Managing ET

Question 1

What are the 2 tx findings for infantile ET?

Answer 1

1. Poor prognosis for normal BV

2. Surgical candidate

Question 2

What is the goal for infantile ET tx?

Answer 2

Good cosmesis and peripheral fusion

Question 3

What is the prognosis for accommodative ET?

Answer 3

Good if intermittent or of short duration

Question 4

What is the tx for accommodative ET?

Answer 4

1. Lenses

Question 5

What 2 things should you consider if tx’ing an accommodative ET patient with lenses?

Answer 5

1. Consider full cyclo Rx

2. Consider add at near if high AC/A

Question 6

What is the prognosis for partially accommodative ET?

Answer 6

• usually good, but worse than fully accom. ET

Question 7

Why should we follow-up with partially accommodative ET?

Answer 7

May have developed sensory anomalies

Question 8

For partially accom ET, it’s treated with lenses and what 3 additional things?

Answer 8

1. Prism
2. Sx
3. VT

Question 9

What are the causes of acute onset comitant ET?

Answer 9

1. Occlusion
2. Physical/emotional shock/stress
3. Idiopathic
4. Neurological causes

Question 10

What is the prognosis for acute onset comitant ET?

Answer 10

Good if not pathology

Question 11

What is the tx for acute onset comitant ET?

Answer 11

Rx full plus w/ prism, VT or Sx

Question 12

What is the initial treatment for ET?

Answer 12

Refractive lenses that correct RE and decrease size of ET

Question 13

What is the 1st and 2nd step of improving monocular visual function?

Answer 13

1. Treat amblyopia

2. Normalize monocular skills

Question 14

When normalizing monocular skills, what 2 things are we working on?

Answer 14

1. Accommodative Skills

2. Ocular motility therapy

Question 15

After monocular skills are normalized, what’s the next step in managing ET?

Answer 15

• Develop normal peripheral fusion

Question 16

What are the 3 steps to develop normal peripheral fusion?

Answer 16

1. Eliminate AC
2. Eliminate peripheral suppression
3. Improve peripheral sensory/motor fusion

Question 17

How can we eliminate AC?

Answer 17

1. sensory stimulation of obj. angle in-instrument (if ET > 15-20pd)
2. Motor stimulation (if ET < 15-20pd)
3. Overcorrecting prism (any size ET)

Question 18

When developing normal peripheral fusion, what size targets should we start with at the objective angle

Answer 18

Large targets

Question 19

After normal peripheral fusion is developed, what 2 things should be worked on?

Answer 19

1. Eliminate central suppression

2. Increase vergence ranges

Question 20

After extending SM fusion to central vision, what do we work on next?

Answer 20

Establish binocular vision in free space

Question 21

If the ET is greater than ___, sensory/motor fusion is very hard to control in free space.

Answer 21

15pd