Board Certified Ophthalmologist Board Certified Ophthalmologist Pediatric Ophthalmology and Strabismus Questions and Answers 2

Question 1

A 4-year-old presents with a head tilt to the left shoulder. Which cranial nerve palsy is most likely responsible?

Accepted Answer

Fourth nerve palsy

Answer

A compensatory head tilt to the contralateral shoulder is the hallmark of a superior oblique (fourth nerve) palsy.

Question 2

What is the critical period for amblyopia treatment in most children?

Accepted Answer

Birth to 7-8 years

Answer

The visual system remains plastic and responsive to amblyopia treatment until approximately age 7-8 years, though some benefit may extend beyond this.

Question 3

Which type of esotropia is characterized by a high accommodative convergence to accommodation (AC/A) ratio?

Accepted Answer

Partially accommodative esotropia with high AC/A ratio

Answer

A high AC/A ratio esotropia shows significantly more deviation at near than at distance, often requiring bifocal correction.

Question 4

A 6-month-old infant presents with a large-angle constant esotropia of 45 prism diopters. What is the recommended management?

Accepted Answer

Bilateral medial rectus recession surgery

Answer

Infantile esotropia with a large constant angle typically requires surgical correction, most commonly bilateral medial rectus recession.

Question 5

Which condition is most commonly associated with dissociated vertical deviation (DVD)?

Accepted Answer

Infantile esotropia

Answer

DVD is strongly associated with infantile esotropia and occurs in up to 90% of cases over time.

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Board Certified Ophthalmologist Board Certified Ophthalmologist Pediatric Ophthalmology and Strabismus Questions and Answers 2