Other Forms Of Strabismus Yo

Question 1

Recording of versions

Answer 1

Movement of both eyes in the same direction (conjugate)

• this can be seen in EOMs; also in saccades, pursuits
• record SAFE (smooth, accurate, full, extensive)

Question 2

Recording of duction

Answer 2

Movement of one eye (with the others eye covered)
-when duction (range of motion in one eye) is incomplete, record as a % of normal. Judge the % that the patient achieves

-50% Abduction (50% abduction ability)

Question 3

Ophthalmology way of recording duction

Answer 3

Underaction: minus
Overaction: +
Full and smooth: 0

Question 4

Complete paralysis of a muscle grading

Answer 4

-4

0%

Question 5

If the Wright later rectus only goes out half way

Answer 5

50% or -2 abduction

Question 6

What are the ways to record duction

Answer 6

• percentage of ability
• number scale, 0 being ortho and 4 being no movement
• limited abduction (screening)

Question 7

Uncrossed diplopia

Answer 7

Eso

Treat with BO

Question 8

Crossed diplopia

Answer 8

Exo

Treat with BI

Question 9

Fusion in worth 4 dot

Answer 9

See all 4

Question 10

Suppressed OS worth dot

Answer 10

See two red

Question 11

Suppressed OD in W4D

Answer 11

Three green dots below

Question 12

Uncrossed diplopia W4D

Answer 12

3 green to left, two red to right

Question 13

Crossed diplopia in W4D

Answer 13

Two red on left and 3 green on right

Question 14

Red is to the right on Maddox Rod

Answer 14

Esophoria

Question 15

MRD

Answer 15

Corneal reflex distance to the top lid margin

-measures ptosis

Question 16

Tissues of the EOMs are abnormal and replaced with fibrotic tissue

Answer 16

Congenital fibrosis of EOMs (CFEOM)

Question 17

Features of CFEOMs

Answer 17

• severely restricted eye movement, due to the severity/degree/variability of the fibrosis
• fibrosis can be generalized, affecting all muscles or just one
• involvement of one or both eyes, mainly both eyes
• ptosis
• abnormal heads postire (chi elevation)
• congenital or required
• autosomal dominant (present at birth)
• healthy patients
• poor bino vision
• natural course: stable, non-progressive

Question 18

EOMs and vision in CFEOMs

Answer 18

• marked restriction of EOMs
• versions and functions similarly poor
• ptosis
• strabismus in primary gaze
• amblyopia can be present in young patients
• involvement of the eyes can be asymmetrical
• cosmesis issues
• social issues/occupation opportunities
• reduced stereopsis and poor bino vision

Question 19

Management of CFEOMs

Answer 19

• amblyopia therapy
• difficult to treat with surgery to restore full range of motion (except when there is a large strabismus in primary)
• will require multiple attempts, if surgery is attempted, surgical outcome is unpredictable
• ptosis
• abnormal head posture

Question 20

Why do we normally not do surgery on CFEOMs

Answer 20

Because never know what the outcome is. Hard to tell how fibrotic it is and how to fix it