Evaluating the Deviation

Question 1

If a patient has a wide bridge of nose, how will the esotropia look vs. exotropia?

Answer 1

esotropia = looks worse
exotropia = looks better

Question 2

If patient has a narrow bridge of nose, how will the ET look vs. XT?

Answer 2

ET = looks better
XT = looks worse

Question 3

If patient has epitcanthal folds, how will the ET look vs. XT?

Answer 3

ET = looks worse
XT = looks better

Question 4

If px has a small IPD, how will the ET vs. XT look?

Answer 4

ET = worse
XT = better

Question 5

If px has a large IPD, how will the ET vs. XT look?

Answer 5

ET = better
XT = worse

Question 6

If px has a wide face, how will the ET vs. XT look?

Answer 6

ET = worse
XT = better

Question 7

If px has a narrow face,, how will the ET vs. XT look?

Answer 7

ET = better
XT = worse

Question 8

If a px has high hyperopia, they are most likely to be ET or XT?

Answer 8

ET

Question 9

If a px has anisometropia and astigmatism, they are most likely to be ET or XT?

Answer 9

XT

Question 10

What are the anatomical etiologies of strabismus?

Answer 10

1. EOM abnormalities
2. Abnormal content of orbit
3. Abnormal ligaments/tendons

Question 11

Ocular disease may cause younger children to have (ET/XT) and older children/adults to have (ET/XT)?

Answer 11

young = ET
older = XT

Question 12

What test can be used to evaluate the alignment objectively?

Answer 12

1. Cover test

2. Hirschberg

Question 13

This objective alignment test is good for young patients who don’t cooperate.

Answer 13

Hirschberg

Question 14

Angle Kappa is measured under (monocular/binocular) conditions.

Answer 14

Monocular conditions

Question 15

When performing the krimsky test, which eye is prism placed over?

Answer 15

The deviating eye

- increase prism until pupil reflex is symmetrical with normal eye

Question 16

When performing unilateral CT, which eye should we be covering?

Answer 16

Fixating eye

Question 17

T/F: For the simultaneous prism cover test (SPCT), you place the CT over fixating eye and prism over deviated eye at same time.

Answer 17

True

- add prism until there’s no movelemt

Question 18

During ACT, if you have a patient who is neutral on different prism magnitudes, what should you record?

Answer 18

The highest neutral reading

Question 19

This the amount of deviation when the normal eye is fixating in primary gaze.

Answer 19

Primary Angle of deviation

Question 20

This is the amount of deviation when the paretic eye is fixating i primary gaze.

Answer 20

Secondary Angle of deviation

• if non-paretic, mag will be same as primary
• if paretic, mag will be the same as primary

Question 21

ACT = 15Δ ET
Visuoscopy = 5Δ of nasal EF
What is the true angle of deviation?

Answer 21

T = M + EF
T = +15pd + (+5pd)
T = 20pd

Question 22

ACT = Ortho
Visuoscopy = 3Δ nasal EF
What’s the true angle of deviation?

Answer 22

T = M + EF
T = 0 + (+3pd)
T = 3pd
- Microtropia w/ identitiy

Question 23

T/F: When stacking prism, stacking horizontal and vertical prisms is ok.

Answer 23

True

Question 24

When performing ACT at distance, using a shorter room will cause what 2 things to happen?

Answer 24

1. decrease mag of XT

2. Increase mag of ET

Question 25

If a patient wears lenses that are +/- 5.00D, what will plus lenses vs. minus lenses do to measured angle of deviation?

Answer 25

+ = decrease angle of dev.

• = increase angle of dev

Question 26

How do you hold prism to minimize prism rotation and power changes?

Answer 26

Hold it in frontal plane position

Question 27

This type of vertical deviation is present when the eyes are straight.

Answer 27

Primary

Question 28

This type of vertical deviation is present when the ares are deviated (strabismic); common in XTs.

Answer 28

Secondary