2 - EOM Evaluation (Exam 1)

Question 1

What is angle kappa?

Answer 1

Angle formed by pupillary axis and the visual axis

Question 2

How are the pupillary axis and visual axis different?

Answer 2

Pupillary axis - center of pupil connected to the cornea via a perpendicular line
Visual axis - Line connects fovea to point of fixation through nodal points of the eye

Question 3

What is the primary deviation of patient with strabismus?

Answer 3

Deviation of non-fixating eye

Measured with other eye fixating

Question 4

What is the secondary deviation of a patient with strabismus?

Answer 4

Deviation of the eye that normally fixates

Measured while deviating eye is forced to fixate

Question 5

What is the difference between comitant and noncomitant strabismus?

Answer 5

Comitant - Deviation constant in all directions of gaze

Noncomitant - Deviation varies with direction of gaze

Question 6

Which type of strabismus (comitant or noncomitant) is characteristic of paralytic strabismus?

Answer 6

Noncomitant strabismus

Question 7

What are ductions?

Answer 7

Monocular eye movements

Question 8

What are versions?

Answer 8

Binocular, parallel eye movements

Question 9

How are enophthalmos and exophthalmos different?

Answer 9

Enophthalmos - Recession of globe into orbit

Exophthalmos - Protrusion of globe from orbit

Question 10

What is Hering’s Law?

Answer 10

Equal innervation
innervation to EOMs of one eye is equal to the magnitude in the other resulting in equal, parallel, symmetric eye movements

Question 11

What is a Hirschberg test?

Answer 11

Test that approximates angle of strabismus

Reflection of fixated light source is observed on the deviating eye

Question 12

What are saccades?

Answer 12

Rapid shifts in fixation (reading)

Question 13

What is Sherrington’s Law?

Answer 13

Reciprocal Innervation
Contraction of a skeletal muscle results in relaxation of its antagonist
Ex: bicep/tricep, lateral rectus/medial rectus

Question 14

What is strabismus?

Answer 14

Heterotropia

Deviation of one eye when fixating a target

Question 15

Where should the function of the superior and inferior recti be assessed?

Answer 15

23 degrees temporal

from straight ahead gaze

Question 16

Where should the function of the superior and inferior oblique muscles be assessed?

Answer 16

51 degrees nasal

from straight ahead gaze

Question 17

What are 4 important questions to ask regarding a double vision complaint?

Answer 17

1. When did it begin?
2. In what directions are the images separated?
3. Is it present constantly?
4. Is it worse in a certain direction of gaze?

Question 18

What type of pattern is used to test ductions?

Answer 18

H pattern

Question 19

What type of pattern is used to test versions?

Answer 19

Double H pattern

Question 20

What is the expected finding for the angle Kappa measurement?

Answer 20

Slightly nasal (about 0.5 mm)
Nasal is positive displacement
Temporal is negative displacement

Question 21

Is angle Kappa testing monocular or binocular?

Answer 21

Monocular

Question 22

What does each millimeter of misalignment in the Hirschberg test correspond to?

Answer 22

22 prism diopters of ocular deviation

Question 23

Is the Hirschberg test monocular or binocular?

Answer 23

Binocular

Question 24

What does the FROM acronym stand for?

Answer 24

Full
Range
Of
Motion

Question 25

What does the NLR acronym stand for?

Answer 25

No
Lags or
Restrictions

Question 26

What are the 5 steps of pupil evaluation?

Answer 26

1. Measure pupil size
2. Note lid position
3. Pupil response to direct illumination
4. RAPD present?
5. Pupil response to near stimulus

Question 27

What does the PERRLA acronym stand for?

Answer 27

Pupils are
Equal
Round and
Reactive to
Light and
Accomodation

Question 28

Should a patient wear their corrective Rx during pupil testing?

Answer 28

Yes

If necessary to see target clearly