Strabismus Flashcards
Exotropia
less common than ET in children
onset 1st 2 years of life
85% intermittent + alternating
- if not, consider neuro/ocular anomaly
consecutive exotropia
after sx tx or plus tx for esotropia, becomes XT but ACTS like ET
Expecting crossed diplopia, but gets uncrossed diplopia
Goals of XT Treatment
improve stereopsis and cosmesis
XT Treatment Options
Plus at Near
VT (train convergence)
BI Prism: facilitate fusion
Overminus Lenses (OMD) - MP
Alternate Patch: 3-4 hrs a day
- better for younger children
Sx: bilateral LR recession or Unilateral Resect + Recess
Infantile Esotropia
Onset from birth to 6 mos
Large Angle (more than 40 prism diopters) in 50%
IOOA: 68%
DVD: 51-90%
- onset after 2 years old or sx
- eyes go same direction with covered
RE more than +3D and amblyopic 50%
Accommodative Esotropia
Refractive: complete resolution with full Rx
Partially Refractive: incomplete resolution with full Rx
- constant, primary unilateral
Non-Refractive: CE ET 5%
- minimal hyperopia
Tx: BF at near
Non-Accommodative ET
early onset is 6 mos to 2 years old and mag around 30-70PD with ocular disease association (retinoblastoma)
late onset: no association
ET Tx Options
RE correction
BO Prism
VT (harder)
Sx: bilateral MR recession or LR resection
Amblyopia Critical Period
1st 8 years of life
Functional Amblyopia Categories
Refractive
Strabismic:
R + S Both:
Image Degradation: physical obstruction in line of sight due to cataracts, ptosis, hyphema, prolonged patching or occlusion
isoametropic amblyopia
HIGH RE in OU
H: more than 5D
M: more than 8D
Astig: more than 2.50DC
Anisometropic Amblyopia
H: more than 1D | 2D (OMD)
M: more than 3D
Astig: more than 1.50DC | 2.00D
Organic Amblyopia
technically not amblyopic bc it is pathology that causes the vision defect (optic atrophy, macular scar, etc)
ATS PEDIG
initial treatment is better than no treatment
patch activities: drawing, no homework, video games, something easy
