Questions and Answers
What is the primary objective of recessing the lateral rectus muscle in a patient with congenital exotropia?
Which of the following conditions is least likely to be associated with congenital exotropia?
Which procedure is characterized by cutting a portion of the eye muscle to increase its tension?
What condition is characterized by the eye turning outward intermittently?
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What type of strabismus presents with a large angle of divergence within the first year of life?
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Which of the following muscles is primarily weakened in a bilateral lateral rectus recession?
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Which factor can affect the consistency of eye alignment in individuals with intermittent exotropia?
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Which of the following is a common indicator for strabismus surgery?
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What is the distinguishing recovery time for an individual with pure phoria (XP) during dissociation?
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In a study of 653 children, what percentage exhibited intermittent exotropia during initial observation?
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Which of these is NOT typically considered a co-manager in pediatric vision issues?
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When considering treatment for intermittent exotropia, which of the following is important to assess?
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Which of the following conditions is NOT associated with intermittent exotropia?
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Study Notes
Co-Management of Pediatric Patients
- Co-management involves collaboration with various professionals, including pediatric ophthalmologists, pediatricians, school nurses, educators, occupational therapists, physical therapists, and instructors for visually impaired children.
Pediatric Ophthalmology
- Key conditions managed in pediatric ophthalmology include:
- Strabismus
- Ptosis
- Congenital cataracts and infant aphakia
- Contact lenses use
- Prism therapy
Types of Strabismus
- Common types of deviations include:
- Exotropia (outward turning)
- Esotropia (inward turning)
- Cranial Nerve (CN) Palsies, specifically CN 3, 4, and 6
- Duane Syndrome
Strabismus Surgery Techniques
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Recession:
- Weakens a muscle by re-positioning it further back to decrease its pulling force.
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Resection:
- Involves removing a section of the muscle to tighten it, enhancing its force upon contraction.
Congenital Exotropia
- Characterized by a large-angle divergence present in the first year of life.
- Often associated with neurological abnormalities or craniofacial syndromes.
- Typical presentation as a form of alternating fixation and ismonitored for significant deviation.
- Surgical management includes either bilateral lateral rectus recessions or monocular medial rectus resections with lateral rectus recession.
Exotropia Surgery Considerations
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Sensory Exotropia:
- Associated with ocular trauma or severe amblyopia.
- Treatment may include prism therapy or additional surgery.
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Consecutive Exotropia:
- Occurs post-exotropia surgery, evaluated for further intervention based on convergence insufficiency or retinal disease.
Intermittent Exotropia Assessment
- Fluctuations in eye position may occur based on time of day.
- Requires careful monitoring to determine if deterioration, stability, or improvement is expected.
- Decisions regarding surgical vs. non-surgical interventions are made on a case-by-case basis.
Intermittent Exotropia Study Findings
- Examined 653 children, documenting presentation frequency.
- Children often display intermittent exotropia, with observations showing varying degrees of deviation (e.g., phorias and tropias).
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Description
Test your knowledge on pediatric ophthalmology, focusing on co-management of patients, key conditions like strabismus, and surgical techniques. Explore various types of strabismus and treatment options available for pediatric patients.