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OKAPs > Untitled spreadsheet - strabismus > Flashcards

Untitled spreadsheet - strabismus Flashcards

3
Q

what axis do SR and IR insert

A

23

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4
Q

what axis do SO, IO insert

A

51

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5
Q

origin of inferior oblique

A

periostem of maxillary

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6
Q

what goes along with inferior oblique?

A

inferior division of CN3 with parasympathetic supply to iris constrictor, injury leads to mydriasis.

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7
Q

what is normal convergene and diversgene amplitudes

A

con (14-38), diverge (6-16). Vertical 2.5

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9
Q

what 2 tests can distinguish monofixation syndrome?

A

worth 4 dot: at near sees 4 lights (fusiion), at distance sees 2,3 lights (due to central scotoma), also 4 prism diopter base out prism, normal eyes will turn, monofixation, eye will not turn

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12
Q

what’s difference between primary and secondary deviation in hering’s law

A

primary: deviation measuring with normal eye fixing, seocndary: measured with paretic eye fixing, larger than primary

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13
Q

Sherring’ton’s law

A

innervation to ipsi antagonist decreases as innvervation to aganoist increaes

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14
Q

example of sherrington’s law

A

Duane’s

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15
Q

postive angle capa:

A

light reflex nasal, mimics XT, ROP, toxocara.

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16
Q

negative angle kapaa

A

light reflex temporal

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17
Q

Krimsky

A

use prizm (Kirm is like glass)

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18
Q

Hirschberg

A

1mm equal 7 degrees 15 PD

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19
Q

what is a duction?

A

monocular rotation of eye

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20
Q

definition of version?

A

conjugate binocular eye movemetns

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21
Q

Name 5 signs of congenital nystagmus.

A

null point, no oscipllopsia, OKN reversal, absent during sleep, dampened by convergence, horiziontal, increase amplitude with distance, decrese with near, increase velocity with slow phase

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22
Q

what is okn reversal?

A

eye moves in slow phase in opposite direction of OKN drum spinning

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23
Q

downbeat nystagmus

A

cervicomedullary (Chiari malformation)

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24
Q

seesaw nystagmus

A

parasellular craniopharyngioma

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25
Q

association with opsoclonus

A

neuroblastoma

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26
Q

periodic alternating nystagmus

A

cervicomedullary

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27
Q

rx for congenital nystagmus

A

base out prizm to force convergence, only fusional convergene helps, no accomodative convergenceminus lenses do not help, Kestanbeaum procedure for surgery

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28
Q

4 characteristics of latent nystagmus

A

fast phase to side of fixing eye, normal OKN, nulls with adduction, DVD 050%

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29
Q

alexander’s law

A

intenstiy increasesa when looking toward fast phase, decreases toward slow phase.

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30
Q

trio of spasmus nutans

A

torticollis, head bobbing, and shimmering nystagmus.

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31
Q

what is divergence excess?

A

XT greater at distance than near by at least 10 PD

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32
Q

how to distinguish simulated divergence excess from true

A

after 30 min patch, exodeviation becomes equal to distance tnd near. Due to enhanced fusional convergence at near due to accomodation. True: after 30 min patch, still has divergence excess at distance

33
Q

what is convergence insufficiency?

A

near XT greater than distance XT

34
Q

5 findings of congenital esotropia

A

present by 6 months, large angle, cross fixation

35
Q

2 association with congenital esotropia

A

DVD in 70%, IOOA in 70% with V pattern, rx with IO weakening

36
Q

what is nystagmus blockage syndrome

A

overaccomodation to dampen nystagmus results in et at near. Asymetry of monocular OKN response. Nasal to temporal smooth pursuit less developed

37
Q

Describe refractive accomodative esotropia

A

high hyperopia, rx with full cyl refraction, normal ACA ratio

38
Q

Nonrefractive accomodative esotopia

A

eso greater at near than distance rx: bifocals, consider miotics to lower ACA ratio

39
Q

what is ACA ratio?

A

nl 3-5:1 PD per dioper of acommodation

40
Q

what does a high ACA ratio mean?

A

near deviation exceed distance deivation by > 10 PD

41
Q

heterophoria method for ACA

A

IPD+(near deviation-distance deviation)/accomodative demand)

42
Q

lens gradient method

A

deviation with lens- deviation without lens/diopter power of lens

43
Q

rx for cyclic ET

A

full hyperopic correction

44
Q

associations with divergence paralysis

A

pontine tumors, head trauma

45
Q

spasm of near synkinetic reflex (ciliary spasm)

A

HA, blurred distance VA.

46
Q

rx for convergence insufifciency

A

pencil pushops

47
Q

pattern for IOOA

A

V pattern

48
Q

pattern for SOOA

A

A pattern

49
Q

rx for SO palsy

A

<15 PD, just one muscle, greater than 15 PD, two mscles. With IO overaction, weaken ipsi IO.

50
Q

define double elevator palsy

A

ptosis with unilateral defect in upgaze

51
Q

causes of double elevator palsy

A

IR restriction, SR and IO weakness., can be supranuclear

52
Q

rx for double elevator palsy with SR weakness

A

Knapp procedure (elevatgiona dn transposition of MR n dLR to side of SR).

53
Q

pattern in Brown’s syndrome

A

V pattern divergence in upgaze

54
Q

rx for brown’s

A

SO weaknening.

55
Q

when are A and V patterns significant

A

A: diverge >10, V pattern converge >15

56
Q

how much does transposition of horizontal muscules corect in A or V pattenrs

A

about 15 PD

57
Q

ir IOO found, how much does IO weakening help?

A

15 PD

58
Q

What is Duane’s syndrome

A

co-contraction of medial and lateral rectus.

59
Q

signs of duane’s

A

retraction of globe with secondary narrowing of PF, leash phenomeon, both LR an MR pulling on eye

60
Q

three types of Duane’s

A

1: abduct problem, 2: adduct problem, 3 both of them

61
Q

associations with duane’s

A

duane’s goldenhar’s klippel-Fiel, fetal alchol

62
Q

associations with CPEO

A

Kerns sayre, Bassen-Kornzweigh, refsum’s cardiac oconduction.

63
Q

what is harada-Ito

A

anterior temporal displacement of ant4iro half of superior oblique tendon, used for excyclotorsion.

64
Q

Kestenbaum procedure

A

bilateral resect/recess to damp nystagmus.

64
Q

A direct ophthalmoscope is what kind I telescope?

A

Galilean

65
Q

what is the Bruckner test

A

sign direct ophthalmoscope, brighter relfex indicates deviating eye

66
Q

What is aicardi syndrome

A

females, chorioretinal lacunae, agenesis of corpus callosum, and infantile spasms

67
Q

what is hutchinson’s triad

A

IK, sensorineurla deafness, malformed incsiors from congenital syphilis

69
Q

which side will a patient with left IO palsy tilt his head

A

tilted toward paretic side

70
Q

findings of bilateral fourth nerve palsy

A

hypertropia that alternate on side gaze, A V pattern esotropia

OKAPs (10 decks)

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