11.2 Squint

Question 1

Each eyes moved by __ muscle
Control by cranial nerve _ _ _

Answer 1

6
4 rectus and 2 oblique

CN III, IV, VI

Question 2

Squint

Answer 2

Strabismus, crossed eyes
Misalignment of eyeball

Question 3

Amblyopia

Answer 3

Lazy eye
Brain suppressing image from one eye

Question 4

Assessment for squint

Answer 4

1. Corneal light reflex
   Direct light source at nasal bridge about 30cm —> light should be reflected symmetrically
2. Cover-uncover test
   observe uncovered eye any movement to focus on target object, then covered eye = the one primarily fixing on object

Question 5

Direction of squint

Answer 5

Esotropia
Exotropia
Hypertropia
Hypotropia

Question 6

Risk factor of squint

Answer 6

Family Hx
Myopia Hyperopia
Cranial nerve damage (injury, viral illness, birth trauma)

Question 7

Clinical manifestations of squint

Answer 7

Poor Vision
Dizziness and headache
Intermittent diplopia (double vision)
Loss of depth perception

Question 8

Management of squint

Answer 8

Occlusion therapy (patching)
Botox injection
Surgery

Question 9

Squint surgury

Answer 9

Relieve double vision, improve fusion of image, prevent lazy eyes, improve appearance and abnormal head posture

GA
Requires suturing
No significant effect on refraction

Question 10

Complication of squint surgery

Answer 10

• Conjunctiva: Swelling redness inflammation and bleeding
• Tearing and mild eye discharge
• eye infection and inflammation
• scarring
• corneal abrasion
• over or under correction
• drooping lid and sinking-in of eyeball (enophthalmos)

Question 11

Post op care for squint surgery

Answer 11

No eye rubbing
Avoid strenuous activity, contact sport, No hot-tubs, sauna, swim for 2 weeks

Infection: Prevent soap, water, shampoo getting into eye, Avoid washing hair first week

Wear clothes with buttons, not pullovers