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Pediatric Ophthalmology and Strabismus Flashcards

7 cards from real ABO practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. A 2-year-old develops intermittent esotropia that becomes constant; cycloplegic refraction shows +4.50 D in both eyes, and the deviation is equal at distance and near. What is the most appropriate initial treatment?

    Answer: Full cycloplegic hyperopic spectacle correction

    Refractive accommodative esotropia with a normal AC/A ratio is treated first with the full cycloplegic hyperopic correction.

  2. A child with accommodative esotropia is aligned at distance with full hyperopic correction but has a 20 PD esotropia at near. Which treatment best addresses this residual deviation?

    Answer: Executive bifocal segment bisecting the pupil

    A high AC/A ratio esotropia is managed with bifocals, classically flat-top or executive segments set high to bisect the pupil.

  3. Which finding is MOST characteristic of infantile (congenital) esotropia?

    Answer: Large, stable angle with cross-fixation and onset before 6 months

    Infantile esotropia has a large stable angle, often with cross-fixation, appearing in the first 6 months and usually with only low hyperopia.

  4. A 6-year-old with a right hypertropia has a deviation that increases on left gaze and on right head tilt. Which muscle is most likely paretic?

    Answer: Right superior oblique

    The Parks-Bielschowsky three-step test (right hyper, worse on left gaze, worse on right tilt) points to the right superior oblique.

  5. A child has limited abduction of the left eye, with globe retraction and palpebral fissure narrowing on adduction. What is the most likely diagnosis?

    Answer: Duane retraction syndrome type 1

    Duane type 1, the most common form, has poor abduction with globe retraction on adduction, caused by aberrant innervation of the lateral rectus by the third nerve.

  6. Which pattern of eye movement is typical of Brown syndrome?

    Answer: Limited elevation in adduction, often with a V pattern

    Brown syndrome comes from a restricted superior oblique tendon-trochlea complex, so the eye cannot elevate in adduction and a V pattern is common.

  7. A 4-year-old has moderate anisometropic amblyopia (20/80) that has stopped improving after 16 weeks of glasses alone. According to PEDIG results, which starting regimen is as effective as 6 hours of daily patching?

    Answer: 2 hours of daily patching

    PEDIG showed that 2 hours of daily patching gave improvement similar to 6 hours for moderate amblyopia.