Ocular Motility Testing Flashcards

In Duane retraction syndrome type I, which movement is primarily limited?

Answer: Abduction

Duane type I is characterized by limited or absent abduction due to misfiring of the lateral rectus by the oculomotor nerve.

When measuring a horizontal deviation with prisms, base direction for an esotropia should be:

Answer: Base-out before the deviating eye

For esotropia (eye turned in), base-out prism is placed before the deviating eye to neutralize the inward deviation.

A patient reports that diplopia is worst when looking down and to the right, and has a positive head-tilt test to the right shoulder. Which muscle is most likely affected?

Answer: Left superior oblique

Worst diplopia in right infraduction plus worsening on right head tilt implicates the left superior oblique by the Parks three-step test logic.

The Worth 4-dot test is performed with red and green filters to assess:

Answer: Suppression and diplopia

The Worth 4-dot test uses red/green dissociation to detect suppression, diplopia, or fusion by asking the patient how many dots they see.

Convergence insufficiency is best characterized by:

Answer: Exophoria greater at near than at distance with remote near point of convergence

Convergence insufficiency presents with exophoria that is greater at near, a receded near point of convergence, and often reduced positive fusional vergence at near.

Which of the following describes an A-pattern esotropia?

Answer: Greater esotropia in upgaze compared to downgaze

An A-pattern esotropia has greater convergence (esotropia) in upgaze and less or exotropia in downgaze.

The Bielschowsky head tilt test helps differentiate superior oblique palsy from:

Answer: Contralateral superior rectus palsy

The head tilt test distinguishes a superior oblique palsy from a contralateral superior rectus palsy because each shows opposite hyperdeviation responses to ipsi- vs. contralateral head tilt.