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Summer Final-VT > Amblyopia Diagnosis And Managment > Flashcards

Amblyopia Diagnosis And Managment Flashcards

1
Q

How do you diagnose amblyopia

A

Diagnosis of exclusion

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2
Q

Detailed history of amblyopia/eye turn

A
  • eye turn
  • which is the better seeming eye
  • medical history
  • probing birth history
  • fam Hx
  • history of any treatment
  • medications
  • development and learning concerns
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3
Q

Exam for amblyopia

A
  • VA
  • CT
  • ocular motility
  • pupils
  • accommodation
  • BV function
  • cycloplegic refraction
  • ant and post seg
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4
Q

Why VA for amblyopia

A

Single line: crowding phenomenon causes difficulty with single line acquitted

Single letter: when single letter acuity is better than single line acuity, prognosis for treatment is better because of the absence of crowding

Single letter surround: VA can be over estimated with single letter, a single letter or optotype with crowding bars offer more reliability

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5
Q

Pinhole

A

If VA does not improve, amblyopia could be a differential

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6
Q

S chart

A

Flom chart or Psychometric chart

Best way to monitor progress of amblyopia. Improves slower than single letter or line during treatment

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7
Q

Contrast sensitivity

A

Can also use to monitor therapy progress

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8
Q

Which is better to test VA for amblyopia

A

Single letter

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9
Q

Issues of VA with amblyopia

A

Crowding is an issue

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10
Q

Not treating amblyopia

A

There are dire consequences if amblyopia is not treated promptly

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11
Q

Loss of better seeing eye in amblyopia

A

High risk of loss of better seeing eye

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12
Q

Treatment goal for amblyopia:

A

Improvement of VA and BV fusion

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13
Q

Amblyopia management

A
  • remove the obstruction
  • optical correction
  • occlusion/penalization of better seeing eye-patches, filters, atropine
  • near point activities with penalization
  • VT
  • surgery fro persistent strabismus (If indicated)
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14
Q

Removing the obstruction

A

Remove it ASAP: as soon as the first two months of life

Resulting refractive error needs to be corrected 1-2 weeks after cataract removal (some infants may need as much as +24.00 to +30.00 correction)
-no IOLS yet bc the eye is still developing, PCA will invade

Prognosis for good vision becomes poorer the older the child is

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15
Q

Removing the obstruction: poor prognosis

A

If a unilateral deprivation exists beyond 3 months of life

Get consultation asap- this is emergent

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16
Q

Refraction and Rxing for amblyopia

A
  • determination of refractive error is the first step in the management plan for a patient with amblyopia or strabismus
  • optical correction is with glasses or CL
  • correction offers a clear retinal image
  • cycloplegic refraction is the method of choice to determine the refractive error in children
17
Q

The goal for optical treatment in amblyopia

A

Clear retinal image for each eye to allow BV

-and stopping any amblyogenic process (accomodative ET sc in VT-really?)

18
Q

Retinoscopy on a deviated eye

A

May not yield the correct amount of refractive error because the retinoscopy is done off axis

19
Q

Glasses for amblyopia

A

Inexpensive way to start
Safety
Carrier for other medications (prisms or bifocals)

20
Q

Contacts for am.yopia

A
  • cosmesis
  • aniseikonia is better in anismoreopia
  • less restriction of VF
  • reduced prism imbalance when looking off axis
  • could be started after improved VA
21
Q

Which is better for amblyope, glasses Vs contacts

A

Occlusion therapy very likely, so no difference

22
Q

Aniseikonia and refractive correction for amblyopia

A

Not the most urgent issue in amblyopia, especially when deep

-may be appararent to the child after successful treatment- patient closing an eye or has diplopia

23
Q

Isoametropia amblyopia: astigmatism

A

> 2.50D

24
Q

Amblyopia isoametria: hyperopia

A

> 5D

25
Q

Isoamatropia amblypia: myopia

A

> 6D

26
Q

Anisometropia amblyopia: hyperopia

A

> 1D

27
Q

Anisometropia amblyopia: myopia

A

> 3D

28
Q

Anisometropia amblyopia Astigmatism

A

> 1.50D

Summer Final-VT (10 decks)

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