p.13
Clinical Presentation and Symptoms of Strabismus
How is Hirschberg's test performed?
By shining a light in the patient's eyes and observing the reflection on the corneas.
p.15
Types of Esotropia and Exotropia
What is the classification of esotropia in infants?
Infantile esotropia occurs in children less than 6 months old.
p.35
Ocular Myasthenia Gravis: Pathophysiology and Symptoms
What is Ocular Myasthenia Gravis?
A neuromuscular disorder that affects the muscles controlling eye and eyelid movement.
p.40
Thyroid Eye Disease: Characteristics and Management
What is Thyroid Eye Disease?
An autoimmune condition affecting the eyes, often associated with thyroid disorders.
p.2
Definition and Classification of Strabismus
What does adduction refer to in eye movement?
Moving the eye towards the nose.
p.26
Differential Diagnosis of Diplopia
What is a common cause of CN3 palsy?
Vascular issues, specifically posterior communicating artery (PCOM) aneurysm.
p.23
Anatomy and Function of Cranial Nerves Related to Strabismus
What are the symptoms of CN3 palsy?
Oculomotor nerve palsy, causing ptosis, dilated pupil, and inability to move the eye in certain directions.
p.6
Clinical Presentation and Symptoms of Strabismus
What are the key aspects to consider in the history of diplopia?
Onset and orientation, constant vs intermittent, and associated symptoms.
p.26
Differential Diagnosis of Diplopia
What condition should be ruled out when evaluating CN3 palsy?
Posterior communicating artery aneurysms.
p.25
Anatomy and Function of Cranial Nerves Related to Strabismus
Which muscles are innervated by the superior division of the oculomotor nerve?
Levator palpebrae superioris (LPS) and superior rectus (SR).
p.38
Ocular Myasthenia Gravis: Pathophysiology and Symptoms
What is the purpose of the ice pack test?
To assess the presence of ocular myasthenia gravis by observing improvement in ptosis or diplopia after cooling the eyelids.
p.13
Definition and Classification of Strabismus
What is Hirschberg's test used for?
To assess ocular alignment and detect strabismus.
p.23
Anatomy and Function of Cranial Nerves Related to Strabismus
What is CN6 palsy associated with?
Abducens nerve palsy, leading to inability to abduct the eye.
p.13
Definition and Classification of Strabismus
What does the position of the light reflection indicate in Hirschberg's test?
It indicates the degree of strabismus present.
p.14
Definition and Classification of Strabismus
What is childhood strabismus?
A condition where the eyes do not properly align with each other during gaze in children.
p.39
Ocular Myasthenia Gravis: Pathophysiology and Symptoms
In which conditions might a fatigability test be particularly useful?
In diagnosing conditions like myasthenia gravis or other neuromuscular disorders.
p.21
Ocular Myasthenia Gravis: Pathophysiology and Symptoms
What is a neuromuscular condition?
A disorder that affects the muscles and the nerves that control them.
p.17
Types of Esotropia and Exotropia
What are the types of acquired exotropia?
Intermittent XT, constant XT, and sensory XT.
p.22
Differential Diagnosis of Diplopia
What is the role of CN3 in diplopia?
CN3 palsy can cause both horizontal and vertical diplopia.
p.21
Anatomy and Function of Cranial Nerves Related to Strabismus
What role do muscles play in movement?
They contract to produce movement and maintain posture.
p.17
Types of Esotropia and Exotropia
What characterizes sensory exotropia?
It occurs in a non-seeing eye.
p.36
Ocular Myasthenia Gravis: Pathophysiology and Symptoms
What is the role of acetylcholine in a normal individual?
It attaches to acetylcholine receptors (AChR’s) on skeletal muscle to initiate contraction.
p.34
Clinical Presentation and Symptoms of Strabismus
What are common symptoms of CN6 palsy?
Diplopia (double vision) and inability to move the eye laterally.
p.24
Clinical Presentation and Symptoms of Strabismus
What is ptosis in the context of Cranial Nerve 3 palsy?
Drooping of the upper eyelid.
p.22
Differential Diagnosis of Diplopia
What is CPEO in relation to diplopia?
