OPTOM FASLU MUHAMMED

It’s a haploscopic deviceIt’s a haploscopic device

Consists of two tubes , having a right Consists of two tubes , having a right angled bend, mounded on a base angled bend, mounded on a base having a chin rest and forehead resthaving a chin rest and forehead rest

Each tubes contain a light source for Each tubes contain a light source for illumination of slides and a slide carrier illumination of slides and a slide carrier at the outer end, a reflecting mirror at at the outer end, a reflecting mirror at the right angled bend and an eye piece the right angled bend and an eye piece of +6.50D at the inner endof +6.50D at the inner end

Correction lenses can be inserted in the Correction lenses can be inserted in the lens holder if necessary lens holder if necessary

Elevtn & diprtnElevtn & diprtn

Horizontal vergenceHorizontal vergence

Tube lockingTube locking

Chin rest controlChin rest control Hand flashing switchsHand flashing switchs

Illumination controlIllumination control

Vertical divtnVertical divtn

handlehandle

MirrorEyepiece(+6.50DS)

Slide carrier

Diffusing screenIris diaphram

Grades of Binocular VisionGrades of Binocular Vision

Simultaneous Macular PerceptionSimultaneous Macular Perception FusionFusion StereopsisStereopsis

Simultaneous Macular Simultaneous Macular PerceptionPerception

Two dissimilar slides such as one having a Two dissimilar slides such as one having a picture of a lion and the other of the cage, picture of a lion and the other of the cage, constitute a pair of SMP slides.constitute a pair of SMP slides.

Each slides is presented separately to each Each slides is presented separately to each eye.eye.

There are three gradesThere are three grades

1.1. Simultaneous foveal PerceptionSimultaneous foveal Perception slidesslidesConsists of small sized pictures, the images of Consists of small sized pictures, the images of

which do not exceed the size of the foveawhich do not exceed the size of the fovea

2. 2. Simultaneous Macular Perception Simultaneous Macular Perception slidesslides

In this pictures are slightly larger than In this pictures are slightly larger than those on the SFP slides those on the SFP slides

3. 3. Simultaneous Para Macular PerceptionSimultaneous Para Macular Perception

Slides have the largest pictures and form Slides have the largest pictures and form the images that extends in to Para the images that extends in to Para macular areasmacular areas

Various varieties availableVarious varieties available

Fusion slidesFusion slides Consists of two dissimilar pictures each of Consists of two dissimilar pictures each of

which is incomplete in small detailswhich is incomplete in small details There are two rabbits each lacking a tail or There are two rabbits each lacking a tail or

bunch of flowers bunch of flowers In the presence of fusion a complete rabbit In the presence of fusion a complete rabbit

holding a bunch of flowers will be seen holding a bunch of flowers will be seen In the presence of suppression either tail or In the presence of suppression either tail or

bunch of flowers will be missing bunch of flowers will be missing

Various varieties availableVarious varieties available

Stereoscopic slidesStereoscopic slides Consists of two pictures of same Consists of two pictures of same

objects which have been taken from objects which have been taken from slightly different angles, ie, picture slightly different angles, ie, picture for one eye is in part dissimilar from for one eye is in part dissimilar from that for the other eye that for the other eye

After imageAfter image Haidinger brushes

For measurement of angle For measurement of angle kappakappa

A slide which consist of numbers and A slide which consist of numbers and letters or animal pictures is used letters or animal pictures is used

After image testingAfter image testing In this right fovea is stimulated with vertical In this right fovea is stimulated with vertical

and left with horizontal bright light and left with horizontal bright light Pt is asked to draw the position of after Pt is asked to draw the position of after

imagesimages A pt with NRC will draw a cross A pt with NRC will draw a cross An esotropic pt with ARC will draw vertical An esotropic pt with ARC will draw vertical

image to the left of horizontalimage to the left of horizontal An exotropic pt with ARC will draw vertical An exotropic pt with ARC will draw vertical

image to the right of horizontalimage to the right of horizontal

Entoptic phenomenaEntoptic phenomena

Operated by 2 on/off switches,2 speed Operated by 2 on/off switches,2 speed control & 2 reversing switchescontrol & 2 reversing switches

Active polarized light falling on maculaActive polarized light falling on macula

Eccentric fixation & ARCEccentric fixation & ARC

HAIDINGER BRUSHES

The pt who learns to recognize the The pt who learns to recognize the brush can be made aware of the brush can be made aware of the spatial projection of the fovea and spatial projection of the fovea and thus use the centre for fixation.thus use the centre for fixation.

This method is employed in This method is employed in treatment of amblyopia treatment of amblyopia

Therapeutic usesTherapeutic uses

Diagnostic usesDiagnostic uses

Measurement of IPDMeasurement of IPD:: >To measure the IPD arms of the >To measure the IPD arms of the

synaptophore are placed at 0 and the pt is synaptophore are placed at 0 and the pt is instructed to look at center of the picture instructed to look at center of the picture in the right hand tube with right eye .in the right hand tube with right eye .

