FREE ABO Pediatric Ophthalmology and Strabismus Questions and Answers

Question 1

A 9-month-old infant presents with a history of persistent tearing and mild mattering in the left eye since birth.
The eye is not red, and the cornea is clear.
The mother reports that symptoms are worse in the cold or wind.
What is the most appropriate initial management for this patient?

Accepted Answer

Observation and instruction on digital lacrimal sac massage.

Answer

Immediate surgical probing of the nasolacrimal duct.

Answer

Prescription of a topical antibiotic-steroid combination.

Answer

Referral for a dacryocystorhinostomy (DCR).

Question 2

A 3-year-old child presents with an intermittent inward turning of the right eye, first noticed six months ago. The deviation is more prominent when the child is looking at toys up close. Cycloplegic refraction reveals +5.00 D sphere in both eyes. What is the most appropriate initial treatment?

Accepted Answer

Prescription of the full cycloplegic hyperopic correction.

Answer

Bilateral medial rectus muscle recession.

Answer

Patching of the left eye for 6 hours per day.

Answer

Botulinum toxin injection into the medial rectus muscles.

Question 3

A pediatrician performing a red reflex test on a 6-month-old infant notes a white pupillary reflex (leukocoria) in the right eye. While retinoblastoma is the most life-threatening cause, what is the most common overall cause of leukocoria in children?

Accepted Answer

Congenital cataract

Answer

Retinoblastoma

Answer

Coats' disease

Answer

Persistent fetal vasculature (PFV)

Question 4

A 7-year-old child is examined for an abnormal head posture. On examination, there is a marked limitation of abduction in the left eye. When the child attempts to adduct the left eye (look to the right), you observe narrowing of the palpebral fissure and globe retraction. What is the most likely diagnosis?

Accepted Answer

Duane retraction syndrome

Answer

Sixth (abducens) nerve palsy

Answer

Brown syndrome

Answer

Möbius syndrome

Question 5

A 5-year-old is diagnosed with intermittent exotropia. The parents report the child's left eye drifts outward primarily when tired or looking in the distance. Which of the following findings is a primary indication for considering surgical intervention?

Accepted Answer

The deviation is manifest for more than 50% of waking hours.

Answer

The deviation measures 15 prism diopters at distance.

Answer

The child frequently closes one eye in bright sunlight.

Answer

The near stereoacuity is 200 seconds of arc.

Question 6

According to the Pediatric Eye Disease Investigator Group (PEDIG) Amblyopia Treatment Studies, which of the following is true regarding the treatment of moderate amblyopia (20/40 to 20/80) in children aged 3 to <7 years?

Accepted Answer

Patching for 2 hours daily was found to be as effective as patching for 6 hours daily.

Answer

Patching for 6 hours daily is significantly more effective than patching for 2 hours daily.

Answer

Daily atropine 1% was found to be superior to patching.

Answer

Optical correction alone is ineffective and patching must be started immediately.

A 9-month-old infant presents with a history of persistent tearing and mild mattering in the left eye since birth.The eye is not red, and the cornea is clear.The mother reports that symptoms are worse in the cold or wind.What is the most appropriate initial management for this patient?

A 9-month-old infant presents with a history of persistent tearing and mild mattering in the left eye since birth.
The eye is not red, and the cornea is clear.
The mother reports that symptoms are worse in the cold or wind.
What is the most appropriate initial management for this patient?