Amblyopia part 3 Flashcards
What do you do before you start amblyopia?
Patient History
Detailed Examination
Diagnosis
Correction of significant refractive error
Reassesment with correction at follow up
If binocular status has improved and VA has significant improved towards normal= monitor it
If status has not improved Start amblyopia treatment
What tests are ran during detailed exam for amblyopia?
Detailed history VA Cover test Ocular Motility Pupils Accommodation Binocular function- (stereopsis. W4D, Fixation) Cycloplegic regraction Anterior and posterior segment eval to make sure no diseases causing bad VA
Amblyopia treatments
Optical treatment
Occlusion therapy- patch the good eye
Vision therapy
How do you refract a person with a strabismus?
occlude one eye so that they pick up fixation
WHat is the first step in the management plan for patients with amblyopia or strabismus?
Determination of refractive error
True/False: Retinoscopy on a strabismus will still yield the correct amount of refractive error because the retinoscopy is done off axis.
False, need to occlude to do retinoscopy
What are some refractive errors that could lead to anisometropia?
Anisometropia
- Hyperopia > 1.00D
- Astigmatism > 1.50D
- Myopia > 3.00D
What are some refractive errors that could lead to isoametropia?
Isoametropia
- Hyperopia > 5.00 D
- Astigmatism > 2.50D
- Myopia > 6.00D
Why do you use cyclopentolate for amblyopia?
it completely relaxes accommodation== gives best objective measurement of the refractive error present
What is a dilating drop that is a anti muscarinic?
Cyclopentolate
If you suspect residual hyperopia, _________ could be used to reveal the complete amount of hyperopia.
atropine
What is the goal of optical treatment?
Clear retinal image for each eye to allow binocularity (by correcting)
-and stopping any amblyogenic process!
True/False: If you see an accommodative ET sc you should put them in Vision therapy.
False, you should correct them first
- allows child to adapt
- determines amount of clarity pt can get
- sees how aggressive you need to be
- improves compliance
- follow up 3-4 months usually
Occlusion for treatment should be direct or indirect?
Direct
Full time or part time
A kid has amblyopia in the right eye… which eye do you put atropine in? (***she said she could ask us this)
Left eye
What are 5 anticholinergic side effects (atropine)?
hot dry blind red mad
This kid has derivation amblyopia… what are the trend steps to take?
Remove any obstructions
Refractive error
Amblyopia treatment
VT
This kid has strabismic amblyopia… what are the trend steps to take?
Correction Reevaluation Amblyopia treatment if necessary VT if prognosis is good If pt has 45 D exotropia they may need surgery.
If pt is purely accommodative does the patient need surgery?
no
