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Strab/Amblyopia > Packet 1 Intro > Flashcards

Packet 1 Intro Flashcards

1
Q

amblyopia is when 1 or more of the following is present before age 6:

A
  • amblyogenic anisometropia
  • constant unilateral strabismus
  • amblyogenic bilateral isometropia
  • amblyogenic uni or bilateral astigmatism
  • image degradation
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2
Q

prevalence of strabismus is about __%

A

3%

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3
Q

prevalence of amblyopia is about __%

A

2%

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4
Q

increased risk of 5 year incident visual impairment in better seeing eye of worse than 20/40

A

relative risk 2.7

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5
Q

strab/amblyopia diagnostic test sequence

A
  • refractive status
  • visual acuity
  • monocular fixation
  • deviation variables (including comitancy)
  • sensorimotor fusion
  • -1st degree: correspondance
  • -2nd degree: sensory fision vs. suppression
  • -3rd degree: stereopsis
  • monocular accommodation and ocular motility
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6
Q

minimum case history for strab/amblyopia

A
  • chief complaint
  • signs/symptoms
  • onset (time, type, associated conditions)
  • patient eye history (esp. previous tx)
  • patient medical history/ meds
  • family eye/ med history
  • patient/parent goals
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7
Q

signs/symptoms of strab

A
  • covering one eye in bright sun
  • head turns, tilts, and tips
  • excessive blinking/rubbing eyes
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8
Q

1st question to ask in diplopia case history

A

-monocular or binocular

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9
Q

when is asthenopia (eye strain) common

A

-with intermittent strab or large phoria

constant strab longstanding usually few symptoms

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10
Q

time of onset for childhood strabismus is usually between what ages? and then adult increases prevalence after what age?

A

5-6 years old

again after 50 years old

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11
Q

what % of amblyopia cases are associated with abnormal refractive error

A

75%

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12
Q

independent risk factors for childhood exotropia

A

astigmatism

  1. 50-2.50: 2.50
  2. 50+: 5.88

aniso

  1. 25-0.50: 2.01
  2. 50+: 2.63
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13
Q

independent risk factors for childhood esotropia

A

SE refractive error aniso
> or = 1: 2.03

as hyperopia increases (+2.00 and greater especially), risk for esotropia increases greatly

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14
Q

to get the best refractive status, your goal is to:

A

control accommodation and scope on axis

goal: of accurate and valid objective refraction

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15
Q

problems with using tropicamide for cycloplegia

A
  • dies off quickly (starting at 20mins)

- doesn’t fully knock out accommodation (still some residual accommodation left at 30 minutes)

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16
Q

pros/cons of atropine

A
  • very long duration (can be up to a week)
  • most complete paralysis
  • most likely to have systemic reaction
17
Q

side effects of atropine

A
  • flushed
  • blurry
  • confusion/ delirious/ hallucinations
  • hot
  • dry
18
Q

standard of case cycloplegia regimen

A
  • typically anesthetic
  • 1% cyclo 2 gtt separated by 5min
  • dilating agent (phenyl or trop)
  • wait about 30 mins to refract (may be earlier in light irises)
19
Q

indications to cyclo

A
  • 1st eye exam
  • strab/amblyopia suspicion
  • hyperopia
  • greater than 1D of aniso
  • suspected latent hyperopia
  • high eso at near
  • high lag on MEM
  • suspected pseudomyopia
  • uncooperative or noncommunicating patient
  • suspected malingering, hysterical amblyopia
  • acuity not corrected to predicted level
  • subjective responses variable and inconsistent during manifest refraction
  • Sx seem unrelated to nature degree of manifest refractive error
20
Q

if your patient is cyclopleged and they look directly at your light during ret, what do you subtract from your gross to get your net?

A

your normal WD (-2.00)

21
Q

set up for Mohindra ret

A
  • dark room
  • occlude other eye
  • 50cm working distance
  • patient looks at retinoscopy light
  • subtract -1.25 from sphere power (leave cyl)
22
Q

pros/cons for Mohindra ret

A
  • allows for on-axis retinoscopy

- but not as good as cycloplegic retinoscopy

23
Q

pros/cons for Mohindra ret

A
  • allows for on-axis retinoscopy

- but not as good as cycloplegic retinoscopy

Strab/Amblyopia (6 decks)

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