investigation of esotropia Flashcards
(19 cards)
What is the purpose of investigating esotropia?
To discuss investigative techniques, explain pertinent investigations for management, and identify when further investigations are required.
List some tests and investigations used in the diagnosis of esotropia.
- Cover test and PCT
- Prism Adaptation Test (PAT)
- Post-op Diplopia Test (PODT)
- AC/A Ratio
- Cycloplegic refraction
- Flipper lenses / Halberg Clips
- Trial prisms
- Tests for BSV
- Ocular Motility
- Synoptophore
What factors should be included in a case history for esotropia?
- Presenting complaints / signs / symptoms
- General Health
- Family History
- Birth History
- Previous Ocular History
What should be observed during visual acuity tests?
- Behaviors
- Objection to occlusion
- Age-appropriate responses
- Crowded conditions
- Reliability of the test
What are the different types of esotropia?
- Fully accommodative ET
- Convergence excess ET
- Near ET
- Distance ET
- Cyclical ET
- Constant ET with accommodative element
- Constant ET without accommodative element
What is the significance of ocular motility in esotropia assessment?
To check for muscle imbalances and conditions like inferior oblique over-actions and lateral rectus function.
True or False: Sixth nerve palsy must be excluded in late-onset esotropia.
True
What is the purpose of the Prism Adaptation Test (PAT)?
To assess potential for BSV and determine maximum angle of deviation before surgical correction.
What are the requirements for a patient to be suitable for the Prism Adaptation Test (PAT)?
- Age 3 years or older
- Equal/near equal visual acuity
- VA of 0.300 logMAR (6/12) or better
- Angle of deviation ≤40Δ
- No vertical deviation
Fill in the blank: The _______ assesses the presence of bi-foveal fusion or central suppression.
[4PD BO/BI Reflex Test]
What does the AC/A ratio help differentiate?
It differentiates accommodative types of esotropia at near and indicates suitability for bifocal therapy.
What is controlled binocular acuity (CBA)?
The maximum visual acuity obtainable while maintaining binocular single vision.
What does the Post-operative Diplopia Test (PODT) assess?
The risk of diplopia after surgery or botulinum toxin injection and predicts surgical outcomes.
What is the method for the Post-operative Diplopia Test (PODT)?
Use prisms in free space near and distance with glasses, under and over-correct angle of deviation up to 20Δ.
What is the significance of measuring deviation in cases of BSV?
It helps assess the control of deviation in relation to accommodative effort and differentiate true from simulated convergence excess esotropia.
What is the aim of surgery for responders in esotropia?
To correct the maximum angle measured.
What indicates a patient’s response to prism adaptation?
If the patient has fusion capabilities or not.
What does the term ‘suppression’ refer to in the context of esotropia?
The condition where one eye’s visual input is ignored to prevent diplopia.
True or False: Visual acuities should be re-evaluated in cases of esotropia to check for explained visual loss.
True
