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OKAPs > Untitled spreadsheet - strabismus > Flashcards

Untitled spreadsheet - strabismus Flashcards

3
Q

what axis do SR and IR insert

A

23

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4
Q

what axis do SO, IO insert

A

51

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5
Q

origin of inferior oblique

A

periostem of maxillary

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6
Q

what goes along with inferior oblique?

A

inferior division of CN3 with parasympathetic supply to iris constrictor, injury leads to mydriasis.

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7
Q

what is normal convergene and diversgene amplitudes

A

con (14-38), diverge (6-16). Vertical 2.5

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9
Q

what 2 tests can distinguish monofixation syndrome?

A

worth 4 dot: at near sees 4 lights (fusiion), at distance sees 2,3 lights (due to central scotoma), also 4 prism diopter base out prism, normal eyes will turn, monofixation, eye will not turn

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12
Q

what’s difference between primary and secondary deviation in hering’s law

A

primary: deviation measuring with normal eye fixing, seocndary: measured with paretic eye fixing, larger than primary

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13
Q

Sherring’ton’s law

A

innervation to ipsi antagonist decreases as innvervation to aganoist increaes

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14
Q

example of sherrington’s law

A

Duane’s

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15
Q

postive angle capa:

A

light reflex nasal, mimics XT, ROP, toxocara.

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16
Q

negative angle kapaa

A

light reflex temporal

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17
Q

Krimsky

A

use prizm (Kirm is like glass)

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18
Q

Hirschberg

A

1mm equal 7 degrees 15 PD

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19
Q

what is a duction?

A

monocular rotation of eye

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20
Q

definition of version?

A

conjugate binocular eye movemetns

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21
Q

Name 5 signs of congenital nystagmus.

A

null point, no oscipllopsia, OKN reversal, absent during sleep, dampened by convergence, horiziontal, increase amplitude with distance, decrese with near, increase velocity with slow phase

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22
Q

what is okn reversal?

A

eye moves in slow phase in opposite direction of OKN drum spinning

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23
Q

downbeat nystagmus

A

cervicomedullary (Chiari malformation)

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24
Q

seesaw nystagmus

A

parasellular craniopharyngioma

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25
Q

association with opsoclonus

A

neuroblastoma

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26
Q

periodic alternating nystagmus

A

cervicomedullary

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27
Q

rx for congenital nystagmus

A

base out prizm to force convergence, only fusional convergene helps, no accomodative convergenceminus lenses do not help, Kestanbeaum procedure for surgery

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28
Q

4 characteristics of latent nystagmus

A

fast phase to side of fixing eye, normal OKN, nulls with adduction, DVD 050%

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29
Q

alexander’s law

A

intenstiy increasesa when looking toward fast phase, decreases toward slow phase.

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30
trio of spasmus nutans
torticollis, head bobbing, and shimmering nystagmus.
31
what is divergence excess?
XT greater at distance than near by at least 10 PD
32
how to distinguish simulated divergence excess from true
after 30 min patch, exodeviation becomes equal to distance tnd near. Due to enhanced fusional convergence at near due to accomodation. True: after 30 min patch, still has divergence excess at distance
33
what is convergence insufficiency?
near XT greater than distance XT
34
5 findings of congenital esotropia
present by 6 months, large angle, cross fixation
35
2 association with congenital esotropia
DVD in 70%, IOOA in 70% with V pattern, rx with IO weakening
36
what is nystagmus blockage syndrome
overaccomodation to dampen nystagmus results in et at near. Asymetry of monocular OKN response. Nasal to temporal smooth pursuit less developed
37
Describe refractive accomodative esotropia
high hyperopia, rx with full cyl refraction, normal ACA ratio
38
Nonrefractive accomodative esotopia
eso greater at near than distance rx: bifocals, consider miotics to lower ACA ratio
39
what is ACA ratio?
nl 3-5:1 PD per dioper of acommodation
40
what does a high ACA ratio mean?
near deviation exceed distance deivation by > 10 PD
41
heterophoria method for ACA
IPD+(near deviation-distance deviation)/accomodative demand)
42
lens gradient method
deviation with lens- deviation without lens/diopter power of lens
43
rx for cyclic ET
full hyperopic correction
44
associations with divergence paralysis
pontine tumors, head trauma
45
spasm of near synkinetic reflex (ciliary spasm)
HA, blurred distance VA.
46
rx for convergence insufifciency
pencil pushops
47
pattern for IOOA
V pattern
48
pattern for SOOA
A pattern
49
rx for SO palsy
<15 PD, just one muscle, greater than 15 PD, two mscles. With IO overaction, weaken ipsi IO.
50
define double elevator palsy
ptosis with unilateral defect in upgaze
51
causes of double elevator palsy
IR restriction, SR and IO weakness., can be supranuclear
52
rx for double elevator palsy with SR weakness
Knapp procedure (elevatgiona dn transposition of MR n dLR to side of SR).
53
pattern in Brown's syndrome
V pattern divergence in upgaze
54
rx for brown's
SO weaknening.
55
when are A and V patterns significant
A: diverge >10, V pattern converge >15
56
how much does transposition of horizontal muscules corect in A or V pattenrs
about 15 PD
57
ir IOO found, how much does IO weakening help?
15 PD
58
What is Duane's syndrome
co-contraction of medial and lateral rectus.
59
signs of duane's
retraction of globe with secondary narrowing of PF, leash phenomeon, both LR an MR pulling on eye
60
three types of Duane's
1: abduct problem, 2: adduct problem, 3 both of them
61
associations with duane's
duane's goldenhar's klippel-Fiel, fetal alchol
62
associations with CPEO
Kerns sayre, Bassen-Kornzweigh, refsum's cardiac oconduction.
63
what is harada-Ito
anterior temporal displacement of ant4iro half of superior oblique tendon, used for excyclotorsion.
64
Kestenbaum procedure
bilateral resect/recess to damp nystagmus.
64
A direct ophthalmoscope is what kind I telescope?
Galilean
65
what is the Bruckner test
sign direct ophthalmoscope, brighter relfex indicates deviating eye
66
What is aicardi syndrome
females, chorioretinal lacunae, agenesis of corpus callosum, and infantile spasms
67
what is hutchinson's triad
IK, sensorineurla deafness, malformed incsiors from congenital syphilis
69
which side will a patient with left IO palsy tilt his head
tilted toward paretic side
70
findings of bilateral fourth nerve palsy
hypertropia that alternate on side gaze, A V pattern esotropia

OKAPs (10 decks)

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