Ocular Motility Evaluation & Binocular Vision Assessment Flashcards

A child has a right esotropia of 35 PD at distance and 20 PD at near. This pattern is most consistent with:

Answer: Divergence insufficiency esotropia

Divergence insufficiency shows a larger esodeviation at distance than near, suggesting a deficiency in tonic divergence.

Anomalous retinal correspondence (ARC) is confirmed when the angle of anomaly equals:

Answer: The objective angle of deviation

In harmonious ARC the angle of anomaly equals the objective angle so the patient perceives no diplopia despite the manifest deviation.

The AC/A ratio is BEST measured clinically using which method?

Answer: Heterophoria (gradient) method with +3.00 lens at 6 m

The gradient AC/A method measures the change in deviation induced by a +3.00 or -3.00 lens at a fixed distance, isolating accommodative convergence.

On the Bagolini striated lens test a patient reports two lines forming an 'X' that passes through the light. This indicates:

Answer: Binocular single vision (fusion)

An unbroken 'X' through the light source on Bagolini testing indicates binocular fusion under natural seeing conditions.

Which clinical test can differentiate a true Brown syndrome from an inferior oblique palsy?

Answer: Forced duction test in the field of the inferior oblique

In Brown syndrome, forced duction is positive (restriction) in the superotemporal direction; in IO palsy, forced duction is negative.

Near point of convergence (NPC) is considered ABNORMAL when the break point is greater than:

Answer: 7–10 cm

A break point beyond 7–10 cm (with poor recovery) is clinically considered a receded NPC, often associated with convergence insufficiency.

In a patient with acquired right sixth nerve palsy, the compensatory head posture would be:

Answer: Right face turn

A right face turn places the gaze direction away from the field of action of the paretic right lateral rectus, reducing diplopia.