revision Flashcards

1
Q

types of phorias

A

XOP: Convergence weakness (XOP at near), Divergence Excess (XOP at distance), Non-Specific
SOP: Convergence Excess (SOP at near), Divergence Weakness (SOP in distance), Non Specific
L/R Hyperphoria or R/L Hypophoria
Cyclophoria (look @ BV’s)
Incomitant = diagnosed by underlying cause e.g. L hypophoria in 4th nerve palsy

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2
Q

Which way to measure deviation in prisms

A

ESO = BO
EXO = BI
HYPO = BU
HYPER = BD

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3
Q

Normal PFR

A

Nr: 35 Dioptres BO -> 15 Dioptres BI
Dis: 15 Dioptres BO -> 5 Dioptres BI
Vertical: 3 BD -> 3 BU

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4
Q

3rd NP muslces

A

MR, SR, IR, IO
Superior division: SR + Levator Muscle
Inferior Division: MR, IR, IO, sphincter muscle + ciliary muscle

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5
Q

functions of muscles

A

MR: Adducion
LR: Abduction
SR: Elevation, Intorsion, Adduction
IR: Depression, Exorsion, Adduction
SO: Intorsion, Depression, Abducion
IO: Extorsion, Elevation, Abduction

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6
Q

SOT Bigger @ Nr

A

Fully Accom SOT, Convergence Excess SOT, Partially Accom (present at all times but increases when accom exerted), Near SOT

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7
Q

SOT bigger @ dist

A

Distance SOT

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8
Q

SOT same Nr + Distance

A

Infantile SOT, Acquired (early vs late onset), Acquired with myopia, MicroSOT

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9
Q

XOT bigger @ nr

A

Intermittent Near XOT

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10
Q

XOT bigger in distance

A

Intermittent Distance XOT

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11
Q

XOT same Nr + Dist

A

Intermittent Non-Specific XT, Early Onset XT, Decompensated intermittent XT

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12
Q

critical period + sensitive period

A

critical = 0-2 years old
sensitive = 2-8/10 years old

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13
Q

types of ambylopia

A

strabismic, meridional, stimulis deprivation, aniometropic, ametropic

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14
Q

pass mark for logMAR + Kays

A

logMAR = 0.2
Kays = 0.1

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15
Q

excercises for EXO + ESO

A

EXO = + fusional vergence
ESO = - fusional vergence
Stereograms ( + = hold card at arms legnth and focus on object between eyes and card) (- = hold card at 33cm, fixate in distance target just above card)

Eso = -‘ve = bar reading (add - or reduce + and read), if BIN can read in front of print, if using one eye, bar will hide text)

Exo at near = smooth convergence (NPC), jump convergence (jump from distant to near target ), Dot card (fix on furthest dot and move to near dot while appreciatign double).

prisms EXO = BO, ESO = BI

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16
Q

post-op diplopia test

A

-use single letter e.g. P or D
-Will get diplopia if overcorrected after surgery?

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17
Q

DVLA what is driving standard

A

0.2 Logmar

18
Q

what prism direction for PFR for ESO + EXO

A

ESO = BI, EXO = BO

19
Q

pupils

A

PERLLA (pupils equally round and responsive to light + accommodation)
RAPD

20
Q

what diff for lateral incomitance?

A

5-10 dioptres

21
Q

diff for A vs V patterns?

A

V = 15 dioptres diff
A = 10 dioptres diff

22
Q

convergence vs accom on RAF rule

A

Convergence = line + dot, go until double then go back and repeat 3 times
Accom = letter chart, go until blurry then go back to first point clear again and repeat 3 times
tilt downwards

23
Q

deviation size for surgery?

A

20 dioptres

24
Q

order of limitations TED

A

IR, MR, SR, LR

25
Q

size of amblyopia

A

mild: 0.2–.3 LogMAR
moderate= 0.3-0.8 logMAR
severe: > 0.8 logMAR

26
Q

refractive adaptation period

A

18-22 wks (PEDIG 2012)
Continued improvment unpto 30 weeks (PEDIG 2006)
2 + 1/2 lines improved (Stewart + Motas 2004)

27
Q

patching moderate ambylopia

A

2 hrs + near tasks ( = 6 hrs) (PEDIG 2003)
baseline acuity 0.6-0.7, more hours
>7 y/o = 6 hours patching

28
Q

max time for patching

A

400 hours , 4 hours per day max

29
Q

how much improvement patching

A

120 hours = 1 line improvement (MOTAS)

30
Q

atropine

A

blurs around 2-3 lines
moderate amblyopia = daily = weekend atropine
severe ambylopia = still works (PEDIG 2009)
cant use in under 3 y/o
8 minims = 4 weeks

31
Q

sizes of deviations

A

minimal: <10 dioptres
small: 10-20 dioptres
moderate: 25-35 dioptres
marked: >40 dioptres

32
Q

VA measure (start from 5 right at 0.1 line –> 0 right)

A

each letter = 0.02 so e.g.
0.1 line:
get 5 right = 0.1
get 4 right = 0.12
get 3 right = 0.14
get 2 right = 0.16
get 1 right = 0.18
get 0 right = 0.2

33
Q

normal palpebral fissue height

A

about 10mm

34
Q

history

A

What brings you in today?
SYMPTOMS = LOFTSEA (Location, Onset, Frequency, Time, Self-treatment, Effect on patient, associations)
GH: Health conditions? Allergies? Medications? smoke?
POH: Previous issues with eyes? Prev attended HES? glasses or eye turn as a child or wear a patch?
FH: Health conditions? Eye conditions? Squint?
BH: Any birth abnormalities? Full-term normal delivery? birth weight?

35
Q

what incom px present as

A

6th = eso worse in distance and side gaze
browns = hypo in PP, cant elevate eye
4th = up + in
3rd = down and out

36
Q

What surgery test do you need to do?

A

Post op diplopia test (like PFR but keep going after they get double)

37
Q

Two management options for consecutive exos

A

Botox and surgery

38
Q

What does a microtropia mean for patching VA’s?

A

VAs will never be perfectly equal

39
Q

What is Aniseikonia?

A

Difference in image sizes due to two very different RX in each eye e.g. RE -7.00 LE: +3.00

40
Q

Anterior Pligiocephaly

A

Shorter orbit on affected side. This results in malpositioned trochlea. This gives rise to superior oblique under actions on ipsilateral side. In this case, it’s the corresponding over action of the L inferior oblique which is most obvious.