Visual Analysis Assistant

Chairside decision support — mock-up

Enter encoded findings below. Every value is checked against the OEP Table of Expecteds in real time, and the Case Chaining engine assembles the High/Low diagnostic fraction as you type. Horizontal phorias use signed notation (Exo (+), Ortho (0), Eso (−)), while VT #12 vertical phorias use signed vertical notation (Right Hyper (+), Ortho (0), Left Hyper (−)).

Status legend WNL within normal limits HIGH (H) above expected LOW (L) below expected BORDERLINE between minimum & average — not yet encoded

Refractive Baseline

Points #4–#7a

Pt.	Finding	Encoded	Expected	Status

Distance Findings (6 m)

Points #8–#11

Pt.	Finding	Encoded	Expected	Status

Vertical Balance & Ductions (VT #12 · 6 m)

Point #12 — Non-accommodative vertical alignment & fusional duction reserves

VT #12 Isolation

Pt.	Finding	Encoded	Expected	Status

Nearpoint Findings (40 cm)

Points #13b–#21

Pt.	Finding	Encoded	Expected	Status

Gradient AC/A Ratio

#13b+1.00 − #13b

—

Enter #13b and #13b +1.00D phorias to calculate

Cross-Cylinder Shift

#15a − #15b

—

Enter #15a and #15b to calculate the shift direction

Hofstetter's Amplitude Norms

Point #19

Patient age—

Minimum (15−0.25·age)—

Average (18.5−0.30·age)—

Measured (#19)—

Interpretation—

Vertical Reserve Analyzer

Point #12 · Sheard's Vertical Criterion

S = ⅔D − ⅓R

Sheard's Vertical Formula: S = (2D − R) / 3

S Prism Demand: Suggested relieving vertical prism to prescribe (Δ BD/BU).
D Vertical Phoria (#12a): Magnitude of Hyperphoria (Δ).
R Compensating Duction (#12b): Opposing vertical recovery point (Δ).

Rule Compensating vertical recovery must be at least twice the vertical phoria (R ≥ 2D).

Vertical Phoria (D = #12a)—

Compensating Reserve (R)—

Sheard's Demand (2 × D)—

Suggested Relieving Prism (S)—

Vertical Compensation—

Case Chaining & Differential Diagnosis

High findings / Low findings

No high findings encoded yet

No low findings encoded yet

AWAITING DATA

Insufficient findings for classification

Encode distance and near vergence reserves, accommodative findings, and the gradient AC/A to activate the syndrome-matching rules for Types B1, B2, C, and Convergence Insufficiency / Excess.

Scheiman & Wick Clinical Battery — Decision Support

Enter optometric findings below. Test results are compared against Morgan's Table of Norms in real time. For tests with direct correspondence to the 21 Visual Steps, the parallel Visual Test No. (#8, #9, #10, #11, #12a, #13b, #16, #17, #19, #20, #21, #4, #6) is shown alongside. Horizontal phorias use signed notation (Exo (+), Ortho (0), Eso (−)).

Morgan's status legend WNL within Morgan's expected HIGH (H) above expected LOW (L) below expected reserve / norm RECEDED receded NPC / borderline — not yet encoded

Refractive Baseline & Patient

Age · Retinoscopy · Dynamic Lag

Test No.	Finding	Encoded	Morgan's Expected	Status

Distance Findings (6 m)

Phoria · Base-In · Base-Out

Test No.	Finding	Encoded	Morgan's Expected	Status

Nearpoint Findings (40 cm)

NPC · Phoria · Base-In · Base-Out

Test No.	Finding	Encoded	Morgan's Expected	Status

Accommodative Battery

Amplitude · Facility · Relative Accomm.

Test No.	Finding	Encoded	Morgan's Expected	Status

AC/A Ratio (Gradient)

Point #13b+1.00 − #13b

—

Enter Near phorias to calculate

Sheard's Criterion Solver

Primary for Exophoria

S = ⅔D − ⅓R

Sheard's Formula Legend

S Prism Demand: Suggested relieving Base-In prism to prescribe (Δ). If S ≤ 0, reserve is adequate.
D Phoria Demand: Magnitude of Exophoria demand (Δ).
R Compensating Reserve: Opposing Base-Out (PFV) blur or break point (Δ).

Rule Compensating reserve must be at least twice the phoria (R ≥ 2D) for comfortable single binocular vision without asthenopia.

Demand (D = Phoria)—

Compensating Reserve (R = BO)—

Required Reserve (2 × D)—

Prism Prescribing Demand (S)—

Clinical Status—

Percival's Criterion Solver

Primary for Esophoria

P = ⅓G − ⅔L

Percival's Formula Legend

P Prism Demand: Suggested relieving Base-Out prism to prescribe (Δ). If P ≤ 0, vergence is balanced.
G Greater Reserve: Larger opposing vergence break (typically BO in Δ).
L Lesser Reserve: Smaller opposing vergence break (typically BI in Δ).

Rule Patient must operate in middle third of total vergence zone (L ≥ ½G). Does not require blur point or phoria.

Greater Reserve (G = BO)—

Lesser Reserve (L = BI)—

Middle-Third Zone Check—

Prism Prescribing Demand (P)—

Clinical Status—

1:1 Rule & Accommodative Analyzer

Esophoria · Near Lag

Prism = (Eso − Rec) / 2

1:1 Rule Formula Legend

Eso Near Esophoria: Magnitude of near esophoria (Δ).
Rec Base-Out Recovery: Recovery of single binocular vision at near (Δ).

