Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Summer Final-VT > ET And XT > Flashcards

ET And XT Flashcards

1
Q

When should you never give a partial prescription

A

Any ET

-they need a full Rx to make sure there is no type of accommodative issue going on

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

You will give the full cyclo refraction to all _____

A

Esotropes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Nonrefractive accommodative ET

A
  • due to high AC/A ratio
  • ET greater at N than D
  • always important to eval at D and N
  • may be intermittent alternating at N
  • moderation hyperopia to myopia is seen (similar to general population)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Treatment for non refractive accomodative ET

A
  • treat underlying refractive error-full RX
  • bifocals based on AC/A
  • segment height must bisect the pupil (executive or flat top)
  • repeat cyclo yearly for any changes
  • surgery is contraindicated. May be weaned off add if there is improved alignment at N
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Who should get a bifocal

A

Non refractive accommodative ET

Mixed accommodative ET

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Surgery and non refractive accommodative ET

A

Contraindicated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How long will the kid be in a bifocal for non refractive accommodative ET

A

Stay in it for a very long time, usually always

-could be weaned off about 7 years later

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Mixed accommodative ET

A
  • combination of refractive accommodative and non refractive accommodative findings
  • high hyperopia and high AC/A ratio
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Management of mixed accommodative ET

A

Full hyperopic Rx
Bifocal (based on AC/A)
Surgery is contraindicated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Surgery and mixed accomodative ET

A

Contraindicated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How can you suspect mixed accommodative ET

A

Some type of ET at D and N

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Partially accommodative ET

A
  • accommodation contribute to, but does not account for the entire deviation
  • there is a reduction in the angle, but there is residual ET after treatment.
  • this may result after delayed treatemtn of trule accommodative ET
  • constant, unilateral
  • suppression, ARC common
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Early onset non accommodative ET

A
  • onset is after about 6 months of age to before age 2
  • clinically similar to infantile ET, but the onset is later
  • ET same at distance and near
  • there is no accommodative element
  • insignificant amount of hyperopia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Management of early onset non accommodative ET

A
  • correct error, consider prisms or bifocal
  • amblyopia treatment
  • VT to improve ranges
  • consider surgery
  • consider near cuases (even if child appears healthy)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Early onset vs infantile non accommodative ET

A

Looks similar but onset is later

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Acute acquired ET

A
  • comitant
  • sudden onset in 3-5 years old (or older)
  • unilateral and constant moderate angle (20-30PD)
  • refractive error similar to general population
  • could be as a s result of illness, stress, aging
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Management of acute acquired ET

A

Neuro evaluations ASAP

Correction

Prism or surgery since patient probably had BV before the ET-sensory adaptations can still occur in some

Amblyopia treatment, if needed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Other esodeviations

A
  • sensory ET
  • divergence insuffiency ET
  • consecutive ET
  • microtropia-ultra small ET
  • decomensating ET- FV no longer able to maintain EP
19
Q

Who is a good candidate for strab surgery

A

Acute acquired ET

20
Q

Sensory ET

A
  • as ET that develops due to vision loss in one eye
  • pathology prevents symmetrical visual stimulation OU
  • poor VA in affected eye
  • constant unilateral deviation, about 10-45 PD, poor cosmesis
21
Q

Things that can cause sensory ET

A 
Congenital cataract 
Corneal scarring 
Optica atrophy 
Prolonged blur 
Retinal/mac disease 
Anisometropia amblyopia 
Ptosis 
PHPV
22
Q

Managment of sensory ET

A

-need to eliminate pathology (if possible) especially during the critical peieord
-polycarbonate lenses
-treat secondary amblyopia
Surgery can be for any residual deviation (or basically for cosmesis)

23
Q

Divergence insufficiency ET

A

A non accommodative esodeviation greater at D than N

  • comitant
  • onset in adutls
  • decreases fusional divergence at distance
  • diplopia complaints at distance
  • HA

Refractive error similar to normal population
No sensory adaptations since ate onset

24
Q

Which deviation would you send out the door to the ER right away

A

Divergence insufficiency ET

25
Q

Managment of DI ET

A
  • neuro referral asap
  • rhrorough eval
  • correct any refractive error
  • BO for diplopia at D
  • VT
  • Botox
  • surgery in some cases if MD decides, but deviation only at distance
26
Q

Consecutive ET

A
  • esodevaition after strab surgery
  • patient could be asymptomatic
  • amblyopia could develop
  • magnitude varies
  • unilateral or alternating
  • spontaneous improvement could occur
  • treat refractive error
  • try BO or plus lenses
  • repeat surgery for very large or symptomatic consecutive deviations
27
Q

Constant XT

A

-commonly seen in older patients with a sensory XT pr patients with a longstanding XT that age decompensating (decomensating XP)

Surgery may be indicated

Some patients may appreciate the enlarged visual field

Examples

  • infantile XT
  • sensory XT
28
Q

Infantile XT

A
  • large, constant angle
  • could alternate
  • less common than infantile ET
  • present before 6 months of age
  • these children are very likely to have neuro issues or craniofacial disorders
29
Q

Things seen in infantile XT

A
  • poor abduction on version (full on duction)
  • DVD and OIO common

Good developmental Hx is needed and consider a an euro consult
Treat refractive error
Treate ambvlyopia

Surgery is performed for these kids-early to promote some form of sensory cooperation, since prognosis for BV is poor

30
Q

Sensory XT

A
  • any condition that causes vision loss in one eye can lead to sensory XT
  • not sure why XT is seen in some and ET inothers
  • poor VA
  • poor cosmesis
  • constant and unilateral
  • large angle
31
Q

VA in sensory XT

A
  • need to determine if VA can be improved since this may improve alignment with peripheral fusion
  • if VA improved, surgery can be useful for better alignment
  • if VA is not correctable, misalignment could occur again after surgery
32
Q

Consecutive XT

A
  • this is common post surgery-could occur after months or years of surgery
  • before another surgery, need to consider the type and mount of precision surgery, any duction limitation/scarring or non comitancy

Atypical UHARC is likely in these cases

33
Q

IXT types

A

DE XT
Basic XT
CI XT

34
Q

Divergence excess XT

A
  • in childhood

- XT larger at distance, and seen prominently when targetis at a distance

35
Q

Basic XT

A

In adutls

XT same at D and N

36
Q

Convergence insufficiency XT

A
  • in adults

- XT larger at near

37
Q

Intermittent XT

A
  • Most common XT
  • deviation is latent and then becomes manifest
  • onset before 5

Manifests during visual inattention, fatugye or stress because compensating fusional factors are not active

Could occur late in the day, with fatugyem, when daydreaming, when drowsy

Bright light may cause reflex closure of one eye

38
Q

IXT can be assocaited with

A

Small hyperopia and/or A/V pattern

39
Q

Untreated intermittent XT

A

Can lead to constant

-it will start to manifest at lower levels of fatigue and occurs for longer

40
Q

Bright light causing someone to close an eye

A

IXT

41
Q

Sensory adaptation of IXT

A

May occur after some diplopia- then suppression or ARC

42
Q

Stereo and NRC and IXT

A

Prestn if control is good

43
Q

Amblyopia and IXT

A

Not common unless constant deviation was early in life

44
Q

CI XT

A
  • XT greater at N
  • usually an intermittent alternating deviation at near
  • low AC/A
  • poor fusion convergence amplitudes and receded NPC
  • VT is successful in these cases-pencil push ups, convergence based computer programs
  • BI reading glasses could be used

Summer Final-VT (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions