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Motility > Neuromuscular Deviations > Flashcards

Neuromuscular Deviations Flashcards

1
Q

Split

Infancy Ocular Instability

A

variable, transient, intermittent angle strabismus
2-3 months
resolves in 4 months
only a problem if tropia persists or is large and constant

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2
Q

Esophoria

A

inward latent deviation controlled by fusional vergences

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3
Q

Esotropia

A

inward manifest deviation not controlled by fusional vergences

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4
Q

Pseudoesotropia

A

appearance of ET when eyes are straight

norm in kids with flat nose bridges and prominent epicanthal folds and small PD

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5
Q

Congenital ET

A

first 6 months
large constant esotropia
may have cross fixation
>30pd

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6
Q

Other findings of Congenital ET

A 
amblyopia
A/V pattern
DVD- both eyes hyper
OIO- overactive
nystagmus
head posturing
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7
Q

Managing Congenital ET

A 
glasses/ bifocals/ prism
patch
VT
surgery
botox
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8
Q

Accommodative Esotropia

A

associated with accommodative reflex
starts intermittent but can become constant
often hereditary

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9
Q

Onset of Accommodative ET

A

6 mo to 7 yrs

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10
Q

Refractive Accommodative ET

A

from uncorrected high hyperopia (forces accom) and insufficient fusional vergence to diverge

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11
Q

Deviation of Refractive Accommodative ET

A

20-35pd

intermittent, alternating with asthenopia

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12
Q

Refractive Accommodative ET refraction

A

+3.00 to +6.00

amblyopia if greater

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13
Q

Managing Refractive Accommodative ET

A 
cycloplegic refraction (2 drops)
Full correction
VT
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14
Q

Non-Refractive Accommodative Esotropia

A

from high AC/ A
insufficient vergence to diverge
greater at N

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15
Q

AC/ A Fromula

A

Absolute change / absolute change in accommodation

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16
Q

Managing Non-Refractive Accommodative Esotropia

A

bifocals- seg height bisects pupil

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17
Q

Mixed Accommodative Esotropia

A

some refractive and some nonrefractive issues

high hyperope w/ high AC/A

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18
Q

Managing Mixed Accommodative Esotropia

A

full hyperopic correction

only do surgery if did not start wearing glasses early enough

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19
Q

Partially Accommodative Esotropia

A

accommodation contributes to but does not completely cause deviation
after delayed treatment- did not start glasses early enough
reduced angle but ET still present- constant, unilateral

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20
Q

Early Onset Non-Accommodative Esotropia

A

6 mo to 2 yrs
same as congenital but starts later
no accomm or hyperopic issue

21
Q

Managing Early Onset Non-Accommodative Esotropia

A

glasses, bifocals/ prisms
VT
surgery
neuro possibilities

22
Q

Acute Acquired Esotropia

A

comitant
3-5 yrs
from illness, stress, aging

23
Q

What should be ordered in an acute acquired esotropia?

A

neuro evaluation

24
Q

Sensory Esotropia

A

from vision loss in one eye from pathology
constant unilateral
10-45pd

25
Q

Managing Sensory Esotropia

A

eliminate pathology
poly lenses
treat secondary amblyopia

26
Q

Divergence Insufficiency Esotropia

A

non-accommodative
greater at distance than near
adults
diplopia

27
Q

Managing Divergence Insufficiency Esotropia

A

Neuro referral

28
Q

Consecutive ET

A

Esodeviation after exo corrective surgery

29
Q

Exophoria

A

outward deviation controlled by fusional vergences

30
Q

Exotropia

A

outward manifest deviation

31
Q

Pseudoexotropia

A

eyes are straight but appears XT

from wide PD

32
Q

Divergence Excess Exotropia

A

larger in distance

kids

33
Q

Basic XT

A

same at distance and near

in adults

34
Q

Convergence Insufficiency XT

A

larger at near

in adults

35
Q

Intermittent Exotropia

A

sometimes latent and sometimes manifest
before 5 yrs
occurs later in day or with fatigue

36
Q

Bright Light and Intermittent Exotropia

A

reflex closure of one eye

37
Q

Good Control of Intermittent XT

A

only manifests on CT, resumes frequency quickly

will have good steropsis and normal retinal correspondence

38
Q

Fair Control of Intermittent XT

A

trope on CT, fusion regained after blinking or refixating

39
Q

Poor Control of Intermittent XT

A

XT manifests spontaneously and for extended period of time

40
Q

Managing Intermittent XT

A

glasses for large refractive issues
mild myopic can make deviation better (converge)
mild hyperopic can make deviation worse (diverge)
patching/ VT
surgery

41
Q

Convergence Insufficiency Exotropia

A

greater at near

low AC/A

42
Q

Symptoms of Convergence Insufficiency XT

A

asthenopia, diplopia, blurred near vision

43
Q

Managing Convergence Insufficiency XT

A

VT

BI reading glasses

44
Q

Constant XT

A

in older patients w/ sensory XT or with longstanding XT

45
Q

Managing Constant XT

46
Q

Congenital XT

A

large, constant angle (30- 80pd)
likely to have neurological issues or craniofacial disorders
poor adduction

47
Q

Managing Congenital XT

48
Q

Sensory Exotropia

A

any condition that causes vision loss in one eye
poor VA
constant and unilateral

49
Q

Consecutive Exotropia

A

post surgery

can occur after months or years of surgery

Motility (9 decks)

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