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Z Strab, VT, & Amblyopia - Final > 7 - Strabismus Dr. O > Flashcards

7 - Strabismus Dr. O Flashcards

1
Q

Consequenses of strab

A

Risk of amblyopia, reduced stereo and fusion, suppression, change of ARC

Symptoms: diplopia, blur, HA, anom head positionsing, asthenopia

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2
Q

Prevalence of strab

A

General pop 2-6%

Young children 2-3%

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3
Q

BEPEDS/MEPEDS:
Risk factors for ET
-122x’s more likely with __D spherical equivalent refractive error
-2x’s more likely with __D aniso

A

+5.00 or more D

1.00+ D

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4
Q 
BEPEDS/MEPEDS:
Risk factors for ET
-pre-K kids have a ~\_\_x’s greater chance
-maternal smoking during pregnancy
-gestational age <33 weeks
A

8x’s

2x’s

4x’s

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5
Q 
BEPEDS/MEPEDS:
Risk factors for XT
-6x’s more likely with \_\_D astigmatism
-maternal smoking during pregnancy
-gestational age <33 weeks
-gender
A

2.50+ D

3x’s

2x’s

1.6x’s more likely if female

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6
Q

BEPEDS/MEPEDS:
Risk factors
-type of deviation assoc w/ family history, gender predilection, and variation by ethnic group

A

XT (females more likely)

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7
Q 
Strabismus
Neuromuscular abnormalities time of onset:
-infantile
-congenital
-acquired
A

I = first 6 months

C = at birth

A = after 6 months

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8
Q

Strabismus

-types of acquired deviations (3)

A

Acute (trauma, infection, etc.)

Long-standing

Consecutive (sx over-correction)

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9
Q

Strabismus

-when to use prism

A

NRC only!

If already developed NRC and BV

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10
Q

Strabismus prognosis

  • sensory adaptations (3)
  • prognosis worse with (3)
A

Amblyopia, suppression, ARC

ET, ARC, constant unilateral strab

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11
Q

Strab: correction of refrative error

  • fully correct (2)
  • if no strabismus
A

Anisometropia, astigmatism

Cut by same amount OD, OS

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12
Q

Strab: added lenses

  • when to use
  • where to place bifocal in younger children
  • how often to weat them
A

For add’l alignment and fusion with high AC/As

Bisect the pupil

FTW

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13
Q

Strab: added lenses

  • added minus
  • why
  • do not over-minus (3)
A

Intermittent XT (IXT scale)

Accomm drive is incr = collapses the angle

CI, presbyopia, accomm problems

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14
Q

Strab: prism

  • how much/range
  • why keep w/in range
A

Up to 16-18pd

Greater than this needs sx

  • deviation becomes visible
  • glasses will weigh a lot
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15
Q

Strab: prism

  • when to use Fresnel
  • when to not use Fresnel and why
A

Acute strab pts

Larger amounts compromise VA (streaks)

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16
Q

Strab: botox

-why it’s not used a lot

A

Varying resopnses and improvement vs sx

17
Q

Strab: referral for sx

  • contraindicated
  • watch __
A

Accommodative ETs

IXTs with good control (0-2 on the scale)

18
Q

Strab: referral for sx

  • make sure __ is tx
  • infantile strab
  • educate family on
A

Amblyopia - w/o clarity, the eye will continue to turn due to lack of stimulation

Earlier = better

Possible need for revisions

19
Q

Strab: sx

-recession vs resection

A

Recession

  • muscle is detached, reattached further back
  • more pull (“stronger”)
  • same length

Resection

  • muscle is shortened, reattached to original site
  • weakens it a bit
20
Q

Strab: sx

  • adjustable sutures
  • why
A

Can be adjusted while in recovery
Afterwards, becomes permanent

Fine-tune, reduce re-operation rates

21
Q

PseudoET

-when is it seen

A

Wide, flat nose bridge with prominent epicanthal folds, small PD

May actually have a deviation - over-diagnosis of pseudo!

22
Q

Infantile ET

  • onset
  • type of deviation
  • assoc condns
  • many have __
A

Birth-6 months

Large constant (>30pd)

Other neurological/developmental condns

Cross fixation - use adducted eye to look into contralateral view

23
Q 
Strab type assoc with:
A or V pattern
DVD (diss vertical dev)
OIO (over-action of IO)
Latent nystagmus
Anomalous head position
A

Infantile ET

24
Q

Accommodative ET

  • onset
  • may be precipitated by
  • amblyopia
  • diplopia may be followed by
A

6mo - 7yrs
Intermittent -> constant

Trauma (accomm spasm)

With large constant unilateral angles

Active suppression

25
Q

Management of refractive accommodative ET

  • correction
  • amblyopia tx
A

Full hyperopic
-residual ET may not respond to correction due to ARC/suppression

If VA doesn’t fully improve with rx

Z Strab, VT, & Amblyopia - Final (7 decks)

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