Physical Therapy Examination

Lenore Herget PT, DPT, SCS, MEd, CSCS
PHYSICAL THERAPIST

Accommodation

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SVA DVA Hand Held Snellen

SVA DVA Wall Snellen

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Accommodation

PURPOSE
Assess for any monocular focusing impairments that may effect visual function and require referral to NO.
POSITION
CLINICIAN: Seated.
PATIENT: Seated facing patient at eye level.
TECHNIQUE
Patient covers one eye, holds target with opposite hand, slowly brings target toward open eye, stops when target starts to blur; Clinician measures distance from bridge of nose to target. Patient brings target away from open eye and stops when target is back in focus; Clinician measures from bridge of nose to in-focus target.
INTERPRETATION
If difference between the 2 distances are greater than 4 cm, accommodation is impaired.
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SVA DVA Hand Held Snellen

PURPOSE
Ability to visually resolve subtle spatial details of an object when the object, the observer, or both, are moving Miller & Ludvigh, 1962.
POSITION
CLINICIAN: Behind patient.
PATIENT: Seated.
TECHNIQUE
Patient sits 20 feet away from snellen eye-chart; Patient reads lowest line clearly (*may also use handheld snellen at arms length distance if space does not allow. Notate patient arms length distance in chart. "lenore thing"); Patient moves head 30 degrees left to right and right to left at 120 BPM or 2Hz with metronome (180 BPM with higher level patients) while reading lowest line possible on snellen eye-chart. Repeat vertically as well.
INTERPRETATION
Greater than 1 line difference when compared with static visual acuity measure is indicative of vestibular dysfunction
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SVA DVA Wall Snellen

PURPOSE
Ability to visually resolve subtle spatial details of an object when the object, the observer, or both, are moving Miller & Ludvigh, 1962.
POSITION
CLINICIAN: Behind patient.
PATIENT: Seated.
TECHNIQUE
Patient sits 20 feet away from snellen eye-chart; Patient reads lowest line clearly (*may also use handheld snellen at arms length distance if space does not allow. Notate patient arms length distance in chart. "lenore thing"); Patient moves head 30 degrees left to right and right to left at 120 BPM or 2Hz with metronome (180 BPM with higher level patients) while reading lowest line possible on snellen eye-chart. Repeat vertically as well.
INTERPRETATION
Greater than 1 line difference when compared with static visual acuity measure is indicative of vestibular dysfunction
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