5 mark revision

Question 1

Infantile eso

Answer 1

onset < 6m
large, constant ET > 30^ d=n
no change with full hyperopic Rx
associated: DVD, latent nystagmus, IO overaction, cross-fixation, assymetric OKN
poor binov potential, near- absent stereo
surgical allignment when angle stable

Question 2

Microtropia

Answer 2

Small ET <10^
ARC, centrall suppression scotom, reduced stereo.
Negative 4^ BO test
often anisometropic amblyopia
seen on bagolini as a central break
management: refracgive correction +/- amblyopia treatment

Question 3

Convergence insufficiency

Answer 3

Near exo > distance exo
reduced NPC, poor BO at near
AC/A normal
Symptoms: near diplopia, asthenopia, headaches
trust: convergence excercises

Question 4

convergence excess

Answer 4

Near eso > disatance eso
High AC/A, lenses at near reduce ET
near stereo improves with +
management: full hyperopic Rx +/- bifocal/near add

Question 5

Fully accmmodative ET

Answer 5

ET at disatnce and near
Eliminated complely by full cyclo hyperopic Rx
AC/A normal or high
Stereo normalises
management: full time glasses

Question 6

Partial accommmodative ET

Answer 6

Et at D + N
Reduced but residual ET remains with full hyperopic Rx
AC/A usualy normal
Stereo often subnormal
Management: Rx +/- prism/surgery

Question 7

ARC

Answer 7

sensory adaptation: non-foveal point of deviating eye mapped to fovera of fixing eye
allows subjective fusion despite manifest deviation
common in small ET / microtropia
tests: bagolini, worth, synoptophore (objective vs subjective angles)
types: harmonious / unharmonous

Question 8

Bagolini glasses

Answer 8

minimal dissociation; near-natural viewing
normal: 2 streaks crossing at eye
Suppression = missing line segement
Crossed lines - exo
uncrossed lines eso
ARC if lines cross centre despite manifest deviation

Question 9

Occlusion therapy guidelines

Answer 9

Treats amblyopia by forcing amblyopic eye use
after full refractive correction
Dose dependant on severity
risks: skin irritation, poor communication, occlusion amblyopia
review regularly: taper after palteau

Question 10

pseudo-squint

Answer 10

appears without true deviation
causes: espicanthal folds, broad nasal bridge, large + or - angle kappa
cover test = orthophoria
sensory fusion intact
management: reassuance only