Strabismus

Question 1

What is Cogan Lid Twitch and what disease is it seen in?

Answer 1

Ocular Mysthenia Gravis. After prolonged downgaze when returning to primary gaze the lid over shoots up.

Question 2

What are the 5 test do diagnose ocular MG?

Answer 2

1. Tensilon test 2. Ice pack 3. Sleep test 4. AutoAB test **(anti-MuSK, anti-acetylcholine receptor Ab) 5. single fiber electromyography

Question 3

What is dissociated nystagmus and give me 3 examples.

Answer 3

When nystgmus occurs only in the ABducting eye. 1. INO 2. MG 3. surgical weakening of rectus muscle

Question 4

What type of OKN response do you get in congenital motor nystagmus.

Answer 4

Paradoxical inversion of OKN response. (i.e.. So if right jerk nystagmus and roll OKN to the left, stimulate pursuit to the left and DAMPEN or even reverese the jerk nystagmus to be to the LEFT.)

Question 5

Which direction is the jerk nystagmus when an eye is covered in Latent nystagmus?

Answer 5

Towards the covered eye.

Question 6

What is the near point of convergence in convergence insufficiency?

Answer 6

> 10cm with an exoPHORIA at near fixation

Question 7

With CN 6 palsy what do you lack on EOM testing?

Answer 7

Full ductions.

Question 8

What does base in prisms cause for intermitent XT?

Answer 8

Reduced fusional amplitutdes.

Question 9

What are 3 treatments for SO Myokimia?

Answer 9

1. Topical timolol 2. Carbamazeme and pheytonin 3. SO tenectomy with IO weakening

Question 10

How do you fix an L SO palsy?

Answer 10

If vertical deviation is 15 PD or less then do ipsilateral IO weakening. If >15 PD then do contralateral IR recession along with ipsilateral IO weakening.

Question 11

Which Cover tests for tropia + phobia?

Answer 11

Alternate cover test

Question 12

What is carried along with the IO muscle?

Answer 12

Parasympathetic supply to iris constrictor

Question 13

Duanes is a violation of what rule and Type 1 causes what?

Answer 13

Sherrington’s law; limits ABDuction

Question 14

What is double elevator palsy and how do u treat?

Answer 14

1. U/L defect in upgaze in Adduction AND ABDuction
2. Ipsilateral ptosis
   (If SR weak do Knapp procedure - elevation of MR/LR to side of SR)

Question 15

Diplopia with monocular Oscillopsia is caused by ?

Answer 15

S.O. Myokymia

Question 16

What are 3 causes of acquired Brown’s syndrome?

Answer 16

1. RA
2. Sinusitis
3. Scleritis

Question 17

Harada Ito is used for what d/o?

Answer 17

SO PALSY

Question 18

Which way is the face turn in Brown’s syndrome?

Answer 18

Contralateral face turn with chin elevation

Question 19

With IO palsy which gaze has a greater deviation?

Answer 19

IPSIlateral gaze

Question 20

With SO palsy which gaze has a greater deviation?

Answer 20

Contralateral gaze

Question 21

In B/L SO palsy in what gaze is the strabismus?

Answer 21

ET in downgaze

Question 22

Smooth pursuit asymmetry is due to lesion in what 2 areas?

Answer 22

1. LGN

2. Straie Cortex

Question 23

How do you treat B/L retinoblastoma?

Answer 23

First systemic chemo with additional local therapy (chemo alone is RARELY successful)

Question 24

How do you monitor kids with trilateral RB?

Answer 24

Serial MRIs every 6 months until age 5