Abv 2 Test 2

Front 1

What will the UCT evaluate? What results do you find? Having a (+) ____ will contaminate the UCT results

Back 1

Whether bifixation present under associated conditions; Determines direction and eye laterality (ONLY estimates frequency and magnitude); +EF

Front 2

T/F Must make sure pt is wearing best correction during UCT, not ACT.

Back 2

False, both UCT and ACT must have best rx

Front 3

What's the difference between primary vertical and secondary vertical?

Back 3

Primary: present when eyes are in ortho alignment.
Sec: present only when eyes are misaligned (why you need to neutralize horizontal before vertical)

Front 4

How do high spectacle powers change a pts deviation on ACT?

Back 4

>+5.00 will DECREASE measured deviation;
>-5.00D will INCREASE deviation

Front 5

Equation for calculated AC/A?

Back 5

AC/A = pd(cm) + m(<Dn - <Df)

Front 6

What is the 4 BO prism test used for? In which case is it especially useful? Does the pt focus at near or distance?

Back 6

Assesses whether there is bifoveal fusion or suppression of one fovea; small angle ET; Distance

Front 7

Double maddox rod test: If RE is rotated EXtorsionally, how would red line be rotated if red lens over RE?

Back 7

Red line would need to be rotated INtorsionally (toward nose)

Front 8

What are the 3 general etiological factors that cause strabismus?

Back 8

anatomical, optical, innervational

Front 9

Most concomitant deviations are __________ in origin, whereas most nonconcomitant deviations are from what type of origin?

Back 9

Supranuclear; Nuclear or infranuclear

Front 10

According to Rush & Younge, what are the 3 most common causes of 3, 4, 6 nerve paresis in adults? Children?

Back 10

Adults: Trauma, vascular, neoplasm; Kids: acute viral illness, trauma, congenital.

Front 11

Which type of deviation, concomitant or nonconcomitant, may represent a life-threatening situation? Which diagnostic question would you ask?

Back 11

Nonconcomitant; Ask about diplopia (can attribute to brain)

Front 12

What is the most likely reason for muscle overaction?

Back 12

underacting contralateral synergist (Hering's law of equal innervation)

Front 13

What would you suspect if your pt came in with their head tilted toward their RIGHT shoulder?

Back 13

Left SO underaction

Front 14

What is the difference between primary vs secondary deviations on ACT?

Back 14

Primary: normal eye fixating, prism in front of deviated eye.
Sec: Paretic eye fixating, prism in front of normal eye.

Front 15

During direct observation, how can you determine if an abnormal head position is ocular torticollis or congenital torticollis?

Back 15

Ocular - tilt will go away with patching; congenital - tilt remains with patching

Front 16

When would you do duction testing? Forced duction testing?

Back 16

Duction: when see UA on version testing; FD: When see UA on duction testing (determines if mechanical or innervational cause)

Front 17

During forced duction testing, what type of anomaly do you suspect if (+) restriction? (-) restriction?

Back 17

(+) = mechanical;
(-) = paresis (eye moves when forced)

Front 18

Which test is good for determining newly acquired paresis?

Back 18

Past pointing (spatial localization testing)

Front 19

Which will be greater in pd, primary deviations or secondary deviations? Why?

Back 19

Secondary because paretic eye is fixating (prism over normal eye). So highest amount of prism to fix underaction will be in the problematic eye.

Front 20

The two subjective diagnostic testing methods Red lens/maddox rod and Hess-Lancaster assume what about the pt?

Back 20

They do not have AC or deep suppression

Front 21

What are the classifications for nonconcomitant deviations?

Back 21

<5pd = Concomitant
6-10pd = Mild
11-15pd = Moderate
>15pd = Marked

Front 22

Who is most likely at risk for developing consecutive XT?

Back 22

Moderately sized ET with +4.5D or greater hyperopia and poor potential for normal BV

Front 23

What would you see on ACT if your pt had a dissociated vertical deviation (DVD)?

Back 23

Spontaneous turning of one or both eyes upward

Front 24

What would you see on versions if your patient had bilateral overacting Inferior Oblique’s (IOs)?

