Board Certified Ophthalmologist FREE Board Certified Ophthalmologist Pediatric Ophthalmology and Strabismus Questions and Answers 2

Question 1

A 4-year-old presents with an alternating exotropia that increases at distance fixation. What is the most likely diagnosis?

Accepted Answer

Intermittent exotropia

Answer

Duane syndrome

Answer

Convergence insufficiency

Answer

Sensory exotropia

Question 2

Which test is most useful for detecting suppression in a child with strabismus?

Accepted Answer

Worth 4-dot test

Answer

Cover-uncover test

Answer

Hirschberg test

Answer

Bruckner test

Question 3

A 6-month-old has a constant large-angle esotropia with cross-fixation. What is the recommended initial management?

Accepted Answer

Bilateral medial rectus recession

Answer

Full-time occlusion therapy

Answer

Observation until age 2

Answer

Prism adaptation followed by surgery

Question 4

A child with retinoblastoma develops secondary esotropia in the affected eye. What is the underlying mechanism?

Accepted Answer

Sensory deprivation disrupting fusion

Answer

Direct infiltration of the medial rectus

Answer

Cranial nerve III palsy from tumor extension

Answer

Increased intraocular pressure restricting motility

Question 5

Which finding on cycloplegic refraction most strongly suggests accommodative esotropia in a 3-year-old?

Accepted Answer

Hyperopia of +4.00 D or greater

Answer

Myopia of -3.00 D

Answer

Astigmatism greater than 2.00 D

Answer

Emmetropia with normal AC/A ratio

Question 6

A 7-year-old with Down syndrome presents with esotropia. Which additional ocular finding is most commonly associated?

Accepted Answer

High accommodative convergence/accommodation ratio

Answer

Brushfield spots

Answer

Persistent fetal vasculature

Answer

Aniridia