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19 Cards in this Set
- Front
- Back
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All patients need THIS before you do any thing
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cyclo refraction
what if pt is under/overcorrected? in full? u need to know this |
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For esos - BO prism is a crutch or an excercise?
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crutch
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esos - Sx - criteria?
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angle must be outside fusion range
stable angle prior to sx amblyopia treated first**** full hyper correction in place |
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How does a miotic help to control esodeviation?
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example phospholene iodide - PI - facilitates accommodation, therefore less of the pt accommodative effort is needed and angle of esodeviation improves
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re: refractive sx
how can this improve eso angle? |
1. better vacuity can help fusing
2. refractive accommodative esotropia |
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Overview of the classification of esos:
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1. fully accommodative (refractive accommodative)
2. nonrefractive accommodative (high AC/A) 3. partially accommodative 4. hypoaccommodative 5. infantile 6. non accommodative 7. acute comitant 8. acquired 9. microtropia/monofixation syndrome 10. sensory/consecutive |
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What amplitudes would you check on a refractive accommodative eso pt?
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- divergence
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treatment (general) for nonrefractive accommodative eso?
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these pts have a high AC/A ratio, give them bifocals; OR if dev is not within fusable range, they can have sx (usually Faden MR recess)
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treatment (general) for a hypoaccommodative eso?
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full hyperopic correction
possible need adds for near |
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partially accommodative esos general treatment
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full hyperopic correction
Sx ONLY ON AMOUNT THAT GLASSES DO NOT CORRECT ******** |
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your pt Dx is infantile esotropia, and has hyperopia. what do u do?
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give moderate amount of hyperopic correction
treat amblyopia and any anisometropia Sx ASAP |
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Why can Sx be alightly problematic for infantile eso pts?
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- often, multiple procedures needed
- complicated by DVD, IOOA - "good" surgical result = micro! |
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treatment for nonaccommodative eso
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sx
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treat for acquired eso?
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these are generally nonaccommodative; cyclo refraction - SCAN; Sx ASAP; prisms or occlusion to prevent suppression
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treat for acute comitant eso?
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sudden onset
cyclo refraction; SCAN - alternate occlusion prevents suppression and diplopia; this may also resolve spontaneously, therefore Sx only after ~ 6 months. Prism therapy to deal with diplopia in this time |
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Other than to prevent/alleviate diplopia, suppression, and amblyopia, why would you occlude the non paretic eye in a pt?
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prevent contracture of muscle in good eye
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treat for micros?
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first treat anisometropia/amblyopia; generally observe; watch for possible decompensation of angle; if already suppressing and visually mature, don't disrupt/break this!
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treat for sensory eso
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improve cosmesis; sx on deviated amblyopic eye
however, there is still a low post-op predictable result, since stimulus to fuse is v v low c/o low vision in one eye |
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treat for consecutive eso
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cyclo refraction
IF pt had X(T) before, then they still have binocular potential - therefore need corrected ASAP usually can treat with BO prism |
