN ANACLETO Q

D. Case Analysis: Case 1

1. In Test # 21, age 30, old Rx OU – 1.25 D, with VAcc 20/60, # 7 OU - 2.00 D with VAcc 20/20.
Px reports blurring with +1.00 D, clear with – 1.50 D, with phoria of 5eso. How do you record?

 Record #21 To Blur: +2.25 D To

clear: - 1.50 D
Phoria: 5^ eso

E. Case Analysis: Case 3

2. In test # 20, The Px is 35 yrs. Old, with old Rx of OU – 2.25 D with the VAcc of 20/50. The # 7
finding is OU – 3.00 D a with VAcc @ far of 20/20 and a near VAccof 20/20, PD is 64/61.

TD: 16 inches
TT: reduced Snellen
PD: 61 mm
LP: -2.25 D
PP: none

Instructions:
 Please report if there is blurring.
 Please report if there is clear.

Method:
 Introduce – lenses over & above the LP until blurring
 Reduce – lenses until clear
 Get the phoria with lens to clear as the LP
 Course Code: Clinical Optometric Practice 1
Module #8

Name: RANON, LYAN ANACLETO Q

C. LESSON WRAP-UP
1) Activity 6: Thinking about Learning (5 mins)

1) INSTRUCTION: Please mark your work w/c have been accomplished so that you will know how much work
there is left for you to do.

1. How was your learning experience?

- It was good.
2. What topic you find it easy and what topic you find it hard for you?

- The topics were all understandable. I just need to repeat reading them so I couldunderstand it
better.
 Course Code: Clinical Optometric Practice 1
Module #8

Name: RANON, LYAN ANACLETO Q

DAY 8 MORNING SESSION B :
Lesson 8- Part 7 Title: FUNCTIIONAL TESTS BY VON GRAEFEOR THE OPTOMETRIC EXTENSION
PROGRAM TESTS (OEP)
Lesson Objectives:
1. To be able to perform correctly the Functional tests.
2. To be able to determine the cause of the visual problem of the Px whether it be accommodative, refractive or
binocularvision problem

WHAT I LEARNED QUESTIONS: WHAT KNOW (ACTIVITY 4)

#4 Static Retinoscopy 1. Give the #4 Static Retinoscopy
# 5 Dynamic Retinoscopy@ 20 in # 6 tests for # 5 Dynamic Retinoscopy@ 20 in # 6 Dynamic
Dynamic Retinoscopy @ 40 in # 7 accommodati Retinoscopy @ 40 in# 7 Distant Subjective Test
Distant Subjective Test on system? # 14 A Dissociated Cross Cyl Test # 14 B Binocular/
# 14 A Dissociated Cross Cyl Test # 14 Fused Cross Cyl. Test
B Binocular/ Fused Cross Cyl. # 19 A & B Amplitude of
Test Accommodation
# 19 A & B Amplitude of # 20 Positive Relative
Accommodation Accommodation
# 20 Positive Relative
Accommodation
# 9 True Adduction @ Far# 2. Give the # 9 True Adduction @ Far# 10
10 Convergence @ Far # 11 tests for Convergence @ Far # 11 Abduction @
Abduction @ Far vergence Far
# 16 A Positive Relative system ? # 16 A Positive RelativeConvergence
Convergence # 16 B Positive Fusional Reserve# 17 A Negative
# 16 B Positive Fusional Reserve# 17 Relative Convergence
A Negative Relative Convergence # 17 B Negative Fusional Reserve
# 17 B Negative Fusional Reserve
# 3 Habitual Phoria @ Far 3. Give the # 3 Habitual Phoria @ Far
# 13 B Habitual Phoria @ near# 8 Lateral # 13 B Habitual Phoria @ near# 8 Induced
Induced Phoria @ Far/ phoria Phoria @ Far/
# 13 B Induced Phoria @ near# 13 tests ? # 13 B Induced Phoria @ near# 13 B + 1.00
B + 1.00 Gradient Gradient
#15 A Induced Phoria Thru # 15 A Induced Phoria ThruUnfused Cross
Unfused Cross Cyl. Cyl.
# 15 B Induced Phoria Thru Fused # 15 B Induced Phoria Thru Fused
Cross Cyl. Cross Cyl.
 Course Code: Clinical Optometric Practice 1
Module #8

Name: RANON, LYAN ANACLETO Q

Activity 3: Create your own mnemonics that will help you remember the following:
1. Equipment used test # 16A
PORP
 Phoroptor head
 Overhead Lamp
 Reduced Snellen
 Prisms

2. Give the 4 expected responses of test # 17A & 17B

BNBB
 Blurring, Break/Recovery
 No blurring record #17 A blurring
 Blurring, Break/-Recovery
 Blurring, no break only moving of targets

