Amblyopia 2

Question 1

3 types of refractive amblyopia

Answer 1

Meridional amblyopia

Isoametropia amblyopia

Anisometropic amblyopia

Question 2

Due to uncorrected high astigmatism in one of both eyes

Answer 2

Meridional amblyopia

Question 3

Why can meridional amblyopia easily be missed?

Answer 3

Due to the orientation of the astigmatism……some children may be able to squint or compensate

Question 4

Caused by very high refractive error in both eyes

Answer 4

Isometropic amblyopia

So high that a clear retinal image cannot be obtained.

This results in a bilateral decrease in visual acuity.

Question 5

Child has a normal refractive error with good visual acuity in one eye and a significant refractive error and reduced visual acuity in the other eye

Answer 5

Anisometropic amblyopia

Question 6

What are some common comments from children with anisometropic amblyopia

Answer 6

“My left eye never sees well”

“Thats my bad eye”

Uncorrected refractive error causes a constant blur that prevents the brain from getting clear information via the visual pathway.

Question 7

When is the effect of blur most crucial?

Answer 7

In the first years of life, the critical period of development

Question 8

Amblyopia resulting from a difference of hyperopia between the 2 eyes

Answer 8

Hyperopic anisometropia

Can be affected by as little as +1.00 D

Question 9

In some cases of hyperopic anisometropia, _________ could develop.

Answer 9

Esotropia

Question 10

In hyperopic anisometropia, ___________ can be affected, W4D can show __________, and you could also pick up a _________ _________.

Answer 10

Stereopsis, fusion, central scotoma

Question 11

High unilateral myopia with lesser myopia in the other eye

Answer 11

Myopic anisometropia

Question 12

Loss of visual acuity in one or both eyes that cannot be improved by corrective lenses

Answer 12

Amblyopia

Question 13

Can a phoria cause amblyopia?

Answer 13

NO!

Question 14

In amblyopic patients, could W4D show fusion?

Answer 14

Yes, depending on the severity of the amblyopia

Question 15

If the patient has a prescription less than -5D in both eyes..

Answer 15

Patient most likely has moderate myopic anisometropia

Patient will most likely not develop amblyopia in this case (for ex, -0.75 DS OD for distance and -3.25 DS OS for near) because both eyes attain clarity at either distance or near.

Question 16

Obstruction of the line of sight that prevents a clear eMate to form on the retina

Answer 16

Form deprivation

Question 17

Can form deprivation occur in one or both eyes?

Answer 17

…..yes

Question 18

Physical obstructions that can lead to amblyopia include….

Answer 18

Congenital cataracts 
Ptosis
Traumatic cataract
Corneal alacrity
Vitreous opacity
Vitreous hemorrhage

Question 19

What can shaken baby syntrome lead to (in the eye)

Answer 19

Vitreous hemorrhage.

So sad.

Question 20

What entrance test determines the presence of a strabismus?

Answer 20

COVER TEST!!!!

Question 21

When the visual axes of both eyes do not intersect at fixation

Answer 21

Strabismus

Question 22

Strabismus is important because it may a result of…

Answer 22

Stroke
Thyroid disease
Retinal disease

Question 23

Heterotropia/tropia/strabismus is classified by

Answer 23

The direction of the non-fixating eye

Question 24

What’re the 3 types of strabismus?

Answer 24

Early onset (within 6 months of birth)

Accommodative

Acquired

Question 25

What betters the chances of re establishing binocularity after diagnosing amblyopia?

Answer 25

The more time that there is equal visual acuity and binocularity before strabismic disruption

Question 26

What important information should you obtain about past history of an amblyopic patient?

Answer 26

Occlusion therapy Glasses/contact Past surgeries This will help you plan and make prognosis

Question 27

The earlier the intervention after the onset of strabismus....

Answer 27

The less the chance of sensory adaptations

Question 28

Examples of sensory adaptions

Answer 28

Amblyopia Scotoma/suppression Anomalous correspondence

Question 29

___________ implies better prognosis.

Answer 29

Stereopsis

Question 30

Strabismus prognosis is worse with..

Answer 30

Esotropia Anomalous correspondence Constant unilateral strabismus

Question 31

How to record frequency of strabismus

Answer 31

Constant or intermittent

Question 32

How to record laterality of strabismus

Answer 32

Right Left Alternating

Question 33

How to record direction of strabismus

Answer 33

``` Esotropia Exotropia Hypertropia Hypotropia Cyclotropia..? ```

Question 34

How to record location of strabismus

Answer 34

Distance | Near

Question 35

How to record magnitude of strabismus

Answer 35

Measured in PD at distance and near

Question 36

How to record comitancy of strabismus

Answer 36

Comitancy (or concomitant) In comitancy (or nonconcomitant)

Question 37

How to record sensory adaptation of strabismus

Answer 37

Normal correspondence Anomalous correspondence Suppression

Question 38

When patients read out of order or drop letters, after likely correctly identifying the first and last ones

Answer 38

Spatial uncertainty, due to strabismic amblyopia

Question 39

In strabismic amblyopia, there is risk of injury to which eye?

Answer 39

The non amblyopic eye

Question 40

What is eccentric fixation?

Answer 40

When amblyopia leads to the patient not using the fovea as a center of the visual axis. Another retinal point will assume the role, and visual acuity is reduced.

Question 41

What is a unilateral strabismus more likely to do?

Answer 41

Cause amblyopia

Question 42

What is an intermittent strabismus or an alternating less likely to lead to

Answer 42

Amblyopia That sure was a shitty question

Question 43

The later the onset of strabismus....

Answer 43

The better the chance of re establishing binocularity that the patient already developed

Question 44

Consider a 75 y/o Asian female with a constant left exotropia with a right hypertropia due to a 3rd nerve palsy that occurred at the age of 73. Did this patient previously have binocularity What is the chance of amblyopia in this patient?

Answer 44

75 years old is out of the critical period. Yes Low

Question 45

Consider a 12 month old Caucasian male with a congenital right esotropia that has never seen an eye doctor. Did this patient previously have binocularity? Could his child have amblyopia?

Answer 45

No | Yes