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Pediatrics > Binocular Vision > Flashcards

Binocular Vision Flashcards

1
Q

Why test binocular vision?

A

if 2 eyes not working together efficiently=symptoms

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2
Q

What happens if only one eye is working?

A

strabismus or amblyopia, reduced acuity, no 3D, career considerations

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3
Q

Why do we do BV testing?

A

to determine if child is using both eyes (motor and sensory)

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4
Q

What are BV tests?

A

alignment, motilities, tests of motor fusion, tests of sensory fusion

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5
Q

What are tests of motor fusion?

A

NPC, vergences

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6
Q

What are tests of sensory fusion?

A

stereopsis, worth 4 dot

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7
Q

T/F infants are esotropic

A

false, may look esotropic because of lid anatomy but are not

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8
Q

T/F infants have poor control of convergence in the first few weeks of life

A

true

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9
Q

How many infants are orthophoric?

A

1/2

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10
Q

How many infants are exotropic/ C or I?

A

1/3

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11
Q

When should you expect orthophoria and convergence from an infant?

A

3 months

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12
Q

What is the purpose of a cover test?

A

to determine ocular alignment in different positions of gaze, frequency and magnitude

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13
Q

What are normal values for cover test?

A

distance: ortho- 3XP
near: ortho-6XP’

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14
Q

What does the unilateral cover test detect?

A

tropia

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15
Q

What does the alternate cover test detect?

A

phoria

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16
Q

What does the prism alternate cover test measure?

A

movement with prism

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17
Q

What prism neutralizes Eso, Exo, Hyper, Hypo?

A

BO, BI, BD, BU

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18
Q

Which distance is harder for infant cover test… distance or near?

A

distance, may only get near info

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19
Q

What should the target be for an infant cover test?

A

your finger

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20
Q

What is angle kappa?

A

angle between the line of sight (fixation to fovea) and the pupillary axis

21
Q

What is the pupillary axis?

A

center of pupil, tangential to cornea

22
Q

How do you measure angle kappa?

A

look at corneal light reflex monocularly with light at 50 cm and midline

23
Q

What is a + angle kappa?

A

reflex nasal=fovea displaced temporally

24
Q

What is a - angle kappa?

A

reflex temporal= fovea displaced nasally

25
Q

Most people have a mild ____ kappa

A

positive, fovea five degrees temporal to center of posterior pole

26
Q

What is the hirschberg test?

A

looking at corneal reflex binocularly to determine if a deviation exists, estimates angle kappa

27
Q

How do you do the hirschberg test?

A

light at 50 cm midline, reflex should be symmetrical OD, OS and roughly 0.5 mm nasal

28
Q

What is 1mm in prism diopters?

A

22 prism diopters

29
Q

Displacement nasal (+)=

A

exo

30
Q

Displacement temporal (-)=

A

eso

31
Q

What is the Krimsky test?

A

essentially hirschberg with prism, still observing corneal reflex with light at 50 cm midline

32
Q

What is fixating v nonfixating eye in krimsky?

A

check for differences and not modified/reverse krimsky for non-fixating eye ????

33
Q

What is the bruckner test?

A

using direct ophthalmoscope, adjust focus so patient’s face is clear, 1 m in front of paitent

34
Q

What do you look at with bruckner test?

A

hirschberg (check for strabismus) and size/color of pupils and brightness of fundus reflex

35
Q

Which eye is brighter in a bruckner test?

A

strabismic, because of the macular pigment

36
Q

What can the size, color and brightness of the pupil tell you?

A

strabismus, anisometropia, media opacities

37
Q

T/F preschool and school aged kids should be able to get a cover test and distance and near

A

true

38
Q

What do you have to record with strabismus?

A

test used, which eye, frequency, direction, distance/near?

39
Q

How do you record the frequency of a strabismus turn?

A

POTT= percentage of time troped, constant or intermittent, exotropia scale

40
Q

How long do you observe before testing and using the exotropia scale?

A

30 seconds

41
Q

What is the procedure to use before looking at the exotropia scale?

A

cover OD 10 sec, cover OS 10 sec, cover OD 10 sec, distance and near

42
Q

What numbers on the exotropia scale depict poor control?

A

3-5

43
Q

Which numbers on the exotropia scale depict good control?

A

0-2

44
Q

What is a 5 on the exotropia scale?

A

constant exotropia

45
Q

What is a 4 on the exotropia scale?

A

exotropia > 50% of exam before dissociation

46
Q

What is a 3 on the exotropia scale?

A

exotropia <50% of exam before dissociation

47
Q

What is a 2 on the exotropia scale?

A

no exotropia unless dissociated, recovers in > 5 sec

48
Q

What is a 1 on the exotropia scale?

A

no exotropia unless dissociated, recovers in 1-5 seconds

49
Q

What is a 0 on the exotropia scale?

A

no exotropia unless dissociated, recovers in <1 second (phoria)

Pediatrics (22 decks)

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