Fogt Lecture (F)

Question 1

What o you treat first: amblyopia or strabismus?

Answer 1

amblyopia

Question 2

What should be sure to tell the parents about patching in treatment of amblyopia?

Answer 2

it generally does not correct strabismus

Question 3

What type of nerve palsy can create a esotropia?

Answer 3

4th and 6th nerve palsies

Question 4

How do you show the parents that the child does not have strabismus, but instead has pseudostrabismus?

Answer 4

pull epicanthal folds away and show alignment

Question 5

How long after birth should the eyes be straight?

Answer 5

3 to 4 months

Question 6

What treatment gives the best chance of binocularity and fusion for a congenital esotropia?

Answer 6

early surgical treatment

Question 7

What is the most common cause of a 6th nerve palsy in adults? 1. In kids? 2

Answer 7

1. stroke

2. trauma

Question 8

At what point is surgery necessary for a 4th nerve palsy that is causing a esotropia?

Answer 8

6 months with no resolution

Question 9

What are the important work up points for an esotropia?

Answer 9

1. always cycloplege kids
2. if hyperopia, give full cyclo plus
3. If high AC/A, get at least +2.50 add
4. wear glasses full time and return after 4 to 5. weeks of wearing them
5. tell parents eye turn may look worse when not wearing glasses
6. remind that patching is likely

Question 10

If after 4 to 6 weeks of wearing glasses full time for a esotopic patient they still have greater or equal to 15pd esotropia at dist and near, what is the treatment?

Answer 10

surgery

Question 11

If after 4 to 6 weeks of wearing glasses full time for a esotopic patient they have less than 15pd esotropia at dist and near, what is the treatment?

Answer 11

treat amblyopia with patching

Question 12

If after 4 to 6 weeks of wearing glasses full time for a esotopic patient they have esotropia at near only now, what is the treatment?

Answer 12

bifocal

Question 13

What should be done on a return visit for an exotropic patient to get the full value and strabismus?

Answer 13

patch for 1hr to dissociate, then check muscle balance

Question 14

Is exotropia usually stable or progressive?

Answer 14

progressive

Question 15

What is the treatment for near XT?

Answer 15

orthoptics (VT)

Question 16

What is minimal XT amount to be considered for surgery? 1. When is surgery avoided in children? 2

Answer 16

1. 15pd

2. no suppression and excellent stereo

Question 17

What is the type of nystagmus that occurs secondary to poor vision early in life?

Answer 17

sensory nystagmus

Question 18

What are the possible treatments of nystagmus?

Answer 18

1. correct refractive error
2. contact lenses
3. surgery to move eyes to null point
4. get imaging
5. recession of all 4 horizontal rectus muscles

Question 19

Who should perform a strabismus surgery?

Answer 19

pediatric ophthalmologist

Question 20

What is the typical follow up schedule for strabismus?

Answer 20

2 wks, 3 months, 6 months, 1 yr