3. Steps on test # 16B

 TD: 16 in.
 PD: near PD
 TT: Reduced Snellen
 LP: depend upon the case
 PP: Whatever is the findings of # 16A (Not specific)HE 7 -
Hyperope or emmetrope - # 7 findings MOR -
Myope – Old Rx
P14B - Presbyope - Net # 14B

Instructions:
1) Please report if the target becomes double
2) and when the becomes one again or recover
3) or the targets will be moving, to the right or to the left.
 Course Code: Clinical Optometric Practice 1
Module #8

Name: RANON, LYAN ANACLETO Q

Activity 5: Check for Understanding (5 mins)

A. Give the indications if there is no break but moving of target in test #16B?
 Move to the right= left eye suppressed
 Move to the left = right eye suppressed

B. Give the indications if the Px will report that there is moving of targets in test# 17B?
 Move to the right= right eye suppressed
 Move to the left = left eye suppressed

C. Discuss the record in test # 16A with negative recovery, what does thatindicate?
 The recovery goes beyond zero and goes to the opposite base

D. Give the expected responses of test 16A & 16B?

 Blurring, Break/Recovery
 No blurring record #16 A X, Break/Recovery
 Blurring, Break/-Recovery
 Blurring, no break only moving of targets

D. Case Analysis: Case 1

1. In Test # 16 A & 16B, Px reports blurring with prism OD 6 ^, OS 7 ^, with breakOD 9 ^, OS
11^, with recovery OD 2 BI, OS 3 BI, how do you Record and support your answer.
 # 16 A 13^
 # 16 B 20/ - 5
We have negative recovery since this is # 16 A & 16 B, we introduce BO butthe recovery
is now BI
 Course Code: Clinical Optometric Practice 1
Module #8

Name: RANON, LYAN ANACLETO Q

E. Case Analysis: Case 3

2. In test # 17 A, The Px is 28 yrs. Old, old Rx – 1.75 D with a Vcc of 20/70, # 7 finding is OU –2.50
D with a VAcc OU 20/25, PD is 64/61. Answer the following forPx to start with in test #17A

TD: 16 in.
TT: reduced Snellen
PD: 61mm
LP: 1.75 D
PP: ready to produce BI & BO

Instructions:
 Please report if the target will become blur
 Report if there is break/recovery

Method
 Introduce BI on both eyes until blurring
 Continue adding BI until the Px reports Break
 Reduce BI until recovery.

C. LESSON WRAP-UP
1) Activity 6: Thinking about Learning (5 mins)

1) INSTRUCTION: Please mark your work w/c have been accomplished so that you will know how much work
there is left for you to do.

1.How was your learning experience?

-It was great that this module taught me so many things.

3. What topic you find it easy and what topic you find it hard for yo?

- -None so far, but I know I have to practice more the different test on this module
 Course Code: Clinical Optometric Practice 1
Module #8

Name: RANON, LYAN ANACLETO Q


Name: RANON, LYAN ANACLETO Q
DAY 8 MORNING SESSION A:
Lesson 8- Part 6 Title: FUNCTIIONAL TESTS BY VON GRAEFEOR THE OPTOMETRIC EXTENSION
PROGRAM TESTS (OEP)
Lesson Objectives:
1. To be able to perform correctly the Functional tests.
2. To be able to determine the cause of the visual problem of the Px whether it be accommodative, refractive or
binocularvision problem.
Activity 1: What I Know Chart, part 1 (3 mins)
WHAT I LEARNED
#4 Static Retinoscopy
# 5 Dynamic Retinoscopy@ 20 in # 6
Dynamic Retinoscopy @ 40 in # 7
Distant Subjective Test
# 14 A Dissociated Cross Cyl Test # 14
B Binocular/ Fused Cross Cyl.
Test
# 19 A & B Amplitude of
Accommodation
# 20 Positive Relative
Accommodation
# 9 True Adduction @ Far#
10 Convergence @ Far # 11
Abduction @ Far
# 16 A Positive Relative
Convergence
# 16 B Positive Fusional Reserve# 17
A Negative Relative Convergence
# 17 B Negative Fusional Reserve
# 3 Habitual Phoria @ Far
# 13 B Habitual Phoria @ near# 8
Induced Phoria @ Far/
# 13 B Induced Phoria @ near# 13
B + 1.00 Gradient
#15 A Induced Phoria Thru
Unfused Cross Cyl.
# 15 B Induced Phoria Thru Fused
Cross Cyl.
Course Code: Clinical Optometric Practice 1
Module #8
QUESTIONS: WHAT KNOW (ACTIVITY 4)
1. Give the tests for #4 Static Retinoscopy
accommodation # 5 Dynamic Retinoscopy@ 20 in # 6
system? Dynamic Retinoscopy @ 40 in # 7
Distant Subjective Test
# 14 A Dissociated Cross Cyl Test # 14
B Binocular/ Fused Cross Cyl.
Test
# 19 A & B Amplitude of
Accommodation
# 20 Positive Relative
Accommodation
2. Give the tests for # 9 True Adduction @ Far#
vergence system ? 10 Convergence @ Far # 11
Abduction @ Far
# 16 A Positive Relative
Convergence
# 16 B Positive Fusional Reserve# 17
A Negative Relative Convergence
# 17 B Negative Fusional Reserve
3. Give the Lateral # 3 Habitual Phoria @ Far
phoria tests ? # 13 B Habitual Phoria @ near# 8
Induced Phoria @ Far/
# 13 B Induced Phoria @ near# 13
B + 1.00 Gradient
# 15 A Induced Phoria Thru
Unfused Cross Cyl.
# 15 B Induced Phoria Thru Fused
Cross Cyl.
 Course Code: Clinical Optometric Practice 1
Module #8

