Untitled spreadsheet - strabismus Flashcards Preview

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Flashcards in Untitled spreadsheet - strabismus Deck (65):
3

what axis do SR and IR insert

23

4

what axis do SO, IO insert

51

5

origin of inferior oblique

periostem of maxillary

6

what goes along with inferior oblique?

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

7

what is normal convergene and diversgene amplitudes

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

9

what 2 tests can distinguish monofixation syndrome?

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

12

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

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

13

Sherring'ton's law

innervation to ipsi antagonist decreases as innvervation to aganoist increaes

14

example of sherrington's law

Duane's

15

postive angle capa:

light reflex nasal, mimics XT, ROP, toxocara.

16

negative angle kapaa

light reflex temporal

17

Krimsky

use prizm (Kirm is like glass)

18

Hirschberg

1mm equal 7 degrees 15 PD

19

what is a duction?

monocular rotation of eye

20

definition of version?

conjugate binocular eye movemetns

21

Name 5 signs of congenital nystagmus.

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

22

what is okn reversal?

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

23

downbeat nystagmus

cervicomedullary (Chiari malformation)

24

seesaw nystagmus

parasellular craniopharyngioma

25

association with opsoclonus

neuroblastoma

26

periodic alternating nystagmus

cervicomedullary

27

rx for congenital nystagmus

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

28

4 characteristics of latent nystagmus

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

29

alexander's law

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

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