Monocular Optometry Student

[qwopty99]

hi there,

i'm a pretty new faculty member of an optometry school.

there is a student starting clinical skills. he's monocular (prosthetic OD). does anyone know of the modifications a monocular optometrist can use during examinations? e.g. how does one measure distance PD? how does one modify retinoscopy? is there a webpage for this?

any help would be appreciated - thanks.

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[r_salis]

I have always been under the impression that being binocular was a pre-requisite for attending optometry school -- without binocularity, how can you appreciate stereo vision and depth? I know there are monocular cues, but you miss a lot on your slit lamp and BIO exams.

 

[sco1styear]

I have always been under the impression that being binocular was a pre-requisite for attending optometry school -- without binocularity, how can you appreciate stereo vision and depth? I know there are monocular cues, but you miss a lot on your slit lamp and BIO exams.

Not true - I know several optometry students that are strabs or amblyopes

 

[cpw]

Not true - I know several optometry students that are strabs or amblyopes

ditto. But, unfortunately I don't know of any web sites or books that address the issue.

 

[Schroder79]

There is a classmate of mine who is monocular due to a corneal transplant that opacified when she was younger. She has a little trouble with judging cup size, but actually she has been doing rather well. Next year she will be doing her rotations. I believe a lot of trained guesswork comes in to play but I could ask her.

 

[PBEA]

hi there,

i'm a pretty new faculty member of an optometry school.

there is a student starting clinical skills. he's monocular (prosthetic OD). does anyone know of the modifications a monocular optometrist can use during examinations? e.g. how does one measure distance PD? how does one modify retinoscopy? is there a webpage for this?

any help would be appreciated - thanks.

puppilometer, or add 3-4mm to near PD (or have your optician do it).

Use the good eye for ret, oscope, etc. Its a little difficult at first, but it can be done (you basically end up slightly off angle, and may partially block patients other eye). I know because I do it everyday. Do not worry about ability to perceive depth (unless it is recently acquired monocular status, then no FB removals for a while ), as other cues contribute far more then stereopsis does. I dont know of any webpage devoted to this, but I think the issue is a non-starter. Just tell the individual that he/she is not the first, and that the condition is not an obstacle, they will learn to adapt without any special instruction.

 

[drmhyde]

hi there,

i'm a pretty new faculty member of an optometry school.

there is a student starting clinical skills. he's monocular (prosthetic OD). does anyone know of the modifications a monocular optometrist can use during examinations? e.g. how does one measure distance PD? how does one modify retinoscopy? is there a webpage for this?

any help would be appreciated - thanks.

I don't know...but I'll keep an eye out for it.

 

[stevec]

Dr. Parkansky on staff at SCO is essentially monocular. I don't know what the deal is with his other eye. He uses his good eye for direct and wears a surgical mask so that his mouth and nose won't be right on the patient. You can probably look him up on the SCO website.

 

[4Eyes]

I don't know...but I'll keep an eye out for it.

Was that a punny?

 

[drmhyde]

Was that a punny?

couldn't resist...sorry

 

[nose_pads]

SCO isn't the only school with monocular faculty.

 

[Ryan_eyeball]

SCO isn't the only school with monocular faculty.
The "binocular vision" schools should get in with the times and not discriminate monocular people as possible candidates to be good optometrists. Let's remember the BV specialists are the same ODs who don't know how to use 90 diopter and don't like to dilate for BIO exams so they are the last ones to use their superior stereoscopic powers in their very own eye exams.

At UMSL we had Dr. Aaron Franze,and hel is an alternating (30 prism) esotrope that is capable of 20/20 out of either eye. He teachs Binocular space perceptions/BV anamolies, BV clinic, and the man probably has never had any moments of stereopsis. He's one of the top minds at the school I attended.

 

[sco1styear]

Dr. Parkansky on staff at SCO is essentially monocular. I don't know what the deal is with his other eye. He uses his good eye for direct and wears a surgical mask so that his mouth and nose won't be right on the patient. You can probably look him up on the SCO website.

Doesn't he wear the surgical mask because of his cancer treatment and wanted to be careful not to catch anything?

 

[nose_pads]

??