Chronic Progressive External Ophthalmoplegia, a muscular condition that can cause diplopia.
p.33
Anatomy and Function of Cranial Nerves Related to Strabismus
Which cranial nerve is affected in CN6 palsy?
Cranial Nerve VI (Abducens nerve).
p.24
Differential Diagnosis of Diplopia
What can cause Cranial Nerve 3 palsy?
Aneurysms, tumors, or diabetes.
p.31
Anatomy and Function of Cranial Nerves Related to Strabismus
What is Cranial Nerve 6 responsible for?
It controls lateral eye movement.
p.30
Differential Diagnosis of Diplopia
What are congenital causes of IOOA SOUA?
Congenital factors can lead to IOOA SOUA.
p.2
Definition and Classification of Strabismus
What is abduction in terms of eye movement?
Moving the eye towards the ear.
p.30
Differential Diagnosis of Diplopia
How can head trauma contribute to IOOA SOUA?
Head trauma can cause IOOA SOUA.
p.41
Ocular Myasthenia Gravis: Pathophysiology and Symptoms
What is the pathophysiology of Thyroid Eye Disease (TED)?
Autoimmune inflammation of the extraocular muscles (EOM).
p.11
Clinical Presentation and Symptoms of Strabismus
What is the purpose of the Cover Test?
To assess eye alignment and detect strabismus.
p.25
Anatomy and Function of Cranial Nerves Related to Strabismus
Which muscles are innervated by the inferior division of the oculomotor nerve?
Medial rectus (MR), inferior rectus (IR), and inferior oblique (IO).
p.14
Clinical Presentation and Symptoms of Strabismus
What symptoms might indicate strabismus in a child?
Crossed eyes, squinting, or difficulty focusing on objects.
p.38
Ocular Myasthenia Gravis: Pathophysiology and Symptoms
How is the ice pack test performed?
An ice pack is placed over the eyelids for a few minutes, and then the patient's eyelid position is evaluated.
p.6
Clinical Presentation and Symptoms of Strabismus
Why is the orientation of diplopia important in history taking?
It helps in diagnosing the underlying cause and determining the appropriate management.
p.1
Definition and Classification of Strabismus
What is the difference between constant and intermittent strabismus?
Constant strabismus is always present, while intermittent strabismus occurs occasionally.
p.40
Thyroid Eye Disease: Characteristics and Management
What are the management options for Thyroid Eye Disease?
Management may include medications, radiation therapy, and surgery in severe cases.
p.16
Types of Esotropia and Exotropia
What characterizes fully accommodative esotropia?
It corrects with glasses for hyperopia.
p.20
Differential Diagnosis of Diplopia
What can cause adult strabismus?
Neurological disorders, trauma, or previous eye surgery.
What organs are part of the digestive system?
Mouth, esophagus, stomach, intestines, liver, pancreas, and gallbladder.
p.37
Ocular Myasthenia Gravis: Pathophysiology and Symptoms
How does muscle fatigue present in Myasthenia Gravis?
Fatigable, worse towards the end of the day, and intermittent.
p.2
Definition and Classification of Strabismus
What is the definition of strabismus?
Misalignment of the eyes.
p.23
Anatomy and Function of Cranial Nerves Related to Strabismus
What does CN4 palsy affect?
Trochlear nerve, resulting in difficulty looking down and inwards.
p.5
Diplopia: Types and Associated Conditions
What is physiologic diplopia?
A type of double vision that occurs under normal conditions, often when looking at objects at different distances.
p.27
Differential Diagnosis of Diplopia
What are some causes of CN3 palsy?
Intracranial aneurysms, compressive lesions in the cavernous sinus, diabetes mellitus, and trauma.
p.5
Diplopia: Types and Associated Conditions
When does physiologic diplopia typically occur?
When viewing objects at varying distances, particularly when one eye is fixated on a near object and the other on a distant object.
p.30
Differential Diagnosis of Diplopia
What microvascular conditions are associated with IOOA SOUA?
Diabetes and hypertension.
p.35
Ocular Myasthenia Gravis: Pathophysiology and Symptoms
What are common symptoms of Ocular Myasthenia Gravis?
Ptosis (drooping eyelids) and diplopia (double vision).
p.39
Clinical Presentation and Symptoms of Strabismus
What is a common method used in a fatigability test?
