Strabismus and Eye Muscle Anatomy
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Questions and Answers

How many recti and oblique muscles are there in the eye?

4 recti and 2 oblique's

Where is the origin of the recti muscles?

The apex of the orbit from a fibrous ring called "Annulus of Zinn"

Where is the insertion of the recti muscles?

Inserted to the globe behind the limbus

Where does the superior oblique muscle originate?

<p>Supero-medial to the optic foramen</p> Signup and view all the answers

What is the function of the trochlea in the superior oblique muscle?

<p>It passes forwards through the trochlea at the angle between the superior and medial walls</p> Signup and view all the answers

Where does the superior oblique muscle insert?

<p>It inserts into the posterior upper temporal quadrant of the globe</p> Signup and view all the answers

Which muscles are innervated by the oculomotor nerve?

<p>Medial, inferior and superior recti (B)</p> Signup and view all the answers

Which muscle is innervated by the abducent nerve?

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

Which muscle is innervated by the trochlear nerve?

<p>Superior oblique (C)</p> Signup and view all the answers

What is the definition of squint?

<p>Misalignment of the visual axes</p> Signup and view all the answers

The visual axis passes through the fovea, nodal point of the eye and the point of fixation

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

The anatomical axis passes through the fovea and the center of the cornea

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

What is the angle between the visual axis and optical axis called?

<p>Angle of Kappa (к)</p> Signup and view all the answers

Pseudostrabismus is a condition where there is a real misalignment of the eyes.

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

What can a large positive angle of Kappa cause?

<p>Pseudoexotropia</p> Signup and view all the answers

What can a negative angle of Kappa cause?

<p>Pseudoesotropia</p> Signup and view all the answers

A manifest squint is a squint that is only seen when one eye is covered.

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

A latent squint is a squint that is only seen when both eyes are open.

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

Orthophoria implies a tendency of the eyes to deviate when fusion is blocked.

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

Which of the following is NOT a type of latent strabismus?

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

Slight phoria is present in most normal individuals and is overcome by the fusion reflex.

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

Decompensating phoria can be associated with symptoms of double vision or asthenopia.

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

Which of the following is NOT a possible cause of strabismus?

<p>Poor lighting conditions (A)</p> Signup and view all the answers

What type of refractive error can cause latent convergent squint?

<p>Hypermetropia</p> Signup and view all the answers

What type of refractive error can cause divergent squint?

<p>Myopia</p> Signup and view all the answers

The Hirschberg test is a light reflex test.

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

The cover-uncover test is used to abolish the stimulus for binocular single vision.

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

The alternate cover test is used to assess the corneal reflex.

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

If the covered eye deviates under the cover and returns to the original position when uncovered, a latent squint is present.

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

The Hirschberg test uses a light to assess the corneal reflex.

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

In the Hirschberg test, an esotropia is characterized by the corneal reflex being in the same position in both eyes.

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

Flashcards

What is the visual axis?

The line passing from the fovea, through the eye's nodal point, to the fixation point. In normal binocular single vision, both eyes' visual axes intersect at the fixation point, creating a single image.

What is the anatomical axis?

A line passing from the posterior pole through the centre of the cornea. It doesn't always align with the visual axis due to fovea's position.

What is the angle of kappa?

The angle between the visual axis and the optical axis. It indicates how the fovea is positioned relative to the anatomical axis.

What is pseudostrabismus?

The impression of a squint when none exists. Often caused by factors like epicanthal folds or abnormal interpupillary distance.

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What is a latent squint (phoria)?

Squint that is only present when one eye is covered. It reveals the eye's tendency to deviate when binocular single vision is disrupted.

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What is a manifest squint (tropia)?

A squint visible when both eyes are open. It indicates persistent deviation of one or both eyes.

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What is orthophoria?

A condition where the eyes are perfectly aligned in the absence of any stimulus for fusion, which is relatively uncommon.

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What is heterophoria?

A tendency of the eyes to deviate when fusion is blocked, usually present in most people.

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What is the medial rectus?

The muscle responsible for turning the eye inward (towards the nose).

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What is the lateral rectus?

The muscle responsible for turning the eye outward (away from the nose).

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What is the superior rectus?

The muscle responsible for raising the eye upwards.

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What is the inferior rectus?

