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Pediatric Ophthalmology & 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. Which finding is most characteristic of infantile (congenital) esotropia?

    Answer: Large-angle constant esotropia with onset before 6 months of age

    Infantile esotropia presents before 6 months as a large, stable angle, often with cross-fixation and minimal hyperopia.

  2. A 2.5-year-old develops intermittent esotropia that becomes constant; cycloplegic refraction shows +4.00 D OU. What is the initial treatment?

    Answer: Full cycloplegic hyperopic correction

    Refractive accommodative esotropia is treated first with full hyperopic correction.

  3. A child with accommodative esotropia is straight at distance with full hyperopic glasses but has 20 PD esotropia at near. Which is the most appropriate next step?

    Answer: Prescribe bifocal add (executive or flat-top) of about +2.50 to +3.00 D

    A high AC/A ratio with residual near esotropia is managed with bifocals that relax accommodation at near.

  4. Which feature best describes Duane retraction syndrome type 1?

    Answer: Limited abduction with globe retraction and palpebral fissure narrowing on adduction

    Type 1 Duane, the most common form, shows deficient abduction with retraction on adduction from aberrant CN III innervation of the lateral rectus.

  5. A child has limited elevation of the right eye in adduction, a positive forced duction test, and no superior oblique overaction. What is the most likely diagnosis?

    Answer: Brown syndrome

    Brown syndrome is a restrictive disorder of the superior oblique tendon-trochlea complex causing a positive forced duction test.

  6. In a left superior oblique palsy, the left hypertropia is expected to increase with which maneuver?

    Answer: Head tilt to the left shoulder

    Ipsilateral head tilt recruits the superior rectus without the superior oblique's depressing action, worsening the hypertropia (Bielschowsky test).

  7. Congenital nasolacrimal duct obstruction is most commonly caused by an imperforate membrane at which location?

    Answer: Valve of Hasner

    The distal membrane at the valve of Hasner in the inferior meatus is the usual site, and most cases resolve spontaneously by age 1.