Name: RANON, LYAN ANACLETO Q

Activity 3: Create your own mnemonics that will help you remember the following:
1. Equipment used test # 19 B
POP 0.62
 Phoroptor head
 Overhead Lamp
 Plus lenses
 0.62 M type reading card or J4

2. Give the setup of test # 19 ASET

UP:
 Px is seated comfortably on the phoroptor chair
 Gently place the phoropter head in front of the Px’s face
 Adjust the forehead rest
 Adjust the near PD of the PX
 Adjust the recent # 7 findings

3. Steps on test # 19 B

TD – 13 inches.
PD – near PD
TT – 0.62M typeLP
- Total near PP –
none Instruction:
1) Instruct the Px to read the 0.62 M line of letters or words
2) Ask him to report if there will be difficulty in reading (DR) on that certain lineMETHOD:
 Introduce plus lenses over & above the LP until the Px reports difficulty inreading of
the 0.62M line.
 Take note of the power on the phoroptor when the Px reports DR and thepower of
the LP for recording “
 Clue: Like signs “Subtract” Unlike signs” Add” SSDA
 Once you have the figure decrease 2.50 (constant)
 Record # 19 A no sign
 Course Code: Clinical Optometric Practice 1
Module #8

Name: RANON, LYAN ANACLETO Q

Activity 5: Check for Understanding (5 mins)

A. What is the test target in test # 19 B?

 0.62 M type reading card

B. Give the equipment’s used in test # 19 A?

 Phoroptor head
 Overhead Lamp
 Minus lenses
 0.62 M type reading card or its equivalent (J4)

C. Give the equipment’s used in test # 19 B?

 Phoroptor head
 Overhead Lamp
 Plus lenses
 0.62 M type reading card or J4

D. Give the method of test 19B?

METHOD
 Introduce plus lenses over & above the LP until the Px reports difficulty inreading of
the 0.62M line.
 Take note of the power on the phoroptor when the Px reports DR and the
power of the LP for recording “
 Clue: Like signs “Subtract” Unlike signs” Add”
 Once you have the figure decrease 2.50 (constant)
 Record # 19 A no sign
 Course Code: Clinical Optometric Practice 1
Module #8

Name: RANON, LYAN ANACLETO Q

D. Case Analysis: Case 1
1. In Test # 19A, age 30, LP is – 2.25 D,Px reports DR with 9.00 D, How do yourecord ? show
your solution?

LP – 2.25 D
DR – 9.00 D
6.75 D
2.50
9.25 D

Record: #19A 9.25D

E. Case Analysis: Case 3

2. In test # 19B, The Px is 45 yrs. Old, # 7 finding is OU – 3.00 D add 2.00 D 20/25,PD is 64/61.

TD: 13 inches
TT: 0.62M line letter targets
PD: 61mm
LP: 1.00 D
PP: none

Instructions:
 Please report if you will have difficulty in reading on the letter target

Method:
 Introduce plus lense over & above the LP untiln DR
 Take note how much plus lenes you have added
 Decrease it with 2.50 D
 Course Code: Clinical Optometric Practice 1
Module #8

Name: RANON, LYAN ANACLETO Q

C. LESSON WRAP-UP
1) Activity 6: Thinking about Learning (5 mins)

2) INSTRUCTION: Please mark your work w/c have been accomplished so that you will know how much work
there is left for you to do.

1.How was your learning experience?

-It was great that this module taught me so many things.

3. What topic you find it easy and what topic you find it hard for yo?

- -None so far, but I know I have to practice more the different test on this module.