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Methods BLOCK 4 > Amblyopia 3 > Flashcards

Amblyopia 3 Flashcards

1
Q

Amblyopia is a diagnosis of _________

A

Exclusion

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2
Q

What are examples of some things that cause reduced VA in one eye but are not amblyopia

A
  • corneal dystrophy
  • macula schisis
  • retinitis pigmentosa
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3
Q

What kind of detailed history should you obtain for someone that you think has amblyopia

A
  • probing birth history (prematurity and low birth weight)
  • family history of amblyopia
  • history of patching or eye drops
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4
Q

What is the very first thing you want to test on a patient in an eye exam?

A

Visual acuity

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5
Q

What does the exam overview look like for someone suspected of having amblyopia

A
  • detailed history
  • VA
  • Cover test
  • ocular motility
  • pupils
  • accommodation
  • binocular function (stereo, W4D, fixation)
  • cycloplegic refraction
  • anterior and posterior segment eval
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6
Q

Why do you want to do a cycloplegic refraction?

A

Completely knock out accommodation so you can get the best refractive error. Gives true picture

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7
Q

Why do you want to check the anterior and posterior segments on someone suspected of having amblyopia

A

Rule out disease

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8
Q

Why do you want to check pupils on someone suspected of having amblyopia

A

Make sure there is nothing wrong with ONH, sensory input

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9
Q

Amblyopia treatments

A
  • optical treatment
  • occlusion therapy
  • vision therapy
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10
Q

What is the first step in the management plan for a patient with amblyopia or strabismus

A

Determination of refractive error

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11
Q

Retinoscopy on a deviated eye

A

May not yield the correct amount of refractive error because the retinoscopy is done off axis. Cover the good eye to have the off axis eye swing back onto axis

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12
Q

What is the method of choice to determine the refractive error in children?

A

Cycloplegic refraction

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13
Q

How is optical correction done?

A

Glasses or contact lenses

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14
Q

What is the difference between the two eyes that is a point of concern in someone who is anisometropic hyperope

A

Difference of 1.00D or more

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15
Q

What is the difference between the two eyes that is a point of concern for someone who is anisometropic myope

A

More than 3.00D

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16
Q

What is the difference in eyes that is a point of concern for someone who is an anisometropic astigmat

A

More than 1.5D

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17
Q

When does it become likely that a hyperope with be isoametropic

A

Greater than +5.00D

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18
Q

At what prescription is it likely that an astigmat will be isoametropic

A

More than 2.50D

19
Q

When is it likely that a myope will be isoametropic

A

More than 6.00D

20
Q

How does amblyopia affect the subjective refraction

A

The visual system is not able to respond well during the subjective refraction. The amblyopic eye is insensitive to the small changes to discriminate during subjective refraction

21
Q

What helps give the best objective measurement of the refractive error present?

A

Completely relaxing accommodation, usually with an anti-muscarinic such as cyclopentolate

22
Q

What is a tough question even for the most seasoned eye care professionals?

A

How much prescription they should give

23
Q

How should prescribing practices be done?

A

Based on the case you are treating

24
Q

After the retinoscopy and subjective refraction, the prescription to issue is based on the ________ and ___________

A
  • findings

- other relevant information

25
Q

Things to think about when prescribing glasses for kids

A
  • is refractive error still changing
  • is there accommodative strabismus that has developed
  • will full Rx interfere with emmetropization
  • will full correction give been better acuity than partial correction
  • is this child still in critical period
  • how early do i treat this child
  • what is prognosis
  • what is the treatment goal for the child
26
Q

What is the goal for optical treatment

A
  • clear retinal image for each eye to allow for binocularity
  • stopping any amblyogenic process
27
Q

Accommodative ET sc in vision therapy

A

This is dumb because they should be corrected before they ever have to consider vision therapy

28
Q

Start with ______first before introducing other management for amblyopia

A

Prescription

29
Q

Why do we start with prescription first before introducing other management for amblyopia?

A
  • allows child to adapt to the prescription
  • allows you to determine the amount of clarity that is gained by correction only
  • allows you to see how aggressive you may have to be
  • improves compliance and the acceptance of subsequent management that may be introduce
  • f/u could be 3-4 months, depending on case
30
Q

If hyperopic anisometropic amblyopia is present without esotropia, what can be prescribed?

A

A partial balanced prescription can be issued

31
Q

If an accommodative esotropia is present, what needs to be prescribed?

A

Close to the full prescription should be considered

32
Q

What is he goal when prescribing?

A

Balance between the two eyes and alignment

33
Q

Occlusion therapy

A

Concluding the better seeing eye to stimulate the amblyopic eye and force it to improve visual function
-also eliminates eccentric fixation

34
Q

What types of occlusions are there?

A
  • direct (over better seeing eye or alternating)
  • full time or part time
  • with occluded or by penalization
35
Q

Penalization

A

A form of occlusion where atropine is used to blur the vision in the better seeing eye

36
Q

Barriers and concerns about occlusion therapy

A
  • compliance
  • development of strabismus
  • occlusion amblyopia (will happen to better seeing eye if it is patched too much)
  • cosmesis
  • skin irritation
  • atropine side effects
37
Q

Atropine side effects

A
  • hot as a hare
  • dry as a bone
  • blind as a bat
  • red as a beet
  • mad as a hatter
38
Q

Vision therapy

A
  • visual tasks and procedures to improve vision
  • improves visual efficiency (eye movement, accommodation, and binocularity)
  • does not replace optical correction, it augments it
39
Q

Case considerations and trends of deprivation amblyopia

A
  • remove any obstructions to minimize binocular disruption
  • refractive error corrected for best vision
  • amblyopia treatment initiated after reevaluation
40
Q

Case considerations and trends for isoametropic amblyopia

A
  • correction as soon as possible
  • reevaluate after 4 months
  • amblyopia treatment initiated
  • VT
41
Q

Case considerations and trends for anisometropic amblyopia

A
  • correction
  • reevaluate 4 moths
  • amblyopia treatment
  • VT
42
Q

Case considerations and trends for strabismic amblyopia

A
  • correction
  • reevaluate VA and bino
  • amblyopia treatment
  • VT
  • prism
  • surgery
43
Q

When is surgery contraindicated when there is a strabismic amblyopia?

A

Contraindicated in most accommodative esotropia

Methods BLOCK 4 (7 decks)

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