Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Motility Block 12 > Nystagmus III > Flashcards

Nystagmus III Flashcards

1
Q

Goal of nystagmus management

A

Improve

  • VA
  • ocular motor control
  • binocularity
  • cosmesis
  • comfort
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Things to do for nystagmus management

A
  • glasses or contacts for refractive error
  • prisms to improve fusion, induce convergence, reduce head turn
  • yoke head turn to move the null point
  • vision therapy to improve fusio nand fixation
  • surgery for severely head positioning
  • medication
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Why do we use prism for nystagmus

A

Improve fusion
Induce convergence
Reduce head turn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Why refractive correction for nystagmus

A

To improve the clarity of the retinal image to maintain steady fixation, to lessen the nystagmus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What’s the first things to take care of when treating nystgmus or anything else

A

The offending problem, such as ptosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Nystagmus correction for hyperopia

A

1-2D

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Nystagmus astigmatism correction

A

0.50D or more

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Rx ____ for myopia in nystagmus

A

0.50D or more

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Can they wear contacts in nystagmus

A

Yes, RGP and soft lenses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Plus adds for nystagmus

A

Valuable at near for improved Va and clarity for near point demands, aid in accommodation at near

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Minus adds in nystagmus

A

Some clinicians may try minus to induce convergence since nystagmus could decrease with convergence
-before doing this make sure it will not interfere with binocularly and make the nystagmus worse

Don’t overminus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Prism in nystagmus

A
  • improve binocularity and reduce nystagmus intensity
  • maybe serve to improve strabismus

May also be used for
-induce convergence or move null point

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Prisms to induce convergence

A

Use a small amount of BO prism (induces convergences). This stimulates fusional convergence to dampen nystagmus

The amount required varies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Prism for anomalous head position

A

Yoked prisms can also be used to improve VA and slow down the nuystagmus by improving abnormal head postures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How is the prism placed for anomalous head position

A

Base is places in the same direction as the head turn-this keeps the patients eyes in the eccentric null position while lessening the head turn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Why do we give BO for inducing convergence

A

Give BO for an ET, if you over do it, you will get a reversal and now the person becalmed XT, they will be able to converge to overcome this small amount

17
Q

BO OD and BI OS will shift the image

A

To the left, improving visio nand improving a small right head/face turn

18
Q

What kind of eye movement do we want to fix anomalous head position with prism

A

Version eye movement
The base Is the same way in both eyes

BO OD and BI OS will shift the image to the left, improving vision and improving a small right head/face turn

19
Q

The use of yoked prism for shifting the null point

A

Yoked prism shifts the retinal image toward the null point

20
Q

What type of prism should you use to move image to null point

A

If fresnel prisms are used for a large amount of prism, there is a degradation to the vision. Ground prism prevents distortion int he vision

21
Q

Where is the apex of the prism placed in prism for null point

A

Towards the null point and base it towards the turn

22
Q

If the patient has a left head turn, the patient has the null point in the right gaze, what kind of prism to use

A

Use base ego the left over each eye. This will shift the image to the right and reduce the head turn

23
Q

Occlusion in nystagmus

A

Unfortunately, this will end to the latent components manifesting

Amblyopia treatment in these patients is difficult-may need to consider plus lenses over the better seeing eye (enough to blur but not enough to disrupt fusion)

24
Q

VT for nystagmus

A

For fusional vergences or to improve motor control

And for suppression that could lead to manifest latent nystagmus

25
Q

Meds for nystagmus due to systemic problems such as infectious, metabolic, or vascular

A

Systemic meds can be used

26
Q

Meds in nystagmus for oscillopsie and vertigo

A

Could need meds to treat that

27
Q

_____ could help to reduce the severeity of nystagmus, but there are adverse effects

A

Gapapentin

28
Q

Surgery in nystagmus

A
  • anomalous head positions are to move the eye into the field of gaze where the nystagmus is lessened and/or VA
  • for face turns, head tilts, chin elevation or any anomalous head position
29
Q

Technique commonly used to shift the null point closer to the primary position and eliminate the head turn (surgery)

A

The kestenbaum

30
Q

Surgical issues to consider for nuystagumus

A
  • only for significant head turns
  • best done in children’s older than 4
  • reoperation in about 50%
31
Q

Dissociated vertical deviation

A
  • spontaneous upward movement of one or both eyes when tired, fusion is broken or inattentive
  • found with infantile strabismus
  • no symptoms
  • age 2-3
  • hyper deviation in one or both, the other eye does not have a hypo
  • can be spontaneous (manifest) or when one eye is covered (latent)
  • nystagmus can be present
32
Q

Treatment for DVD

A
  • surgical treatment only if larger or occurs frequently
  • mostly no treatment
  • difficult to measure and can be subjective
33
Q

Inferior oblique overaction

A
  • ey is elevated in adduction
  • presentin children with infantile strabismus mainly
  • bilateral or unilateral
  • little or no deviation in primary
  • found in about 2/3 of children with congenital strabismus
  • surgery only if large
34
Q

Pattern strabismus

A

-present when a horizontal deviation changes in magnitude between upgrade and downgaze
-vertical and non-comitant
-can be seen in XT or ET
=jury out on what the cause is-dysfunction of oblique muscles, or rectus muscles

35
Q

V pattern strabismus

A

Horizaotnal deviation is more divergent in upgrade than in downgaze

36
Q

A pattern strabismus

A

Deviation is more divergent in downgaze than in upgaze

37
Q

How are A/V pattern strabismus determined

A

By measuring alignment in primary at distance (with habitual) and then about 25 degrees from primary in upgaze and downgaze

38
Q

V pattern strabismus significance

A
  • clinically significant when difference in measurement between upgaze and down gaze is at least 15pd
  • most common pattern deviation
  • seen in infantile esotropia
  • also in pts with SO palsies, especially if bilateral
  • patient may adopt chin up compensatory head posture
39
Q

A pattern clinical significance

A
  • clinically significant when difference in measurement between upgaze and down gaze is at least 10pd. More divergent inferiority
  • seen more frequently in patients with exotropia
  • patient may adopt chin down compensatory head posture
  • more common in patients with infantile strabismus associated with craniofacial malformations, downs

Motility Block 12 (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions