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25 Cards in this Set

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What % of adult vision is a neonates vision at birth?
10%, 20/200
Define the term Amblyopia
Poor vision
Until what age does poor vision result if an clear image is not focused onto the macula in BOTH eyes?
7 years old
Define strabismus
Any condition in which both eyes do not work well together.
Which are more common, comitant or incomitant strabismus?
Comitant strabismus
Which type of strabismus is more common in children?
Comitant
What is the etiology of comitant strabismus?
No known neuromuscular etiology.
How does a comitant strabismus vary with gaze?
It does not, the strabismus remains the same regardless of direction of gaze.
What is the etiology of incomitant strabismus?
Cranial nn palsy
Thyroid disease
Mechanical restriction of involved muscle
What happens to an incomitant strabismus with shift in gaze?
The strabismus is worse when the gaze is in the direction of the involved muscle.
Name 4 types of strabismus
Comitant
Incomitant
Esotropia/ Exotropia
Hypertropia/ Hypotropia
A 2 month old baby with CC of esotropia is brought in, most likely has amblyopia. There is no known neuromuscular etiology. What is the etiology?
Congenital (Infantile)
A 2 month old baby with CC of esotropia is brought in, most likely has amblyopia. There is no known neuromuscular etiology. How would you treat this?
First treat amblyopia - Patch good eye.
Treat the bad eye: glasses if refractive or surgery.
Definitive treatment is: Surgery, preferably before 6 months if caught at birth. Rarely succesful after age 8
A 2 year old boy, CC: esotropia. Has poor vision, is far sighted. The vision has gradually got worse. What is the Etiology?
Accomodative
Patient is hyperopic and to see well, uses excessive accomodation to see well and hence develops esotropia
A 2 year old boy, CC: esotropia. Has poor vision, is far sighted. The vision has gradually got worse. How should this be treated?
Glasses
in 15%, this does not work and they would need to have surgery
What kind of comitant strabismus can be seen with sensory loss? Esotropia or Exotropia
Either Esotropia and Exotropia.
Surgery offered for cosmetic purposes, will not affect vision. Might need to be repeated in 10 yrs.
Other than sensory loss, what other etiology is associated with exotropia and how is this treated?
Idiopathic.
Rx: Eye surgery
What Etiologies are seen with incomitant strabismus?
CN palsy (III, IV and VI)
Thyroid eye disease- Graves
Myasthenia Gravis - ptosis
Mehanical limitation (Blow out fracture or orbital mass)
Patient who has had an aneurysm presents with ptosis, dilated pupil, eye is down and out. What CN palsy are we dealing with here?
CN 3, only two working muscles Lateral rectus (out) and Superior oblique (down)
Patient complains of vertical diplopia, which is worse when he looks down. Titling head makes it better. What CN is out?
CN IV, Superior oblique muscle
Patient complains of vertical diplopia, which is worse when he looks down. Titling head makes it better. What should be done for him?
Give prism glasses
If don't help, then surgery
Patient complains of vertical diplopia, which is worse when he looks down. Titling head makes it better. What is the treatment option?
prism glasses, if don't help then do surgery
Patient presenting with horizontal diplopia and using face turn to eliminate this has problems with what CN?
CN VI palsy.
Rx:
Prism glasses are helpful, if not then do surgery
List 3 causes of amblyopia
Refractive 49%
Strabismus 49%
Ocular pathology eg. cataract 2%
How is amblyopia corrected/ treated
Patch the good eye
Correct the cause
Success with improving vision rarely seen if caught after 8 years old.