Diagnosis & Management of Strabismus and Amblyopia Flashcards

A 4-year-old has 20/200 vision in the left eye with no structural abnormality. Best initial treatment after refractive correction is:

Answer: Patching the fellow (sound) eye

Occlusion therapy for amblyopia involves patching the sound (fellow) eye to force use of the amblyopic eye.

Which of the following best describes anisometropic amblyopia?

Answer: Amblyopia resulting from unequal refractive error between the two eyes

Anisometropic amblyopia results from a significant difference in refractive error between the two eyes, causing chronic blur in one eye.

The Krimsky test is used to measure:

Answer: Angle of deviation using prisms and the corneal light reflex

The Krimsky test measures the angle of strabismus by centering the corneal light reflex with a prism placed over the deviating eye.

A child with esotropia shows a larger deviation on alternate prism cover test than on simultaneous prism cover test. This finding is most consistent with:

Answer: Monofixation syndrome

In monofixation syndrome, the APCT reveals a larger deviation because it breaks down any peripheral fusion, unmasking the full angle.

In intermittent exotropia, the deviation is typically best controlled:

Answer: At near fixation

Near fusion is usually stronger than distance fusion in intermittent exotropia, so the deviation is better controlled at near.

Atropine penalization for amblyopia works by:

Answer: Blurring near vision in the sound eye to promote use of the amblyopic eye

Atropine cyclopleges the sound eye, blurring near vision and forcing the child to use the amblyopic eye for close tasks.

Which measurement is critical when planning strabismus surgery for an incomitant deviation?

Answer: Deviation measurements in all nine diagnostic positions of gaze

Incomitant deviations vary by gaze position, so measurements in all nine positions are needed to plan appropriate muscle surgery.