Rule Recovery should equal or exceed phoria demand. If recovery < esophoria, relieving BO prism is indicated.

1:1 Rule Prism (Near Eso)—

MEM Accommodative Lag—

Accommodative Facility (BAF)—

Accommodative Status—

Scheiman & Wick Clinical Classification

Differential Diagnostic Matcher

AWAITING CLINICAL DATA

Enter findings above to classify binocular and accommodative status

Encode distance and near lateral phorias, NPC, fusional vergence reserves, and accommodative findings to activate the diagnostic evaluation for Convergence Insufficiency/Excess, Divergence Insufficiency/Excess, Basic Exo/Eso, Fusional Vergence Dysfunction, or Accommodative Dysfunctions.

📖 View Morgan's System of Normative Values Reference Table

Visual Test No.	Clinical Finding	Test Condition	Expected Mean Norm	Standard Dev.
Pt. #8	Distance Lateral Phoria	6 m (Von Graefe / Maddox)	1Δ Exophoria	± 2.00Δ
Pt. #11	Distance BI Vergence (NFV)	6 m smooth vergence	× / 7 / 4	± 3 / ± 2
Pt. #9, #10	Distance BO Vergence (PFV)	6 m smooth vergence	9 / 19 / 10	± 4 / ± 8 / ± 4
Pt. #12a	Distance Vertical Phoria	6 m Maddox / Von Graefe	Ortho (0Δ)	± 0.5Δ
—	Near Point of Convergence (NPC)	Accommodative target (TTM)	Break < 5 cm	Rec < 7 cm
Pt. #13b	Near Lateral Phoria	40 cm (Von Graefe)	3Δ Exophoria	± 3.00Δ
Pt. #13b+1.00	Gradient AC/A Ratio	+1.00 D at 40 cm	4 : 1	± 2 : 1
Pt. #17a, #17b	Near BI Vergence (NFV)	40 cm smooth vergence	13 / 21 / 13	± 4 / ± 4 / ± 5
Pt. #16a, #16b	Near BO Vergence (PFV)	40 cm smooth vergence	17 / 21 / 11	± 5 / ± 6 / ± 7
Pt. #19	Accommodative Amplitude	Push-up / Hofstetter	18.5 − 0.30·Age	Min: 15 − 0.25·Age
—	Binocular Accomm. Facility (BAF)	±2.00 D flipper (40 cm)	8 cpm	± 5.0 cpm
—	Monocular Accomm. Facility (MAF)	±2.00 D flipper (40 cm)	11 cpm	± 5.0 cpm
Pt. #6	MEM Retinoscopy	40 cm dynamic card	+0.50 D	± 0.25 D
Pt. #21	NRA	Plus to blur at 40 cm	+2.00 D	± 0.50 D
Pt. #20	PRA	Minus to blur at 40 cm	−2.37 D	± 1.00 D

Clinical Diagnostic Summary Reference

Scheiman & Wick Nonstrabismic Binocular & Accommodative Anomalies Matrix

11 Conditions · 12 Parameters

Condition	Cover Test	AC/A Ratio	NPC	Vergence Amplitude	Vergence Facility	Stereopsis	Accommodative Amplitude	Binocular Accommodative Facility	Monocular Accommodative Facility	NRA and PRA	Monocular Estimation Method
Accommodative insufficiency	No predictable pattern	Normal	Normal	BO blur at near may be low	Normal	Normal	Low	Fails −	Fails −	Low PRA	High
Ill-sustained accommodation	No predictable pattern	Normal	Normal	BO blur at near may be low	Normal	Normal	Normal	Fails −	Fails −	Low PRA	High
Accommodative excess	No predictable pattern	Normal	Normal	BI blur at near may be low	Normal	Normal	Normal	Fails +	Fails +	Low NRA	Low
Accommodative infacility	No predictable pattern	Normal	Normal	BO and BI blur at near may be low	Normal	Normal	Normal	Fails +/−	Fails +/−	Low NRA and PRA	Normal
Convergence insufficiency	Exo > N	Low	Receded	Low BO	Low BO	Normal	Normal	Fails +	Normal	Low NRA	Low
Convergence excess	Eso > N	High	Normal	Low BI	Low BI	Normal	Normal	Fails −	Normal	Low PRA	High
Fusional vergence dysfunction	Low eso or low exo	Normal	Normal	Low BO and BI	Low BO and BI	Normal	Normal	Fails +/−	Normal	Low NRA and PRA	Normal
Divergence insufficiency	Eso > D	Low	Normal	Low BI at D	Low BI at D	Normal	Normal	Normal	Normal	Normal	Normal
Divergence excess	Exo > D	High	Normal	Low BO at D Low BI at N	Low BO at D Low BI at N	Normal	Normal	Normal	Normal	Normal	Normal
Basic exophoria	Equal exo at D and N	Normal	Normal	Low BO at D and N	Low BO at D and N	Normal	Normal	Fails +	Normal	Low NRA	Low
Basic esophoria	Equal eso at D and N	Normal	Normal	Low BI at D and N	Low BI at D and N	Normal	Normal	Fails −	Normal	Low PRA	High

*NPC, near point convergence; NRA, negative relative accommodation; PRA, positive relative accommodation; BO, base-out; BI, base-in; N, near; D, distance.