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Block 5; Week 3 > Strabismus > Flashcards

Strabismus Flashcards

1
Q

What is the function of the medial rectus?

A

it adducts the eye

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2
Q

What is the function of the lateral rectus?

A

it abducts the eye

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3
Q

What are the functions of the superior rectus muscle?

A

it primarily elevates the eye

it also adducts & intorts the eye

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4
Q

What are the functions of the inferior rectus muscle?

A

it depresses, adducts, and excyclotorts the eye

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5
Q

What is the function of the superior oblique muscle?

A

depresses & intorts the eye

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6
Q

What is the function of the inferior oblique muscle?

A

elevates & extorts the eye

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7
Q

Which extra ocular muscles are innervated by the 3rd CN?

A 
medial rectus
inferior rectus
superior rectus
inferior oblique 
levator palpebra
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8
Q

Which extra ocular muscles are innervated by the 4th CN?

A

innervates the superior oblique

Think SO4

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9
Q

Which extra ocular muscles are innervated by the 6th CN?

A

lateral rectus

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10
Q

What are ductions?

A

movements of one eye

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11
Q

What are versions?

A

movements of both eyes in the same direction (conjugate)

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12
Q

What are vergences?

A

movements of both eyes in a disconjugate way (not same direction)

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13
Q

What is strabismus?

A

misalignment of visual axes

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14
Q

What is phoria?

A

latent deviation of eyes

**appears only when fusion disrupted

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15
Q

What is tropia?

A

manifest deviation

**beyond the range of fusional control

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16
Q

What is esotropia?

A

nasalward deviation of an eye (cross eye)

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17
Q

What is exotropia?

A

temporal deviation “wall eye”

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18
Q

What is hypertropia?

A

vertical deviation, relative to higher eye

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19
Q

What is concomitant strabismus?

A
  • *this is where the angle of deviation remains constant regardless of the direction of gaze
  • *range of motion of eyes is full-without limitations
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20
Q

What is incomitant strabismus?

A
  • *this is where the angle of deviation varies with the direction of the gaze
  • *ocular movements are limited
  • *pt may have head in an abnormal posture to maintain binocularity…
21
Q

Which type of strabismus is more commonly seen in childhood onset strabismus?

A

concomitant strabismus more common

22
Q

Is incomitant strabismus congenital?

A

it can be…or it can be acquired.

23
Q

In which type of strabismus do you esp see abnormalities of binocularity, motion processing, poor fusional vergences?

A

comitant strabismus

24
Q

Which type of developmental diseases can lead to incomitant strabismus?

A

Duane’s
Brown’s
mobius

25
Q

Which type of neurologic diseases can lead to incomitant strabismus?

A

cranial nerve palsy

myasthenia

26
Q

Which type of restrictive diseases can lead to incomitant strabismus?

A

orbital fractures-trauma
grave’s disease-thyroid disease
congenital fibrosis syndrome

27
Q

What are some important tests to do when diagnosing strabismus?

A 
cover test, alternate cover test
light reflex testing
angle of deviation measured with prisms
motility evaluation for ductions & versions
sensory testing to assess binocularity
28
Q

What is pseudoesotropia? Which category does this fall into? Which age group is this common in? What are some of its other characteristics?

A

this is where the eyes appear to be crossed, but really they are straight & properly aligned
**characteristics: wide flat nasal bridge, epicanthal folds
**common in infants
Category: comitant strabismus

29
Q

How does pseudoesotropia do with light reflex & cover tests?

A

all is normal with these tests, b/c there really isn’t a problem, just large epicanthal folds.

30
Q

What is congenital esotropia?

A

this is a congenital condition in which the eyes are turned inward
there is a large angle deviation, cross fixation, and limitation of abduction

31
Q

Congenital esotropia is often confused with which condition? What is the treatment? Which category does it fall into?

A

confused with congenital sixth nerve palsy
requires surgical treatment
falls into the category of comitant strabismus

32
Q

What is accommodative esotropia? Which category does it fall into? What is the usual age of onset?

A

this is where the eyes are deviated inwardly somewhat, but really only b/c the kid is trying to focus–over-convergence related to accommodation in hyperopia

  • *usual onset: 2-3 years
  • *comitant strabismus
33
Q

What is the treatment for accommodative esotropia?

A

glasses

bifocals are sometimes necessary

34
Q

What is exotropia? Which category does this belong to? Which age group does this affect?

A

eyes deviate outward when fatigued or not paying attention
normal binocular vision when eyes are straight
seen intermittently in childhood
belong to comitant strabismus category

35
Q

What is Duane’s Retraction Syndrome? Which category does this fall into?

A

absence of 6th nerve nucleus–deficient abduction
miswiring of 3rd nerve–cocontraction of medial & lateral rectus.
**gives globe retraction on adduction
Category: Incomitant Strabismus, developmental

36
Q

What is mobius syndrome? Which category does it fall into?

A

congenital bilateral 6th & 7th nerve palsies.

Category: Incomitant Strabismus, developmental

37
Q

What is Brown’s syndrome? Is it congenital? Which category does it belong to?

A

abnormality of a trochlear pulley–superior oblique problems
deficit of elevation of eye in adduction
**can be congenital or acquired
**Incomitant Strabismus, Developmental

38
Q

What is congenital fibrosis syndrome? How is it inherited? What is its category?

A

w/ this syndrome you have inelastic muscles & ptosis
get positive forced ductions
autosomal dominant disorder
Incomitant Strabismus, Restrictive

39
Q

How does Graves’ disease lead to eye problems? Which category does it fall into?

A

you get lymphocyte infiltration & secondary fibrosis of the extra ocular muscles
Category: Incomitant Strabismus, Restrictive

40
Q

What’s the deal with orbital fractures? Which category does this fit into?

A

this causes scarring or entrapment of orbital tissues & extra ocular muscles…
Category: Incomitant Strabismus, Restrictive

41
Q

What are some things that can cause cranial nerve palsies & neurological incomitant strabismus?

A

microvascular problems
a tumor
trauma
aneurysm

42
Q

What is the specific effects seen in 3rd nerve palsy?

A

the eye moves down & out
you get droopy eyelid (ptosis)
sometimes have pupillary involvement

43
Q

What are the specific effects seen in 4th nerve palsy?

A

oblique diplopia & torsion

this is seen bilaterally, usu following trauma

44
Q

What are the specific effects seen in 6th nerve palsy?

A

difficulty with abduction of eyes

face turns towards the affected side

45
Q

What’s the deal with myasthenia gravis? Which category does this fall into?

A

this is a problem involving acetylcholine receptor antibodies
you get variable strabismus & ptosis
can use the tensilon test
Category: Neurological Incomitant Strabismus

46
Q

When you do recession in strabismus surgery…what happens to the eye you operate on?

A

it weakens the effect of this operated muscle

47
Q

When you do resection in strabismus surgery…what happens to the eye you operate on?

A

this enhances the effect of the operated muscle

48
Q

When transposition happens in strabismus surgery…what is the result?

A

this shifts the force vector of the muscle

49
Q

What happens in normal single binocular vision? What is steropsis?

A

there is a fusion of images from both eyes

if you get sufficient fusion you get stereopsis & you can have depth perception.

Block 5; Week 3 (9 decks)

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