Strabismus patterns

Question 1

Convergence insufficiency

Answer 1

Exo at near
NPC reduced
Poor BO near
Normal AC/A
Reading strain

Question 2

True distance exotropia

Answer 2

Exo at distacne > Near
AC/A normal
Distacne suppression
Near fusion / Stero normal
Surgical is persistant

Question 3

Stimulated distance Exotropia

Answer 3

Looks like distance XOT initially
Near Exo ‘grows’ after occlsuion
AC/A oftren borderline high
Good sensory potential
Obsrerve before surgery

Question 4

Convergence excess Esotropia (High AC/A)

Answer 4

Eso at near
High AC/A
Near angle drops with + lenses
Stero improves when corrected
Bifocal / Near add

Question 5

Fully accommodative Esotropia

Answer 5

ET absent when corrected
AC/A normal
Sensory normal when corrected
no surgery
Rx full time

Question 6

Partially accommodative Esotropia

Answer 6

Residual ET with full correction
AC/A normal
Reuced but not cured
Risk of suppression stereo
Surgical if angle stale and significant

Question 7

Infantile Esotropia

Answer 7

Onset < 6 months
ET > 30^ constant
No reduction with full Rx
DVD, Latent nystagmus and IO overaction
Poor stereo potential

Question 8

Microtropia

Answer 8

Tiny angle
ARC
Central suppression scotoma
4^ BO negative
Anisometropia / Amblyopia is common

Question 9

Convergence spasm

Answer 9

Eso deviation
Small reactive pupils
Over-Accommodation
Often intermittent
“stress/Functional” association

Question 10

Divergence insufficeincy

Answer 10

Distance Eso > near
AC/A normal
Diplopia at distance
no MR pasly
rare but examinable

Question 11

Decompensating esophoria

Answer 11

Gradual loss control
Poor CT recovery
blurred stereo
no accommodative triggers
symptomatic

Question 12

Near Exotropia

Answer 12

True near Exo
AC/A low
Stero reduced at near
Suppression near
rare

Question 13

Intermittent XOT

Answer 13

fluctuating angle
fatigue worsens
control score Deteriorates
Stereo fall off
Surgical when control is poor

Question 14

Paralytic ET

Answer 14

Adduction deficit
Non-comitant
diplopia
head turn
neuro referral if acute

Question 15

Convergence paralysis

Answer 15

zero convergence ability
diplopia normal
NPC cannot be reached
Normal AC/A
Neurological workup