33 - BV motility

Question 1

How to remember secondary and tertiary action of EOMs?

Answer 1

RAD SIN
Rectii ADduct, Superiors INtort

Question 2

Define incomitancy

Answer 2

Ocular deviations that change depending on gaze direction. A.K.A. anisophoria.

Question 3

Define
1) Paralytic stabismus
2) Paralysis vs paresis
3) Palsy

Answer 3

1) Incomitant stabismus due to muscle/nerve function loss.
2) Paralysis = complete loss of muscle function. Paresis = partial.
3) Term encompassing both paralysis and paresis.

Question 4

What’s dissociated broad H?
Purpose:
Equipment:
Method:

Answer 4

Purpose: Compare versions to ductions, establish if incomitancy is neuro or mechanical, paresis vs paralysis.
Equipment: Pentorch, cover paddle
Method:
- To test ductions, cover one eye and do H or star pattern. Repeat for other eye.
- To compare muscle o/a or u/a, cover one eye with gap so you can see it. This means covered eye cannot see pentorch but you can see uncovered eye. Do normal broad H and observe covered eye for equal or unequal action. Repeat for other eye.
- If above test suggests incomitancies at different gazes, perform cover test at different gazes.