10 - Opth - Squints - Concomitant Squints

Question 1

baby prevalence? what happens?

Answer 1

73% - usually intermittent and resolve by 4 months

Question 2

associations?

Answer 2

idiopathic
anisometropia
severe hypermetropia or myopia
retinoblastoma

Question 3

features

Answer 3

no diplopia
EOmuscles and CN grossly normal
both eyes have full movement if tested separately

Question 4

Commonest type in children? 3 ways this type can differ

Answer 4

convergent (esotropia)

• may be constant/intermittent,
• may be due to hypermetropia
• may be accomodative or non-accomodative

Question 5

what is the other type? (non convergent) - 2 features

Answer 5

divergent - exotropia - tend to be in older kids and often intermittent

Question 6

Two tests to assess squints

Answer 6

cover test - test for manifests

alternate cover test - test for latents

Question 7

3 other investigations of squints

Answer 7

corneal reflections - asymmetry if squint present
assess VA (rule out amblyopia)
fundoscopy (rule out retinoblastoma)

Question 8

4 principles of mgmt

Answer 8

correct refractive error
eye patching (if <8 and amblyopia)
eye exercises (in mild esotropia)
surgery

Question 9

3 ways to correct refractive error

Answer 9

convex lenses helps convergent deviations - reduces accomodation

concave lenses help divergent deviations - induces accomodation

prisms may be used to correct diplopia

Question 10

Surgery - when? 2 principles?

Answer 10

if severe squint, treatment resistant

resection - shortens and thus strengthens muscle
recession - weakens the muscle