Lecture VIII

Question 1

Corneal ulcers in a contact lens wearer = ?

Answer 1

Pseudomonas infection

Question 2

MOA of Ketorolac = ?

Answer 2

NSAID–inhibit COX

Question 3

What is amblyopia?

Answer 3

Decreased VA in the absence of detectable organic disease

Question 4

What is strabismus?

Answer 4

the eyes do not properly align with each other.

Question 5

What causes amblyopia?

Answer 5

Abnormal visual development–brain selects (favors) the aligned or least blurred image and suppresses the blurred or conflicting image caused by the lazy eye

Question 6

Is amblyopia usually unilateral or bilateral?

Answer 6

Unilateral usually

Question 7

True or false: there is a benign exam findings with amblyopia

Answer 7

True

Question 8

What does the treatment of amblyopia depend on?

Answer 8

Plasticity of the visual system–youngins

Question 9

When should treatment for amblyopia begin?

Answer 9

Prior to age 5

Question 10

True or false: if not detected and properly treated, amblyopia carries on their entire life

Answer 10

True

Question 11

What is the nucleus in the brain that atrophies with amblyopia?

Answer 11

Lateral geniculate nucleus

Question 12

What is the role of the lateral geniculate nucleus?

Answer 12

a relay center in the thalamus for the visual pathway. It receives a major sensory input from the retina. The LGN is the main central connection for the optic nerve to the occipital lobe.

Question 13

What are the three major etiologies of amblyopia?

Answer 13

• Strabismic
• Refractive (lens refractive error)
• Form-deprivation (cataracts/corneal scarring)

Question 14

What is a tropia?

Answer 14

a misalignment of the two eyes when a patient is looking with both eyes uncovered

Question 15

What is a phoria?

Answer 15

A latent deviation that only appears when binocular viewing is broken and the two eyes are no longer looking at the same object.

Question 16

True or false: diplopia is usually found with strabismus

Answer 16

False–usually absent since the rain will turn off the visual pathway from that eye early on in development

Question 17

What is the usual presentation of unilateral amblyopia? (3)

Answer 17

• Failed vision test
• Strabismus
• Parental concern

Question 18

How can you detect amblyopia? (3)

Answer 18

• Assess red reflex
• Determine visual acuity
• Evaluate ocular alignment

Question 19

Enlarged cornea is suspicious for what?

Answer 19

Tumor or glaucoma

Question 20

How do you test for strabismus with a general inspection?

Answer 20

• Cardinal positions
• Epicanthus
• Facies

Question 21

What are the two tests for strabismus?

Answer 21

• Corneal light reflex

- Cover/uncover test

Question 22

What is pseudostrabismus?

Answer 22

Increased epicanthal folds may cause an appearance of strabismus

Question 23

True or false: children do not see double

Answer 23

True

Question 24

True or false: newborns should never have a sluggish pupil reflex

Answer 24

False–often the case d/t immature muscle control

Question 25

What are the eye exams that should be done with newborns? (3)

Answer 25

- Corneal light reflex - Red reflex - Pupillary reflex

Question 26

EOM may be uncoordinated for how long after birth?

Answer 26

3-4 months old

Question 27

When are infants able to fix and follow with their eyes?

Answer 27

2 years

Question 28

How do you perform a cover test with 2 year olds?

Answer 28

If cover eye, evaluate how child reacts--if objecting, then suspect problem

Question 29

What is the "E" game that is played with 2-4 year olds?

Answer 29

Choose the right E amongst a series of Es

Question 30

If a 2-4 yo vision is less than what acuity should you refer?

Answer 30

20/40

Question 31

When is the cover/uncover test performed on children?

Answer 31

at 2-4 years

Question 32

Is a photoscreener a substitute for visual acuity?

Answer 32

No

Question 33

When should children be able to use the regular snellen eye chart?

Answer 33

Over age 5

Question 34

Who treats amblyopia?

Answer 34

Ophthalmologists

Question 35

How do you correct amblyopia?

Answer 35

- Clear visual pathway if needed | - Correct refractive error

Question 36

How do you intensify the neural image to the visual cortex with an eye affected with amblyopia?

Answer 36

Occlusion therapy or penalization (defocus) the other eye

Question 37

Success of the treatment for amblyopia depends on what factors (3)?

Answer 37

- Age - Degree of amblyopia - Compliance with patching

Question 38

Does occlusion therapy eliminate strabismus?

Answer 38

No

Question 39

What is the drug that is used to penalize the good eye in the treatment of amblyopia?

Answer 39

Atropine (antimuscarinic)

Question 40

True or false: glasses alone can sometimes correct esotropia

Answer 40

True

Question 41

What is the indication for a lateral canthotomy?

Answer 41

Increased pressure in the eye 2/2 orbital edema or retrobulbar hemorrhage

Question 42

What does it mean when the strabismus is concomitant?

Answer 42

Angle of deviation is "constant" in all gazes