COA Ocular Motility and Alignment 2

Question 1

During the cover-uncover test, the examiner covers the right eye. The left eye moves outward (temporally) to pick up fixation. This finding MOST likely indicates:

Accepted Answer

Left esotropia

Answer

Left exotropia

Answer

Right hypertropia

Answer

Orthophoria

Question 2

In ocular motility testing using the H pattern (nine cardinal positions of gaze), which muscle is being evaluated when the patient looks to the right and UP?

Accepted Answer

Right superior rectus (SR) and left inferior oblique (IO)

Answer

Right inferior oblique (IO) and left superior rectus (SR)

Answer

Right lateral rectus (LR) and left medial rectus (MR)

Answer

Right superior oblique (SO) and left inferior rectus (IR)

Question 3

A patient reports diplopia that is WORSE when looking down and to the left. Which cranial nerve palsy is MOST likely?

Accepted Answer

Right CN IV (trochlear) palsy

Answer

Right CN III (oculomotor) palsy

Answer

Left CN VI (abducens) palsy

Answer

Left CN IV (trochlear) palsy

Question 4

The Hirschberg test estimates the angle of strabismus by observing corneal light reflections. If the corneal reflex appears at the pupil margin of the right eye and centered in the left eye, approximately how many prism diopters of deviation is estimated?

Accepted Answer

15–20 prism diopters

Answer

5–10 prism diopters

Answer

30–45 prism diopters

Answer

60–80 prism diopters

Question 5

Which test best evaluates for a latent deviation (phoria) that is only revealed when binocular fusion is disrupted?

Accepted Answer

Alternate cover test

Answer

Cover-uncover test

Answer

Hirschberg corneal reflex test

Answer

Maddox rod test only

Question 6

A child is found to have a right esotropia measuring 30 prism diopters by the prism and alternate cover test. The child is 3 years old. What is the MOST important reason to treat this promptly?

Accepted Answer

To prevent amblyopia from developing in the deviated eye

Answer

To prevent astigmatism from developing

Answer

To strengthen the extraocular muscles

Answer

To reduce intraocular pressure