 

[prettygreeneyes]

SCO isn't the only school with monocular faculty.
The "binocular vision" schools should get in with the times and not discriminate monocular people as possible candidates to be good optometrists. Let's remember the BV specialists are the same ODs who don't know how to use 90 diopter and don't like to dilate for BIO exams so they are the last ones to use their superior stereoscopic powers in their very own eye exams.

Who are these "binocular vision" schools you are speaking of? And... for the benefit of my naive first year mind... what's wrong with a BV specialist? Why do you assume they can't use a 90D?

I feel like I'm on the wrong side of an inside joke...

pge

 

[4Eyes]

Dr. Franzel is awesome.

I feel like I'm on the wrong side of an inside joke...

I don't get it either.

 

[nose_pads]

Wait a couple of years.

 

[prettygreeneyes]

Wait a couple of years.

I'll wait with baited breath...

Maybe when I finish my pediatrics/binocular vision residency I'll get it.

(That is... if I feel like another year of optometry school after the next four!)

 

[Schroder79]

Binocular vision schools (PUCO is one) should be more open. Its why we do most of the near tests in the OEP 21 point and Cover test, and fixational disparity. A lot of binocular tests aren't used as much as they were 20+ years ago. You will get it all later.

So like I said there is a person in my class who is effectively monocular and she has little problems. Most offices have a pupilometer so pd measurement isn't as big a deal.

I asked a faculty member my first year if an optometrist could still practice if they were legally blind. With all the technology now (which if they used they would become a tech and not a doctor) they could not practice effectively. There are too many visual signs we rely on to practice effectively without being able to see.

 

[4Eyes]

Wait a couple of years.

Maybe it's just been my luck that the BV ODs I've known happen to be some of the most excellent and thorough clinicians I've met.

 

[Ben Chudner]

Its why we do most of the near tests in the OEP 21 point and Cover test, and fixational disparity.

21 point exam. I think PUCO is still the only school that teaches that.

 

[Schroder79]

21 point exam. I think PUCO is still the only school that teaches that.

We probably are. There are a few other things that PUCO is probably the only school to teach also (Normalization method I forget the author.) We learn the 21 point till we get to clinic then we only use pertinant nearpoint tests. I guess you could call it overprepared. Doesn't any other school touch on OEP?

 

[Ben Chudner]

We probably are. There are a few other things that PUCO is probably the only school to teach also (Normalization method I forget the author.) We learn the 21 point till we get to clinic then we only use pertinant nearpoint tests. I guess you could call it overprepared. Doesn't any other school touch on OEP?

I wasn't implying it's a bad thing. I just remember a Saturday clinic instructor at Berkeley that was a PUCO grad. He would go on and on about looking to see if 7 was greater than 14 but less than 3 and if it was to prescribe prism (I'm making up the numbers, but I'm sure you know what I mean). On a Saturday in the summer in Berkeley, the last thing you want to do is listen to that. I always found the 21 point exam amusing because of him.

 

[Schroder79]

I wasn't implying it's a bad thing. I just remember a Saturday clinic instructor at Berkeley that was a PUCO grad. He would go on and on about looking to see if 7 was greater than 14 but less than 3 and if it was to prescribe prism (I'm making up the numbers, but I'm sure you know what I mean). On a Saturday in the summer in Berkeley, the last thing you want to do is listen to that. I always found the 21 point exam amusing because of him.

Don't worry about it. I agree but I don't have enough experience yet to know which tests are important and which aren't. I'm sure there are more tests out there that I don't know about yet too. Optometric care is really dynamic isn't it? Guess the only way to keep up (or what people say anyway) is by reading magazines like Review of Optometry or others like that. Of course there is continuing ed to. Anyway, I agree, did you ever have to do a graph with AC/A ratios and all the vergence values? Glad we don't (I guess years ago they did.) BTW, #7 is the first value from + blur to get 20/20 and 14 is the cross cylinder test....

 

[Ben Chudner]

Anyway, I agree, did you ever have to do a graph with AC/A ratios and all the vergence values? Glad we don't (I guess years ago they did.)

Of course I did. And you know I still do it to this day