Diagnosis & Management of Strabismus and Amblyopia Flashcards
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Read the first 7 Diagnosis & Management of Strabismus and Amblyopia flashcards as text
A patient with Duane retraction syndrome type I shows:
Answer: Limited abduction with globe retraction and narrowing of the palpebral fissure on adduction
Duane type I features limited abduction; co-contraction of horizontal recti during adduction causes globe retraction and fissure narrowing.
Which treatment is first-line for convergence insufficiency in a school-age child?
Answer: Office-based vergence/accommodative therapy supplemented with home exercises
The CITT trial showed that office-based vergence/accommodative therapy is significantly more effective than home exercises or prism glasses alone for convergence insufficiency.
Which refractive error is most commonly associated with accommodative esotropia?
Answer: Hyperopia
Accommodative esotropia is driven by excessive accommodative effort to overcome hyperopia, which triggers over-convergence through the high AC/A linkage.
On the Hirschberg test, a corneal light reflex displaced 1 mm nasally in the left eye corresponds to approximately how many prism diopters of left exotropia?
Answer: 15 prism diopters
Each 1 mm of corneal reflex displacement corresponds to approximately 15 prism diopters (or 7°) of deviation.
A child presents with a left hypotropia that increases in right gaze and with right head tilt. By the Parks three-step test, the paretic muscle is most likely the:
Answer: Left superior oblique
Step 1 (left hypo = right hyper) → right-side depressors or left-side elevators; Step 2 (worse in right gaze) → right SO or right IR; Step 3 (worse on right tilt) → right SO confirmed.
Which form of amblyopia has the BEST prognosis for visual recovery with appropriate treatment?
Answer: Anisometropic amblyopia detected at age 3-4 years
Anisometropic amblyopia without deprivation, treated within the sensitive period (before age 7-8), typically responds well to refractive correction and patching.
The critical period for amblyopia treatment, during which the visual cortex remains most plastic, is generally considered to end at approximately:
Answer: Age 7-8 years
The visual cortex is most plastic during early childhood, with the critical period closing around age 7-8, though some plasticity persists into adolescence.