Managment Of Ocular Motility Anomalies

Question 1

Talking to pt about management plan

Answer 1

It is very important that you communicate with your patient their condition and the management plan. Make sure to explain the pros/cons of the difference treatment options, if applicable
-refer patient to appropriate specialist when needed

Question 2

Plus lenses

Answer 2

Decrease accommodation, decreases eso

Question 3

Minus lenses

Answer 3

Increased accommodation, decreases exo

Question 4

Fresnel

Answer 4

Short term for diplopia

Question 5

What prism is best for long term

Answer 5

Ground in

Question 6

Occlusion

Answer 6

Good for short term option for diplopia

Question 7

Botox management

Answer 7

• for acute paralytic strabismus due to unilateral CN6 palsy
• side effects: soreness at injection site, rash and allergic reaction, muscle weakness in surrounding tissues

Question 8

Pharmacological management options

Answer 8

Corticosteroids
Insulin
AntiHTN meds
Chemotherapy

Question 9

Surgery

Answer 9

• long term tx
• may need glasses after tx
• meant to weaken,m strengthen, or change the vector of force for a given muscle based on the strabismus

Question 10

Risks of surgery

Answer 10

• mild discomfort following
• continued strabismus
• endophthalmitis
• ocular ischemia

Question 11

CN3 palsy’s

Answer 11

KNOW IF PUPILS ARE AFFECTED

-if so, tumor or aneurysm

Question 12

CN4 palsy

Answer 12

Trauma probably

-refer out for neuro and comanage

Question 13

Treatment for palsy’s

Answer 13

Treat underlying condition
Glasses
Surgery if its a long term thing

Question 14

Inability of one eye to obtain binocular vision with the other because of imbalance of the muscles of the eyeball

Answer 14

Strabismus

Question 15

Strabismus treatment

Answer 15

Glasses number one

Occlusion
Surgery
Meds

Question 16

Nonrefractive acommodative ET and mixed acommodative ET surgery

Answer 16

None

Question 17

Refractive accommodative ET

Answer 17

Uncorrected hyperopia

Question 18

High AC/A

Answer 18

Non refractive accommodative ET

Question 19

High AC/A and I uncorrected hyperopia

Answer 19

Mixed accommodative EY

Question 20

Infantile eso

Answer 20

Birth to 6 months

Question 21

Early onset non accommodative eso

Answer 21

6 months-2 years

Question 22

Surgery in infantile ET

Answer 22

Yes

Question 23

Early onset non accommodative eso and surgery

Answer 23

Consider it if nothing else works

Question 24

Sensory ET

Answer 24

From losing vision in an eye

-always protect good eye with polycarbonate

Question 25

Intermittent XT

Answer 25

XT only sometimes
Only diplopia sometimes
-get a good case HX of when and how often it happens
-thinking of someone who is doing a lot of studying and now not able to fuse and keep the image single

Question 26

Consecutive XT

Answer 26

After surgery

Question 27

Duane syndrome

Answer 27

1: abduction
2: adduction
3; abduction and adduction combined

Limited

Question 28

Browns syndrome

Answer 28

Restricted elevation in adduction

Question 29

Rx for browns

Answer 29

BU or yoked prism for secondary and surgery for primary

Question 30

MG

Answer 30

• autoimmune
• ice test
• weakness
• achase inhibitors
• weakness at end of day

Question 31

Graves

Answer 31

• autoimmune
• dry eye
• diplopia

Question 32

Fibrosis syndrome

Answer 32

EOMs replaced with fibrotic tissue

-surgery based on significant strabismus and then treat for amblyopia

Question 33

Involuntary rhythmic oscillation of one or both eyes

Answer 33

Nystagmus

Question 34

Treatment goals of nystagmus

Answer 34

Improve VA, ocular motor control, improve binocularity, cosmesis, and comfort

Glasses
Prisms
Therapy
Surgery