Repetitive muscle contractions or sustained muscle activity.
p.11
Clinical Presentation and Symptoms of Strabismus
How does the Cover Test work?
One eye is covered while observing the uncovered eye for movement.
p.25
Anatomy and Function of Cranial Nerves Related to Strabismus
What autonomic function travels with the inferior division of the oculomotor nerve?
Parasympathetics for pupil constriction.
p.11
Clinical Presentation and Symptoms of Strabismus
What does a movement of the uncovered eye during the Cover Test indicate?
It indicates a misalignment or strabismus in the covered eye.
p.40
Thyroid Eye Disease: Characteristics and Management
How is Thyroid Eye Disease diagnosed?
Diagnosis is typically made through clinical examination and imaging studies.
p.34
Differential Diagnosis of Diplopia
What can cause CN6 palsy?
Causes can include trauma, tumors, vascular issues, or increased intracranial pressure.
p.16
Types of Esotropia and Exotropia
What are the two classifications of esotropia based on age?
Infantile (<6 months) and Acquired (6 months - 7 years).
p.43
Management Strategies for Strabismus in Children
When is strabismus surgery considered in adults?
If the strabismus is stable.
p.36
Ocular Myasthenia Gravis: Pathophysiology and Symptoms
What are common symptoms of Myasthenia Gravis?
Intermittent fatigable diplopia and/or ptosis.
p.24
Diplopia: Types and Associated Conditions
How does Cranial Nerve 3 palsy affect vision?
It can lead to double vision (diplopia).
What are the major components of the human circulatory system?
The heart, blood vessels, and blood.
What is the function of the nervous system?
To transmit signals between different parts of the body and coordinate responses.
p.29
Anatomy and Function of Cranial Nerves Related to Strabismus
What is the primary function of Cranial Nerve IV (CN4)?
Incyclotorsion, depression, and abduction of the eye.
p.29
Clinical Presentation and Symptoms of Strabismus
What symptoms are associated with dysfunction of CN4?
Vertical/torsional diplopia and head tilt.
p.39
Clinical Presentation and Symptoms of Strabismus
What is the purpose of a fatigability test?
To assess the endurance and fatigue levels of a muscle or muscle group.
p.13
Clinical Presentation and Symptoms of Strabismus
What is a normal finding in Hirschberg's test?
The light reflection should be centered on the cornea of both eyes.
p.19
Management Strategies for Strabismus in Children
How can amblyopia be treated in children?
Through patching if needed.
p.5
Diplopia: Types and Associated Conditions
Is physiologic diplopia a permanent condition?
No, it is usually temporary and resolves when the eyes are aligned properly.
p.30
Differential Diagnosis of Diplopia
What role do tumors play in IOOA SOUA?
Tumors can be a cause of IOOA SOUA.
p.1
Definition and Classification of Strabismus
What is strabismus?
Strabismus is a condition in which the eyes do not properly align with each other when looking at an object.
p.5
Diplopia: Types and Associated Conditions
What causes physiologic diplopia?
It is caused by the brain's inability to fuse images from both eyes when they are not aligned.
p.30
Differential Diagnosis of Diplopia
How can an aneurysm lead to IOOA SOUA?
An aneurysm can cause IOOA SOUA.
p.14
Management Strategies for Strabismus in Children
What are some management strategies for childhood strabismus?
Eyewear, vision therapy, or surgery.
p.24
Clinical Presentation and Symptoms of Strabismus
What does ophthalmoplegia refer to?
Paralysis or weakness of the eye muscles.
p.36
Ocular Myasthenia Gravis: Pathophysiology and Symptoms
What is the result of defective transmission at the neuromuscular junction (NMJ) in MG?
Muscle fatigability and weakness.
p.34
Differential Diagnosis of Diplopia
How is CN6 palsy diagnosed?
Through clinical examination and imaging studies to identify underlying causes.
p.20
Definition and Classification of Strabismus
What is adult strabismus?
A condition where the eyes do not properly align when looking at an object.
p.10
Anatomy and Function of Cranial Nerves Related to Strabismus
Which cranial nerves innervate the extraocular muscles?
Oculomotor (III), Trochlear (IV), and Abducens (VI).
