Related literature

Question 1

3rd nerve palsy

Answer 1

Jacobson et al (1994) Ocular motor nerve palsies
Diabetes - 5.75 increase
Left ventricular hypertrophy – 5.5 increase NOT hypertension alone

Question 2

4th nerve palsy

Answer 2

In most cases, it may be congenital or post-traumatic but can occasionally manifest a more sinister underlying disease and require timely intervention (Khanam et al 2023)

Question 3

6th nerve palsy

Answer 3

Patel et al (2005) 6th nerve palsies
Confirmed diabetes as a risk factor – 6 fold increase for diabetes, 8 fold increase for diabetes and hypertension
Hypertension alone – no increase

Question 4

Convergence insufficiency

Answer 4

Cause of primary CI is increased close work demands
(Jenkins, 1999)

Question 5

What syndrome can cause convergence paralysis

DP

Answer 5

Dorsal midbrain syndrome Parinaud’s syndrome (Feroze and Bhimji, 2017)

Question 6

Convergence spasm

Answer 6

Hyndman 2018 most common cause is head injury

Question 7

A cause of accomodative anomalies

Answer 7

Anticholinergics e.g. Scopolamine patch used for: motion sickness, nausea, vomiting

Or used to reduced drooling in children with disabilities
Firth and Walker (2006) found reduced accomm in this cohort

Question 8

Infantile esotropia spontaneous recovery

Answer 8

In less than 8 month old with angle smaller than 40D, variable or intermittent this has been found in 27% of cases who were predominetly referred early

Question 9

Dyslexia findings

Answer 9

Dyslexia is thought to be caused by a combination of genetic and
environmental factors & it can be found within families (Snowling et al, 2007).
It is more common in males (Shaywitz et al, 2008)

Question 10

DVD and fixation

Answer 10

Fixation is required for DVD to be elicited first described by Posner (1944) and later confirmed by Spielmann (1986)

Question 11

Myogenic disorders

Answer 11

Abnormal MRI (Salvan et al 1998)

Muscle co-contraction (Blodi 1970)

Question 12

Cause of A and V patterns

Answer 12

Loss of fusion predisposes the oculomotor system to cyclodeviations of the eyes which in turn causes A and V patterns Guyton (1988, 1992), Deng et al (2013)

Question 13

Marcus Gunn findings on MRI

Answer 13

Supported by MRI evidence (Conte et al, 2012)
Structural abnormality in brainstem (midbrain tegmentum)
Neural misdirection happens in brainstem

Question 14

What all mechanical palsies have in common

Answer 14

+ FDT

Question 15

Transposition procedure

Answer 15

Hummelsheim is a partial transposition procedure and this was introduced in 1907

Question 16

Angle of deviation- longstanding

Answer 16

Concomitant

Objective > subjective
difference of >18º between subjective and objective measurement indicates subjective adaptation (McNamara et al, 1995)

Question 17

Ptosis in RSO and LSR

Answer 17

RSO- absent
LSR- L ptosis (ptosis of affected eye)