Page 27 - BOAF Journal 1 2012:2707

Behavioral Optometry
BOAF
Volume1 Number1 2012
Basal Conditions
A charting will show very little difference in the percent- age of restriction when taken under non-basal and then basal conditions if dental foci of infec- tion alone are involved. For a more definitive test test for den- tal involvement, the following routine is suggested. A basal plotting of the physiological blind-spot is made. /See figure 4a.) The patient is then given at least two large sticks of gum to chew vigorously for exactly fif- teen minutes and is again charted. The reason for the gum chewing is to pump any toxe- mia from around the tooth roots, sockets, and the gingival tissue. If dental foci are in- volved, the charting will show an increased restriction after this provocative test. (See Fig- ure 4b.)
Fig.4a
Figure No.4a is a basal charting of the physiological blind spot by the Davidson technique of visible to invisible showing typical evi- dence of focal infection emanat- ing from the oral region with probably more infectious tissue on the right side of the mouth as indicated by the greater restric- tion in the plotting of the right eye.
Fig.4b
Figure No.4b is a provocative plotting on the same patient taken fifteen minutes later after vigorous chewing.
A basal condition for cae- canometry is to chart the pa- tient in as nearly their first awakening situation as is clini- cally practical. The patient should be advised to arise in the morning, dress slowly, do absolutely nothing to exert themselves, to not brush their teeth, to abstain from food, beverages, or smoking, and to not use their eyes any more than they absolutely must. If the patient has exerted themselves in reaching the doctor‘s office, they should be given a period of rest before the charting is taken.
it is possible through a knowledgeable eliciting of symptoms to obtain much in- formation that will assist you in making a differential diagnosis. Many of the symptoms associ- ated with toxic involvements are the same as those associated with visual problems. As you gain experience, the accuracy of your diagnosis should in- crease. Difficulty in diagnosis is always increased by a patient who has a multiple involvement.
Pathology Detection
The use of a tangent screen to plot the nerve-head and ex- plore the field of each eye re- quires fifteen minutes to one hour but with the Caecanome- ter, both eyes can be charted in approximately five to ten min- utes. The patient is less fatigued because the conflict producing conditions of peripheral move- ment of hand and wand are eliminated, the field of view is restricted to the charting table
with no distracting light in the room, the fixation and charting distances are optimally placed, and the recording is made di- rectly on the chart in the instru- ment and absolute foveal fixa- tion is facilitated. The field is 30° horizontally and vertically but the earliest field changes indi- cating glaucoma occur in the region of the optic nerve-head.
The procedure and instruc- tions used to adjust the instru- ment to the patient and those concerning fixation on the yel- low light are the same as those described earlier. The examina- tion for draining infection and pathological scotoma are es- sentially the same with the ex- ception of the direction of the movement of the test object, size of the test object, and the amount of illumination.
It is suggested that the doc- tor chart first the dominant and then the non-dominant eye of the patient for focal infection using a silver or white lead pen- cil to mark the findings. He can then return to the dominant eye, using the same chart, and use a yellow or orange lead pencil to record the findings for patho- logical scotomata.
The instrument illumination is turned to LO before the chart- ing for pathological scotomata is begun and the test object size is changed to either the 1.00 m/m, 0.79 m/m, or the 0.50 m/m. In some cases, it is suggested that pathology chart- ings should be taken with the test objects used in the order of their diminishing size using a
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