The muscle responsible for lowering the eye downwards.

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What is the superior oblique?

The muscle that rotates the top of the eye inwards, causing downward and inward movement.

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What is the inferior oblique?

The muscle that rotates the top of the eye outwards, causing upward and outward movement.

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What is the oculomotor nerve?

The nerve that controls the medial, inferior, and superior recti muscles, as well as the inferior oblique.

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What is the abducent nerve?

The nerve that controls the lateral rectus muscle, responsible for outward eye movement.

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What is the trochlear nerve?

The nerve that controls the superior oblique muscle, responsible for downward and inward rotation of the eye.

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What is the Hirschberg test?

A test that uses a light source to assess eye alignment by observing the reflection of light on the cornea.

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What is the cover-uncover test?

A test that covers one eye at a time to assess if an eye deviates when binocular single vision is disrupted. It helps detect latent strabismus.

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What is the alternate cover test?

A test where the cover is moved alternately between the eyes to observe any movement or deviation of the eyes. This helps detect both latent and manifest squints.

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What is esotropia?

The tendency to look inwards, resulting in eyes converging towards the nose.

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What is exotropia?

The tendency to look outwards, resulting in eyes diverging away from the nose.

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What is hypertropia?

The tendency for one eye to look upwards, causing a vertical deviation.

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What is hypotropia?

The tendency for one eye to look downwards, causing a vertical deviation.

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How does hypermetropia contribute to squint?

Excessive use of accommodation to see clearly, often seen in hypermetropia. This can lead to excessive convergence and latent convergent squint.

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How does myopia contribute to squint?

Relaxation of accommodation, often seen in myopia. This can lead to a lack of convergence and divergent squint.

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Study Notes

Strabismus

  • Strabismus is a condition where the eyes do not look in the same direction
  • The anatomy of extraocular muscles is crucial in understanding strabismus
  • There are four recti muscles and two oblique muscles that control eye movement
  • Recti muscles originate from a fibrous ring around the optic nerve
  • Recti muscles insert behind the limbus
  • Superior oblique originates above and to the inside of the optic foramen
  • It passes through a pulley-like structure called the trochlea
  • Then passing backwards and laterally to insert into the upper temporal quadrant of the eye
  • Inferior oblique originates from a depression near the orbital rim, laterally to the lacrimal sac
  • It passes backwards and laterally to insert into the lower temporal quadrant of the globe
  • Medial, inferior, and superior rectus muscles are innervated by the oculomotor nerve
  • The lateral rectus is innervated by the abducens nerve
  • Inferior oblique is innervated by the oculomotor nerve
  • Superior oblique is innervated by the trochlear nerve

Anatomy of Extraocular Muscles

  • Four recti muscles and two oblique muscles control eye movement
  • Recti muscles originate from the apex (top) of the orbit from a fibrous ring called "Annulus of Zinn"
  • Oblique muscles originate in different locations within the orbit.

Innervations

  • Medial, inferior, and superior recti muscles are innervated by the oculomotor nerve
  • Lateral rectus is innervated by the abducens nerve
  • Inferior oblique is innervated by the oculomotor nerve
  • Superior oblique is innervated by the trochlear nerve

Types of Squint

  • Manifest (tropia): A squint present when both eyes are open
  • Latent (phoria): A squint only seen when one eye is covered
  • Latent squint is not normally visible with both eyes open but is observable when one eye is covered
  • Eso- means inward, Exo- means outward, Hyper- means elevation, Hypo- means depression
  • There are various types of latent strabismus or phoria: esophoria, exophoria, hyperphoria, and hypophoria

Etiology of Squint

  • Uncorrected refractive errors (e.g., hypermetropia, myopia)
  • Congenital weakness of one or more extraocular muscles
  • Secondary to other eye diseases (e.g., cataracts, retinoblastoma)

Examination of Squint

  • Hirschberg test: assesses the corneal light reflex to check for deviations
  • Cover-uncover test: used to detect latent deviation when one eye is covered and then uncovered

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Strabismus Overview PDF

Description

This quiz covers strabismus, a condition impacting eye alignment, and delves into the anatomy and function of the extraocular muscles. Understanding the roles of the recti and oblique muscles, along with their innervation, is essential for comprehending how they influence eye movement.

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