Back 24

Upward and nasal movement

Front 25

What types of A-V pattern stabismus are most common? Least?

Back 25

V-Eso > A-Eso > V-Exo > A-Exo

Front 26

How to you differentiate paretic vs. Nonparetic strabismus?

Back 26

Paretic = Acute, sudden, diplopic, differing primary/secondary deviation, past-pointing; Nonparetic = chronic, childhood, no head posture

Front 27

How do you differentiate congenital/old vs recent paralysis?

Back 27

Recent - diplopia always present, incomitant, past-pointing Congenital - toticollis

Front 28

What are the three stages that a recent paresis may under go?

Back 28

1)Weakness of paretic muscle, followed by OA of its direct antagonist. 2)Contracture of direct antagonist. 3) Spread of concomitancy

Front 29

Which paralysis would cause the eye to turn down and out? What also accompanys this paralysis?

Back 29

Complete third nerve palsy; ptosis and fixed, dilated pupil

Front 30

What are the most common causes of complete 3rd nerve palsies?

Back 30

(1) Undetermined. (2) Vascular. (3) Trauma. (4) Aneurysm
VTA

Front 31

Superior rectus paresis will present with what?

Back 31

hypo-deviation of affected eye and limitation of elevation when eye is abducted. Often head is tilted AWAY from affected side

Front 32

What is a ddx of superior rectus paresis?

Back 32

mechanical (limited elevation) or thyroid myopathy

Front 33

Medial rectus paresis will present with what?

Back 33

limited/absence of adduction, probable XT in primary gaze, face turned TOWARD affected side

Front 34

Which palsies would present with pt head tilted TOWARD affected side? AWAY from affected side?

Back 34

MR, LR, IR, and IO paresis would have pt present tilted toward side; SR, SO(CN4) would be away

Front 35

What are the most common etiologies for CN4 SO palsy in adults? Children?

Back 35

Trauma, Vascular, Neoplasms (TVN); Congenital, trauma, inflammation (CTI)

Front 36

What are the most common etiologies for CN6 LR palsy in adults? Children?

Back 36

Vascular, trauma, neoplasm (VTN); Neoplasm, trauma, inflammation (NTI)

Front 37

What kind of oculomotor anomaly is endocrine myopathy often associated with?

Back 37

Graves

Front 38

Which test that DIRECTLY asses the angle of anomaly is NOT effected by (+) EF?

Back 38

Maculo-macula test of cuppers (bifoveal test)

Front 39

What do the 3 categories of Duane's syndrome look like?

Back 39

I: AbDuction deficit
II: ADDuction deficit
III: AbDuction and aDDuction deficit.

Front 40

In acute-onset esotropia, whould should NOT be present?

Back 40

Amblyopia, suppression or AC

Front 41

T/F If an esotrope is comitant, there is no neurological disease

Back 41

False, it does not rule out path.

Front 42

What is Cyclic esotropia?

Back 42

Alternate day Esotropia (24 hrs normal then 24hrs ET)

Front 43

What are some causes of Paretic esotropia?

Back 43

Mechanical restriction, Duane's I and III, Thyroid myopathy, MR fibrosis, trauma, LR6 palsy.

Front 44

What is Blind-spot esotropia?

Back 44

Blind spot of deviating eye consistently overlying fixation area NC

Front 45

What would you observe on the UCT with microesotropia? Visuoscopy?

Back 45

No movement; + EF which is equal to the angle of anomaly

Front 46

What pt will typically have monofixation syndrome (MFS)?

Back 46

Infantile ET that underwent surgery to have cosmetically straight eyes, central/paracentral suppression, peripheral fusion, and No global but limited local stereo

Front 47

Which one of the secondary exotropias are usually caused by pathology?

Back 47

Sensory exotropia - constant, unilateral XT following loss or severe reduction of vision in one eye.

Front 48

What are two ways in which exotropia classified?

Back 48

Constant XT or intermittent XT

Front 49

which muscle is least likely to be paralyzed? What is the etiology, most likely?

Back 49

IO; congenital