“The Art of Prescribing” Course with Dr Rob Lewis and Paul Harris

"The Art of Prescribing" Course with Dr Rob Lewis and Paul Harris

Date: 3/09/2022 (AEST)

Venue: ACBO Office, Q2 Building, 2/8 Queen Street, Melbourne, VIC, 3000

Provider: ACBO

Contact: Sarah Edwards, [E] info@acbo.org.au, [P] 0418 117 717

Learning Objectives

• At the completion of the CPD activity, participants should be able to: 1.1.1 Recall a rational principled basis for prescribing in the context of vision as a neuro-sensory process.
• At the completion of the CPD activity, participants should be able to: 1.1.2 Remember that each optometrist’s understanding of the visual process is further defined by the optometrist’s understanding of human development.
• At the completion of the CPD activity, participants should be able to: 1.1.3 Restate the issues that the use of cycloplegia in a total-population screening program makes the screening procedure relatively slow for the individual child, with families having to wait for 30 to 40 minutes for the cycloplegia to become effective, and it requires a large clinic area to accommodate waiting children and their parents. In addition, the requirement for eye drops may deter some families from attending.
• At the completion of the CPD activity, participants should be able to: 1.1.4 Remember that in 1920, Sheard published a course of study through AOA including mechanism of accommodation, determination of far point of accommodation (subjective refraction), determination of near point of accommodation and amplitude of accommodation, testing procedures, symptoms, systemic conditions affecting accommodation, and accommodative anomalies.
• At the completion of the CPD activity, participants should be able to: 1.1.5 Describe the differences in approach to prescribing of: A To compensate for the refractive anomaly approach typified by ophthalmology with heavy dependence on what is thought to be a true refraction obtained through cycloplegia. B Graphical analytical methods which depend on measures of accommodation and convergence to obtain a rational description of the visual process typified by dependance on AC/A ratios.
• At the completion of the CPD activity, participants should be able to: 1.1.5 Describe the differences in approach to prescribing of: The behavioural model which looks at how the organism actively postures itself in order to anticipate upcoming needs based on an examination which describes the dynamic use of the visual process to derive meaning and to direction action.
• At the completion of the CPD activity, participants should be able to: 1.1.6 Paraphrase why patients come to see us, including, to be certain of performing up to their potential; there is something they cannot do; and they have ocular or visual discomfort.
• At the completion of the CPD activity, participants should be able to: 2.1.1Describe the use of lenses, with an emphasis on prisms from a behavioral-optical point of view
• At the completion of the CPD activity, participants should be able to: 2.1.2Illustrate that the way a prism works is that it takes light longer to pass through the thicker base of the prism than the thin apex, and the wave fronts of light passing through the thicker base of the prism take longer to arrive so the light passing through the base is as if it is coming from further away.
• At the completion of the CPD activity, participants should be able to: 2.1.3Interpret the concept that prism prescriptions are significantly asymmetrical and so require (or sometimes compensate for) a large skew in visual organization.
• At the completion of the CPD activity, participants should be able to: 2.1.4Describe the behavioural concept that vision problems are products of interference or inadequacy in development and/or interference in that which has been developed; and, thus, visual problems are representations of adaptations
• At the completion of the CPD activity, participants should be able to: 2.1.5Report that although the process of accommodation is autonomic in nature, it is accessible to voluntary control, and assumes a position of readiness—a posture in space—as does vergence.
• At the completion of the CPD activity, participants should be able to: 2.1.6Argue that when distressed, the sympathetic enervation to the pupil is increased while parasympathetic enervation to the pupil and the ciliary muscle is reduced, which leads to the volume of adequate clarity being reduced and the range of accommodation being reduced at the same time
• At the completion of the CPD activity, participants should be able to: 2.2.1Recall that convergence insufficiency (CI) consists of a receded near point of convergence (NPC), exophoria at near, reduced positive fusional convergence (PFC), and deficiencies in negative relative accommodation (NRA). However, not all patients with CI have all of these clinical findings. CI can be described as a deficiency of PFC relative to the demand and/or a deficiency of total convergence, as measured by the NPC.
