ABO Pediatric Ophthalmology & Strabismus 2

Question 1

Which finding is most characteristic of infantile (congenital) esotropia?

Accepted Answer

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

Answer

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

Question 2

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

Accepted Answer

Full cycloplegic hyperopic correction

Answer

Refractive accommodative esotropia is treated first with full hyperopic correction.

Question 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?

Accepted Answer

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

Answer

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

Question 4

Which feature best describes Duane retraction syndrome type 1?

Accepted Answer

Limited abduction with globe retraction and palpebral fissure narrowing on adduction

Answer

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

Question 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?

Accepted Answer

Brown syndrome

Answer

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

ABO - American Board of Ophthalmology Practice Test

ABO - American Board of Ophthalmology Practice Test

ABO Pediatric Ophthalmology & Strabismus 2