FREE Board Certified Ophthalmologist Pediatric Ophthalmology and Strabismus Questions and Answers Flashcards
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Read the first 6 FREE Board Certified Ophthalmologist Pediatric Ophthalmology and Strabismus Questions and Answers flashcards as text
A 4-year-old presents with an alternating exotropia that increases at distance fixation. What is the most likely diagnosis?
Answer: Intermittent exotropia
Intermittent exotropia characteristically worsens at distance and often presents with alternation in young children.
Which test is most useful for detecting suppression in a child with strabismus?
Answer: Worth 4-dot test
The Worth 4-dot test evaluates fusional status and readily identifies suppression by the absence of dots seen by one eye.
A 6-month-old has a constant large-angle esotropia with cross-fixation. What is the recommended initial management?
Answer: Bilateral medial rectus recession
Infantile esotropia with large constant angles is best treated with early bilateral medial rectus recession to achieve alignment before cortical maturation.
A child with retinoblastoma develops secondary esotropia in the affected eye. What is the underlying mechanism?
Answer: Sensory deprivation disrupting fusion
Loss of central vision from retinoblastoma causes sensory deprivation strabismus, most commonly esotropia.
Which finding on cycloplegic refraction most strongly suggests accommodative esotropia in a 3-year-old?
Answer: Hyperopia of +4.00 D or greater
Significant hyperopia drives excessive accommodative convergence, which is the hallmark mechanism of accommodative esotropia.
A 7-year-old with Down syndrome presents with esotropia. Which additional ocular finding is most commonly associated?
Answer: High accommodative convergence/accommodation ratio
Children with Down syndrome frequently have a high AC/A ratio contributing to their esotropia, in addition to other common findings like Brushfield spots.