AOA Vision Therapy and Rehabilitation 1 — Questions and Answers
Question 1: The primary goal of vision therapy for convergence insufficiency is to:
- Improve convergence amplitude and fusional vergence ranges (Correct answer)
- Correct the refractive error causing asthenopia
- Strengthen extraocular muscles surgically
- Eliminate the need for reading glasses
Correct answer: Improve convergence amplitude and fusional vergence ranges
Vision therapy for CI aims to recondition the neuromuscular control of convergence, increasing both the amplitude and the positive fusional vergence reserves.
Question 2: Amblyopia is defined as reduced best-corrected visual acuity in one or both eyes due to:
- Abnormal visual experience during the critical period of development (Correct answer)
- Structural abnormality of the retina or optic nerve
- Refractive error alone that cannot be corrected with glasses
- Intraocular pressure damage to the optic nerve
Correct answer: Abnormal visual experience during the critical period of development
Amblyopia is a neurodevelopmental condition caused by abnormal visual input (deprivation, strabismus, or anisometropia) during the sensitive period, leading to cortical suppression.
Question 3: Which treatment is considered the gold standard for anisometropic amblyopia?
- Full refractive correction followed by patching or atropine penalization of the fellow eye (Correct answer)
- Vision therapy alone without refractive correction
- Immediate patching before refractive correction
- Surgical realignment of the eyes
Correct answer: Full refractive correction followed by patching or atropine penalization of the fellow eye
Full refractive correction must be provided first; many children with anisometropic amblyopia improve with glasses alone, and patching or atropine is added if improvement plateaus.
Question 4: The AC/A ratio describes the relationship between:
- Accommodative convergence and accommodation (Correct answer)
- Amplitude of accommodation and age
- Axial length and corneal curvature
- Anterior chamber depth and intraocular pressure
Correct answer: Accommodative convergence and accommodation
The AC/A ratio quantifies how many prism diopters of convergence (AC) are elicited per diopter of accommodation (A) stimulated.
Question 5: Strabismus surgery for constant exotropia primarily aims to:
- Realign the visual axes to restore binocular vision potential (Correct answer)
- Improve visual acuity in the amblyopic eye
- Reduce intraocular pressure in the affected eye
- Correct the refractive error causing the deviation
Correct answer: Realign the visual axes to restore binocular vision potential
Strabismus surgery repositions the extraocular muscles to realign the eyes, creating the opportunity for binocular fusion and stereopsis to develop or be restored.
Question 6: A patient with 4th cranial nerve palsy would show which characteristic ocular deviation?
- Hypertropia that worsens with contralateral head tilt (Correct answer)
- Esotropia greater at near than at distance
- Exotropia in primary position
- Hypotropia in all positions of gaze
Correct answer: Hypertropia that worsens with contralateral head tilt
Fourth nerve (trochlear) palsy causes ipsilateral superior oblique paresis, producing a hypertropia that worsens when tilting the head toward the affected side (Bielschowsky head tilt test).
AOA Vision Therapy and Rehabilitation 1
The primary goal of vision therapy for convergence insufficiency is to: