Pediatric Ophthalmology Quiz

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Questions and Answers

What is the primary objective of recessing the lateral rectus muscle in a patient with congenital exotropia?

  • To eliminate all symptoms of strabismus
  • To strengthen the muscle's pulling action
  • To completely remove the muscle from the eye
  • To move the muscle insertion back on the eye (correct)

Which of the following conditions is least likely to be associated with congenital exotropia?

  • Significant refractive error (correct)
  • Neurological abnormalities
  • Alternating fixation
  • Craniofacial syndromes

Which procedure is characterized by cutting a portion of the eye muscle to increase its tension?

  • Recession
  • Rehabilitation
  • Resection (correct)
  • Realignment

What condition is characterized by the eye turning outward intermittently?

<p>Intermittent Exotropia (B)</p> Signup and view all the answers

What type of strabismus presents with a large angle of divergence within the first year of life?

<p>Congenital exotropia (B)</p> Signup and view all the answers

Which of the following muscles is primarily weakened in a bilateral lateral rectus recession?

<p>Lateral rectus (B)</p> Signup and view all the answers

Which factor can affect the consistency of eye alignment in individuals with intermittent exotropia?

<p>Time of day (D)</p> Signup and view all the answers

Which of the following is a common indicator for strabismus surgery?

<p>Significant cosmetic concern (C)</p> Signup and view all the answers

What is the distinguishing recovery time for an individual with pure phoria (XP) during dissociation?

<p>Immediate recovery (A)</p> Signup and view all the answers

In a study of 653 children, what percentage exhibited intermittent exotropia during initial observation?

<p>50% (B)</p> Signup and view all the answers

Which of these is NOT typically considered a co-manager in pediatric vision issues?

<p>Culinary Arts Instructors (A)</p> Signup and view all the answers

When considering treatment for intermittent exotropia, which of the following is important to assess?

<p>Frequency of eye turn (B)</p> Signup and view all the answers

Which of the following conditions is NOT associated with intermittent exotropia?

<p>Optic nerve hypoplasia (D)</p> Signup and view all the answers

Flashcards

Co-management in Pediatrics

Collaboration among professionals (pediatric ophthalmologists, pediatricians, nurses, therapists, etc.) to care for children with complex conditions.

Pediatric Ophthalmology

Specialized branch of medicine focusing on children's eye health.

Strabismus types

Eye misalignment conditions, like exotropia (outward turn), esotropia (inward turn).

Recession Surgery (Strabismus)

Surgery weakening an eye muscle by moving it further back.

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Resection Surgery (Strabismus)

Surgery shortening and tightening an eye muscle.

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Congenital Exotropia

Large-angle outward eye turn present from birth, often linked to neurological issues.

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Sensory Exotropia

Outward eye turn related to eye injury or poor vision.

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Consecutive Exotropia

Outward eye turn that develops after surgery.

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Intermittent Exotropia

Outward turning eyes that comes and goes.

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Exotropia Surgery Considerations

Factors to evaluate before deciding on any exotropia surgery, including sensory, consecutive, and intermittent types, and associated conditions.

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Intermittent Exotropia Assessment

Close observation of varying eye positions throughout the day to decide whether to treat surgically or with non-surgical methods.

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Pediatric Ophthalmology Conditions

Eye conditions commonly seen in children, including strabismus, ptosis, congenital cataracts, aphakia, contact lens use and prism therapy.

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Types of deviations in Strabismus

Different types of misalignment including exotropia and esotropia, and Cranial Nerve Palsies, specifically CN 3, 4, and 6, and Duane Syndrome.

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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

  • Recession:
    • Weakens a muscle by re-positioning it further back to decrease its pulling force.
  • 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

  • Sensory Exotropia:
    • Associated with ocular trauma or severe amblyopia.
    • Treatment may include prism therapy or additional surgery.
  • 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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