Week 1.11 Classifications

Question 1

Onset before 1 year of age

Answer 1

• may be difficult to ascertain
• maybe review photographs
• infantile esotropia (or exo)
• usually onset before 6 moths
• large and relatively stable angle of strabismus
• px are usually emmetropic and rarely have more than a low degree of hyperopia or astigmatism
• often associated with nystagmus and dissociated vertical deviation
• urgent referral - early treatment has better prognosis

Question 2

What is dissociated vertical deviation

Answer 2

When you cover an eye both eyes go up in the same direction
Both eyes go up or both eyes go down

Question 3

What are the different classifications of esotropia

Answer 3

Accommodative (refractive)
Non-accommodative (non-refractive)
Microtropia

May be primary, secondary or consecutive

Question 4

Primary esotropia

Answer 4

• after 6 months of age
• Most prevalent from ~2yrs
• AC/A ratio may be abnormal
• binocularity can be restored if eye can be re-aligned by optical, prismatic or orthoptic means

Question 5

Fully accommodative SOT

Answer 5

Intermittent deviation, secondary to the presence of hyperopia I.e. no manifest deviation with full rx (perhaps latent tho)
- uncorrected requires accompanying for dist and near that stimulates excessive converg sufficient to cause a strab
- onset usually 2-5yrs
AC/A ratio normal
BSV present in nearly all cases; may have MT if anisohyperopic
Usually no or slight amblyopia