• At the completion of the CPD activity, participants should be able to: 2.2.2Repeat that the most important thing in the delivery of high-quality Visual Therapy is not an instrument, nor is it an activity or procedure; the most important element in providing for an excellent outcome, outside of the patient themselves, is the imagination and skill of the therapist.
• At the completion of the CPD activity, participants should be able to: 2.2.3Repeat that accommodation and convergence are specialized forms of movement designed to help move vision through space.
• At the completion of the CPD activity, participants should be able to: 2.2.4Vision Therapy acts to reduce the need to turn an eye or suppress visual information by helping the person learn to consistently calculate space and to direct action based on their newfound visual skill.
• At the completion of the CPD activity, participants should be able to: 2.2.5Every person needs to understand and regulate the volume of space in which they choose to act, and to come to an understanding of the relationships between everything within the space, including the self, defined as Centering.
• At the completion of the CPD activity, participants should be able to: 3.1.1Recall that in full-term newborns 30% will have astigmatism > 1.00 diopter, which increases in the first 3 months of life.
• At the completion of the CPD activity, participants should be able to: 3.1.2Repeat that astigmatism is highest in first 2 years, reduces by age 4-5, and by 2.5-5 years of age decreases to about 1.00D.
• At the completion of the CPD activity, participants should be able to: 3.1.3Remember that there are five types of Astigmatism
• At the completion of the CPD activity, participants should be able to: 3.1.4Explain that astigmatism is a result of function altering structure.
• At the completion of the CPD activity, participants should be able to: 3.1.5Argue that minus cylinder axis 90 is often associated with a low amplitude of accommodation.
• At the completion of the CPD activity, participants should be able to: 3.1.6Remember that very high astigmatism usually is found in native populations of Eskimos, Laplanders, Aborigines, & American Indians, and is most often axis 180, and -5.00 and greater.
• At the completion of the CPD activity, participants should be able to: 3.2.1Understand better and to differentiate between neglect and unilateral spatial inattention.
• At the completion of the CPD activity, participants should be able to: 3.2.2Patients with the syndrome of neglect act as though whole regions of space contralateral to their lesions do not exist. In early stages, patients may deny ownership of their contralateral limb and also neglect parts of their own body.
• At the completion of the CPD activity, participants should be able to: 3.2.3Right hemisphere damage is a more common and more severe cause of unilateral neglect than left hemisphere damage
• Participants should be able to: 3.2.4Recall that the left hemisphere is specialized for many aspects of language and the right hemisphere for emotions and ‘global’ or holistic aspects of sensory processing. The right hemisphere has a broad ‘searchlight’ of attention that encompasses both the entire left and entire right visual fields. The left hemisphere, on the other hand, has a much smaller searchlight, which is confined entirely to the right side of the world.
• At the completion of the CPD activity, participants should be able to: 3.2.5Repeat that blindsight is a phenomena where conscious awareness of seeing in a part of the visual field (usually a homonymous hemianopia) is gone but unconscious seeing is present.
• At the completion of the CPD activity, participants should be able to: 3.2.6Recognise that neglect carries the connotation of a willful act on the part of the individual, while inattention more accurately describes the individual’s unawareness of, and lack of attentional control over, the condition
• At the completion of the CPD activity, participants should be able to: 1.2.1Explain a concept of the visual process as an anticipatory process, developed in order to direct a person’s diverse movements, two of which include accommodation and convergence.
• At the completion of the CPD activity, participants should be able to: 1.2.2Recall that the common concept of the linear ACA is different to the ACA as a continuous function.
• At the completion of the CPD activity, participants should be able to: 1.2.3Describe the concept that visual impressions supply the foci and cues for attentional fixations; but the infant’s knowledge of the physical world is built up through the dynamic adaptations of the organism as a motor reaction system.
• At the completion of the CPD activity, participants should be able to: 1.2.4 Express that in order to move with intention, it is necessary that we develop an understanding of space, and to understand space we must experience the volume of space through movement.
• At the completion of the CPD activity, participants should be able to: 1.2.5Restate that lenses offer us the opportunity to change the volume and direction of the visual space presented to the person, including: minus lenses compress and move space inward; plus lenses expand and move space outward; and prism induces a rotation in the whole field.

Max CPD hours awarded: 18

Session Information