Managing ET

Question 1

What is the prognosis & goal of treating infantile ET?

Answer 1

• Poor prog for normal BV

- Good cosmesis and peripheral fusion

Question 2

What is the prognosis for accommodative ET?

Answer 2

Good if intermittent or of short duration

Question 3

What is the prognosis for partially accommodative ET?

Answer 3

• usually good, but worse than fully accom. ET

Question 4

For partially accom ET, it’s treated with lenses and what 3 additional things?

Answer 4

1. Prism
2. Sx
3. VT

Question 5

What is the initial treatment for ET?

Answer 5

Refractive lenses that correct RE and decrease size of ET

Question 6

What are the steps to treat/manage ET?

Answer 6

1. Spec Rx
2. Improve monocular function
3. Develop sensory and motor fusion
4. establish BV in free space
5. Maintain and monitor BV

Question 7

What is the 1st and 2nd step of improving monocular visual function?

Answer 7

1. Treat amblyopia

2. Normalize monocular skills

Question 8

When normalizing monocular skills, what 2 things are we working on?

Answer 8

1. Accommodative Skills

2. Ocular motility therapy

Question 9

After monocular skills are normalized, what’s the next step in managing ET?

Answer 9

• Develop normal peripheral fusion

Question 10

What are the 3 steps to develop normal peripheral fusion?

Answer 10

1. Eliminate AC
2. Eliminate peripheral suppression
3. Improve peripheral sensory/motor fusion

Question 11

How can we eliminate AC?

Answer 11

1. sensory stimulation of obj. angle in-instrument (if ET > 15-20pd)
2. Motor stimulation (if ET < 15-20pd)
3. Overcorrecting prism (any size ET)

Question 12

When developing normal peripheral fusion, what size targets should we start with at the objective angle

Answer 12

Large targets

Question 13

After normal peripheral fusion is developed, what 2 things should be worked on?

Answer 13

1. Eliminate central suppression

2. Increase vergence ranges

Question 14

After extending S/M fusion to central vision, what do we work on next?

Answer 14

Establish binocular vision in free space

Question 15

If the ET is greater than ___, sensory/motor fusion is very hard to control in free space.

Answer 15

15 pd