CO CO Pediatric Vision Development & Screening 2 — Questions and Answers
Question 1: Infantile esotropia (congenital esotropia) is defined by onset before which age with what typical characteristics?
- 6 months; large angle, no significant refractive error (Correct answer)
- 12 months; small angle, high hyperopia
- 18 months; variable angle, unilateral
- 24 months; large angle, high myopia
Correct answer: 6 months; large angle, no significant refractive error
Infantile esotropia presents before 6 months of age with a large, stable angle of deviation and typically normal or low degrees of hyperopia.
Question 2: Accommodative esotropia is MOST commonly associated with which refractive error?
- High myopia
- High hyperopia (Correct answer)
- High myopic astigmatism
- Oblique astigmatism
Correct answer: High hyperopia
Accommodative esotropia is typically caused by uncorrected hyperopia, which drives excessive accommodation and associated convergence, causing esotropia.
Question 3: Deprivation amblyopia, caused by conditions such as congenital cataracts, is the MOST severe form because:
- It affects only the peripheral visual field
- It completely deprives the visual cortex of form vision during the critical period (Correct answer)
- It is easily reversed with patching alone
- It only occurs in bilateral cases
Correct answer: It completely deprives the visual cortex of form vision during the critical period
Deprivation amblyopia is most severe because form vision is completely blocked during the critical sensitive period, causing profound cortical underrepresentation.
Question 4: When performing a cover-uncover test on a child, a refixation movement of the uncovered eye indicates which condition?
- Heterophoria (latent deviation)
- Heterotropia (manifest deviation) (Correct answer)
- Normal binocular alignment
- Suppression only
Correct answer: Heterotropia (manifest deviation)
If the uncovered eye moves to take up fixation when the other eye is covered, a manifest tropia (heterotropia) is present in that eye.
Question 5: Duane retraction syndrome Type I is characterized by which motility pattern?
- Limitation of adduction with normal abduction
- Limitation of abduction with globe retraction on adduction (Correct answer)
- Limitation of both abduction and adduction equally
- Limitation of elevation in adduction only
Correct answer: Limitation of abduction with globe retraction on adduction
Duane Type I presents with limited or absent abduction and globe retraction with narrowing of the palpebral fissure on adduction, due to aberrant CN III innervation of the lateral rectus.
Question 6: The AAPOS guidelines recommend that vision screening in children should begin at which age?
- 6 months
- 1 year
- 3 years (Correct answer)
- 5 years
Correct answer: 3 years
AAPOS and AAP guidelines recommend that all children have a vision screening at age 3 years, when cooperation allows photo-screening or acuity testing.
CO CO Pediatric Vision Development & Screening 2
Infantile esotropia (congenital esotropia) is defined by onset before which age with what typical characteristics?