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OQ Review > BCSC 6. Pediatric Ophthalmology and Strabismus > Flashcards

BCSC 6. Pediatric Ophthalmology and Strabismus Flashcards

1
Q

Alignment measurement when paretic or restricted eye is fixating

A

Secondary deviation

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2
Q

Deviation measured when nonparetic eye is fixating

A

Primary deviation (less than secondary deviation)

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3
Q

Deviation in strabismus that is in directino opposite to one that thte patient had originally

A

Consecutive deviation

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4
Q

Strabismus that is the same size in all positions of gaze

A

Comitant deviation

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5
Q

Only extraocular muscle whose origin is on medial orbital wall

A

Inferior oblique

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6
Q

Only extraocular muscle that passes through the trochlea

A

Superior oblique

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7
Q

Primary action of inferior oblique

A

extorsion

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8
Q

Innervates the MR, IR, and IO muscles

A

inferior division of CN III

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9
Q

Primary component of the extraocular muscle pulleys

A

Elastin (and smooth muscle and collagen)

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10
Q

Form of b/l symmetric refractive error at 3.5D would place greatest risk for isoametropic amblyopia

A

Astigmatism -> isoametropic amblyopia

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11
Q

Primary synergistic (yoke) muscles used for gazing up and to the right

A

Left IO and right SR

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12
Q

Term for positions of gaze in which single extraocular muscle is prime mover

A

Cardinal positions (6)

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13
Q

Sensory adaptation to manifest strabismus most commonly seen in patients

A

Peripheral suppression - eliminates diplopia

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14
Q

Best test for measuring amount of strabismus in patient who has amblyopic eye with VA 20/400 and eccentric fixation

A

Krimsky test - does not depend on sensory or motor response. (Lancaster test depends on subjective localization of targets)

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15
Q

What is the most appropriate initial therapy for high accomodative convergence/accomodation (AC/A) esotropia

A

Bifocals - reduce need for accomodation at near and allow for development of fusion and stereopsis. Overminus increase accomodation

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16
Q

Eye motility abnormality commonly associated with infantile esotropia?

A

Dissociated vertical deviation (DVD).

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17
Q

Asymmetric smooth pursuit, better in temporal to nasal direction

A

Infantile esotropia

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18
Q

Exodeviation most commonly seen in general population

A

intermittent exotropia

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19
Q

Exodeviation in which orthoptic exercises are most appropriate initial therapy

A

Convergence insufficiency

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20
Q

Pseudostrabismus in which eyes appear exotropic but visual axes are optically aligned

A

Positive angle kappa

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21
Q

A-pattern exotropia with compensatory head posture

A

Chin-down

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22
Q

Clinical finding that accompanies upward movement of the eye in DVD

A

Extorsion of globe - (extorsion and exodeviation of elevating eye)

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23
Q

DVD is seen in

A

infantile strabismus

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24
Q

Finding most suggestive of bilateral rather than unilateral SO muscle palsy

A

Large V pattern - extorsion well over 10 degrees in downgaze, esotropic shift in downgaze, head posture chin down to avoid cyclodiplopia in downgaze

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25
Q

Finding on exam of esotropic patient that makes type 1 Duane retraction more likely than 6th nerve palsy

A

Limited adduction of affected eye

26
Q

Most helpful in distinguishing congenital motor nystagmus (infantile nystagmus syndrome) from acquired nystagmus

A

abnormal head position - (CMN; inflantile nystagmus syndrome) adopt abnormal hed position to take advantage of the better vision possible at null point

27
Q

Exponential decrease in velocity of slow phase and fast-phase direction that reverses with change in fixation

A

latent nystagmus (fusion maldevelopment nystagmus syndrome)

28
Q

4 weeks after b/l MR muscle recession, patient presents with new exotropia of 15 prism diopters iwth limited adduction of right eye..