>The examiner aligns the central white line of >The examiner aligns the central white line of the tube with the reflection of the light on the tube with the reflection of the light on center of the pts pupilcenter of the pts pupil

Measurement of objective angle of Measurement of objective angle of deviation:deviation:

>>SMP slides are used .SMP slides are used .>the pt is asked to look at the pictures and >the pt is asked to look at the pictures and

then the arm controlling the picture in then the arm controlling the picture in front of the deviating eye is moved by front of the deviating eye is moved by the examiner until there is no movement the examiner until there is no movement of either eye on a cover test, performed of either eye on a cover test, performed by alternatively turning of the lightby alternatively turning of the light

Measurement of OA for near Measurement of OA for near fixationfixation

>A -3.00D lens is inserted in the lens >A -3.00D lens is inserted in the lens holder situated infront of eyepiece lens holder situated infront of eyepiece lens

Measurement of SA of deviationMeasurement of SA of deviation >the pt is asked to move the handle >the pt is asked to move the handle

controlling the picture in front of the non controlling the picture in front of the non fixating eye until he sees the 2 pictures fixating eye until he sees the 2 pictures superimposed superimposed

Measurement of cyclodeviationMeasurement of cyclodeviation>>SMP slides are used. SMP slides are used. >in presence of cyclodeviation the image >in presence of cyclodeviation the image

appears tilted .appears tilted .

Measurement of angle kappaMeasurement of angle kappa>the pt is asked to focus the zero mark of >the pt is asked to focus the zero mark of

the slide , while the examiner looks for the slide , while the examiner looks for the corneal reflex.the corneal reflex.

>if the corneal reflex is on the nasal side of >if the corneal reflex is on the nasal side of the center of pupil the angle is positivethe center of pupil the angle is positive

>if it is on the temporal side it is negative>if it is on the temporal side it is negative>the pt is then asked to look in turn either >the pt is then asked to look in turn either

one letter or number until the reflex is one letter or number until the reflex is centered centered

>the degree of deviation corresponding to >the degree of deviation corresponding to the letter is then recorded the letter is then recorded

To estimate the presence of To estimate the presence of suppressionsuppression

>SMP slides and fusion slides can be used .>SMP slides and fusion slides can be used .>In the presence of suppression pts sees only >In the presence of suppression pts sees only

one image .one image . To detect ARCTo detect ARC>>OA & SA of deviation are measured .OA & SA of deviation are measured .>If the angles are equal NRC is present>If the angles are equal NRC is present>If the OA>SA ARC is present.>If the OA>SA ARC is present. Measurement of range of fusionMeasurement of range of fusion>Deviation is determined using SMP slides .>Deviation is determined using SMP slides .> Then the fusion slides are introduced and > Then the fusion slides are introduced and

blocks the arms at the objective angle .blocks the arms at the objective angle .>Amplitude of divergence and convergence >Amplitude of divergence and convergence

are measured with break and recovery pointare measured with break and recovery point

NORMAL VALUES(NORMAL VALUES(IN PRISAMIN PRISAM DIOPTERSDIOPTERS))

In adductions In adductions

DistanceDistance NearNear

BlurBlur 12-1612-16 20-2820-28BreakBreak 18-2218-22 26-3426-34RecovRecoveryery

14-1814-18 22-3022-30

In abductionIn abduction

DistanceDistance NearNearBlurBlur NANA 6-106-10BreakBreak 6-126-12 12-1812-18RecoverRecoveryy

4-84-8 8-148-14

Fusion Vergence exercisesFusion Vergence exercises Management of suppression-Management of suppression-

antisuppression exercisesantisuppression exercises Eccentric fixation & ARCEccentric fixation & ARC Amblyopia therapy using Amblyopia therapy using

H.brushesH.brushes

Proficiency testProficiency test The power of eye piece lens The power of eye piece lens 1.1. +6.50D+6.50D2.2. +6.00D+6.00D3.3. +5.00D+5.00D4.4. +6.25D+6.25D

Principle of synaptophorePrinciple of synaptophore1.1. Haploscopic PrincipleHaploscopic Principle2.2. Polarization PrinciplePolarization Principle3.3. Equal image size and variable object Equal image size and variable object

sizesize4.4. Diffraction Diffraction

Which slide is used in objective Which slide is used in objective angle measurement angle measurement

1.1. FusionFusion2.2. SMPSMP3.3. Steriopsis slideSteriopsis slide4.4. After image slideAfter image slide

Principle of haidinger brushesPrinciple of haidinger brushes1.1. PolarizationPolarization2.2. Reflection Reflection 3.3. Diffraction Diffraction 4.4. interferenceinterference

Normal range of break point in Normal range of break point in adduction for distance isadduction for distance is

1.1. 18-22PD18-22PD2.2. 12-16PD12-16PD3.3. 6-12PD6-12PD4.4. 8-4PD8-4PD