Diagnosis & Management of Strabismus and Amblyopia Flashcards

What is the most common type of strabismus in children?

Answer: Esotropia

Esotropia, an inward turning of one or both eyes, is the most common type of strabismus found in children. It can be constant or intermittent and often presents early in life. Early detection and treatment are crucial to prevent amblyopia and ensure proper visual development.

Which test is commonly used to quantify the angle of deviation in strabismus?

Answer: Prism cover test

The prism cover test is the gold standard for quantifying the angle of deviation in strabismus. It combines the cover test with prisms to neutralize the eye's movement. By placing prisms of increasing strength in front of the deviating eye until no movement is observed upon uncovering, the orthoptist can accurately measure the magnitude of the deviation in prism diopters.

What is the primary treatment for amblyopia in young children?

Answer: Occlusion therapy (patching)

Occlusion therapy, commonly known as patching, is the primary and most effective treatment for amblyopia in young children. It involves covering the stronger, better-seeing eye for a prescribed period each day, forcing the brain to use and develop the vision in the weaker, amblyopic eye. This stimulates the visual pathways and helps improve visual acuity.

Which of the following conditions is most likely to result in amblyopia if left untreated?

Answer: Strabismus

Strabismus, or eye misalignment, is a leading cause of amblyopia if left untreated. When the eyes are misaligned, the brain receives two different images and, to avoid double vision, it suppresses the image from the deviating eye. This prolonged suppression prevents the visual pathway of the deviating eye from developing properly, leading to reduced vision (amblyopia).

Which tool helps distinguish between comitant and incomitant strabismus?

Answer: Cover-uncover test

The cover-uncover test is crucial for distinguishing between comitant and incomitant strabismus. In comitant strabismus, the angle of deviation remains constant in all gaze positions, while in incomitant strabismus, the angle varies with the direction of gaze, indicating a paretic or restrictive muscle. Observing the eye movements during the cover test in different gaze positions helps identify this difference.

At what age is amblyopia treatment most effective?

Answer: Before age 7

Amblyopia treatment is most effective when initiated early in childhood, ideally before the age of 7 or 8. The visual system is still developing during this critical period, making it more responsive to interventions like patching or atropine penalization. Treatment success significantly decreases after this age as the visual pathways become less plastic.

Which of the following is a surgical treatment for strabismus?

Answer: Strabismus muscle surgery

Strabismus muscle surgery is a common surgical treatment for strabismus. It involves adjusting the length or position of the extraocular muscles that control eye movement to realign the eyes. The goal is to improve ocular alignment, restore binocular vision, and enhance cosmetic appearance.

How does atropine penalization work in amblyopia treatment?

Answer: Blurs the better-seeing eye

Atropine penalization is a treatment for amblyopia that involves instilling atropine eye drops into the better-seeing eye. Atropine dilates the pupil and paralyzes the ciliary muscle, blurring the vision in that eye. This forces the brain to rely more on the amblyopic (weaker) eye, thereby stimulating its visual development, similar to the effect of patching.

What is the primary goal in managing strabismus?

Answer: Restore binocular alignment

The primary goal in managing strabismus is to restore proper binocular alignment of the eyes. This not only improves the cosmetic appearance but, more importantly, aims to establish or restore binocular vision (the ability of both eyes to work together to create a single, three-dimensional image). Achieving alignment helps prevent amblyopia and improves visual function.