A

Slipped muscle

29
Q

Beneficial effect on visual field can occur as a result of strabismus surgery

A

Expansion of binocular visual field following surgery for esotropia. (surgery for exotropia constricts binocular visual field)

30
Q

Visual field following surgery for exotropia

A

constricts binocular visual field

31
Q

Refractive condition true for most infants during first year of life

A

Hyperopic refractive error that decreases over time

32
Q

Eye movement abnormality can occur in healthy infants in first months of life

A

intermittent esotropia

33
Q

Congenital ocular disorder most commonly a/w paradoxical pupils

A

Inherited retinal dystrophy

34
Q

Age infant should be able to maintain fixation and react to facial expression

A

6-8 weeks

35
Q

Best initial treatment for 11-mo old F with epiblepharon

A

Observation - often resolves

36
Q

Condition of affected eye a/w pseudoptosis

A

Hypotropia (upper eyelid “follows” eye in upgaze and downgaze - eyelid moves in same direction)

37
Q

Congenital eyelid malformation that requires early repair

A

Eyelid coloboma (eyelid cleft, eyelid notch) risk for significant exposure keratopathy and early closure of eyelid defect is often required.

38
Q

Vision threatening periocular hemangiomas

A

Oral propranolol

39
Q

Orbital cellulitis can be distinguished from preseptal cellulitis by this clinical finding

A

Chemosis - suggests orbital involvement

40
Q

Most common location of bloackage in congenital NLDO

A

Valve of hasner

41
Q

Curvilinear tears in Descemet membrane

A

Primary congenital glaucoma - Haab striae seen b/c of rapid stretching of cornea. (forceps are linear, not curvilinear)

42
Q

Linear tears in descemet membrane

A

Forceps injury during delivery

43
Q

Congenital iris ectropion is most commonly seen in

A

Neurofibromatosis 1, Prader-Willi syndrome, or facial hemihypertrophy

44
Q

Most important associated medical condition to exclude in patient with sporadic aniridia

A

Wilms tumor - renal U/S, repeated until molecular genetic analysis rules out an 11p13 deletion and confirms an intragenic PAX6 mutation

45
Q

Iris abnormality + horner syndrome

A

neuroblastoma

46
Q

Heterochromia in child

A

Waardenburg syndrome

47
Q

Treatment for infant with ophthalmia neonatorum 2/2 chlamydia trachomatis

A

Erythromycin - systemic c trachomatis may cause PNA and otitis media

48
Q

Most severe ocular complication of SJS

A

Corneal ulcer

49
Q

Finding predisposes child to glaucoma following surgery for congenital cataract

A

Microcornea - a/w higher incidence of glaucoma

50
Q

Inheritance of primary congenital glaucoma

A

SPORADIC - but may be inherited as AR

51
Q

Genetic disorder that pupillary block glaucoma is most likely to occur

A

Weill-Marchesani syndrome a/w microspherophakia

52
Q

Type of uveitis most common in children

A

Anterior uveitis - 1) idiopathic 2) related to trauma 3) JIA

53
Q

Most significant risk factor for developing ROP

A

Gestational age and birth weight

54
Q

Preferred imaging for Rb

A

MRI and U/S - high risk for secondary radiation induced tumors

55
Q

Moyamoya

A

dx with abnormalities of carotid circulation - Morning glory disc

56
Q

Morning glory disc

A

A/w basal encephalocele in patients with midfacial anomolies, PHACE syndrome (posterior fossa malformations, hemangiomas, arterial lesions, cardiac and eye anomolies) and carotid circulation (moya moya)

57
Q

Pseudopapilledema a/w

A

hyperopia - small C:D ratio resembling papilledema

58
Q

African american child with hyphema

A

Sickle cell testing must be performed.

59
Q

Management of white-eyed blowout fx in child

A

presents with marked vertical motility restriction in both directions, minimal soft tissue findings requires early surgical repair of fx, (IR muscle and associated nerve may become permanently damaged.)

60
Q

Most common cause of visual impairment in children with head trauma

A

Cortical or cerebral visual impairment

61
Q

Mode of inheritance in incontinentia pigmenti

A

X-linked dominant - lethal effect on hemizygous male fetus

62
Q

Most common inheritance of NF1

A

Autosomal dominant in 50%, 50% with no FHx (high rate of new mutations)

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