Page 17 - BOAF Journal 1 2012:2707

Behavioral Optometry BOAF
Volume1 Number1 2012
Cover Test: Do they try and close the eye be- ing covered? Can they maintain their fixation on the target? Does the patient perceive movement of the target in the same direction you see their eyes move?
Motility Testing: Does the patient attempt to move their head? If yes, is the head movement slight or excessively? Do they move their head in the same or opposite direction of their eye move- ments? Do their eyes widen? Do they hold their breath? Is there jaw movement? Is there sustain- ability to their tracking? How accurate is their tracking?
Near Point of Convergence: Do they back away? Hold their breath? Close an eye? If they have a ‘break’ in convergence, do they appreciate diplopia? What about their ability to regain fusion?
Stereo Testing: (I use the Randot Stereo Test from Stereo Optical as recommended by Paul Har- ris). (This test has 6 different figures on the right hand page.) Does the patient call out these figures in a preferred left-right, top-bottom pattern? (On the left page there are eight different diamond shapes. There should be one corner of the dia- mond with a circle that ‘floats’.) Can the patient use the proper spatial language to describe which location has the floating circle? (How is their Ex- pressive Language?)
Pupil Testing: Do they wince when the light is shone in their eyes? Do you see any sort of reac- tion in their body, such as an arm or leg flinch?
Refraction: What is their JND (Just Noticeable Difference) like? Can they appreciate changes in 0.25 steps? Do they need a 0.50 step to notice a change? Are they consistent with their cylinder responses?
OEP Analytical: Can the patient understand your instructional set? (How is their Receptive Language?) Phorias: Do they miss-time their re- sponse, either early or late? Vergences: Can the patient appreciate a blur? Do they notice any per- ceived movement of the target either in or out? Does this perception following the preferred SILO (Small In, Large Out), or is it SOLI?
Posture: Does the child sit still while in the exam chair? Are they wriggling all over? Do they
lean on the arm rests? Do they slump? Do they push against the phoropter?
Do they back away? How many times do they back away? Do they try and look out from the phoropter to see how things look differently? How are their feet positioned? Does their feet posture match their phoria findings?
V.O. Star: How do they stand against the ma- chine? How well do they use both hands when picking up the pencils? Can they hold both pencils in a similar manner? Can they accurately locate with their tactile system where the board is? Do they accidentally pound the machine with their hands? Do they lead with their pinkies to find the screen? Can they move both hands simultaneously when drawing lines?
I am sure there are many more, or different tests you perform during your evaluation of a pa- tient. My list is not meant to be all-inclusive. I am also sure that you already have many different ob- servations that you make, and derive a lot of in- credible information from those observations. Hopefully I have at least stirred up some curiosity, or stimulation for you to think further, and deeper in this area!
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Geoffrey A. Heddle