What is the role of the respiratory system?
To facilitate gas exchange, primarily oxygen and carbon dioxide.
p.31
Differential Diagnosis of Diplopia
How is Cranial Nerve 6 palsy diagnosed?
Through clinical examination and imaging studies.
p.28
Differential Diagnosis of Diplopia
What can cause Cranial Nerve 4 palsy?
Trauma, vascular disease, or tumors.
p.19
Management Strategies for Strabismus in Children
What is the first step in managing strabismus in children?
Treat the underlying cause.
p.27
Clinical Presentation and Symptoms of Strabismus
What are the limitations in eye movement associated with CN3 palsy?
Limited right supraduction, infraduction, and adduction, along with ptosis.
p.19
Management Strategies for Strabismus in Children
What should be checked for in children with strabismus?
Refractive errors (glasses).
p.39
Clinical Presentation and Symptoms of Strabismus
What does a fatigability test typically measure?
The ability of muscles to sustain activity over time.
p.21
Anatomy and Function of Cranial Nerves Related to Strabismus
What is the primary function of nerves in the body?
To transmit signals between the brain and other parts of the body.
p.6
Clinical Presentation and Symptoms of Strabismus
What associated symptoms should be noted in a diplopia history?
Myasthenia gravis, thyroid issues, focal neurological deficit, and high intracranial pressure (ICP).
p.6
Clinical Presentation and Symptoms of Strabismus
What is the difference between constant and intermittent diplopia?
Constant diplopia occurs all the time, while intermittent diplopia occurs occasionally.
p.1
Definition and Classification of Strabismus
What are the two main types of strabismus?
Esotropia (inward turning of the eye) and exotropia (outward turning of the eye).
p.33
Clinical Presentation and Symptoms of Strabismus
What is a primary symptom of CN6 palsy?
Limited abduction of the right eye.
p.43
Management Strategies for Strabismus in Children
What type of glasses can be used to manage strabismus?
Prism glasses (stick on Fresnel or ground in).
p.36
Ocular Myasthenia Gravis: Pathophysiology and Symptoms
What happens to acetylcholine receptors in Myasthenia Gravis (MG) patients?
Acetylcholine receptor antibodies (AChR - Ab’s) bind to AChR’s and reduce their number.
p.35
Ocular Myasthenia Gravis: Pathophysiology and Symptoms
What treatments are available for Ocular Myasthenia Gravis?
Treatments include medications like anticholinesterase agents, immunosuppressants, and in some cases, surgery.
What is the primary function of the human skeletal system?
To provide structure, support, and protection to the body.
p.28
Clinical Presentation and Symptoms of Strabismus
What is a common symptom of Cranial Nerve 4 palsy?
Vertical diplopia (double vision).
p.20
Definition and Classification of Strabismus
How is adult strabismus diagnosed?
Through a comprehensive eye examination and assessment of eye alignment.
p.31
Management Strategies for Strabismus in Children
What is a potential treatment for Cranial Nerve 6 palsy?
Management may include prism glasses or surgery in severe cases.
What is the role of the immune system?
To defend the body against pathogens and diseases.
p.7
Differential Diagnosis of Diplopia
What past medical history (PMHx) conditions are noted?
Diabetes Mellitus (DM), Hypertension (HTN), dyslipidemia, infections (URTIs), vaccinations.
p.43
Management Strategies for Strabismus in Children
What is the first step in managing strabismus in adults?
Treat the underlying cause (e.g., MG, Thyroid, intracranial pathology).
p.40
Thyroid Eye Disease: Characteristics and Management
What are common symptoms of Thyroid Eye Disease?
Symptoms include bulging eyes, dryness, irritation, and vision changes.
p.34
Anatomy and Function of Cranial Nerves Related to Strabismus
What is CN6 palsy?
A condition resulting from the dysfunction of the sixth cranial nerve, affecting lateral eye movement.
p.40
Thyroid Eye Disease: Characteristics and Management
What causes Thyroid Eye Disease?
It is caused by an autoimmune response that affects the muscles and tissues around the eyes.
p.14
Diplopia: Types and Associated Conditions
How can strabismus affect a child's vision?
It can lead to amblyopia or double vision if not treated.
p.38
Ocular Myasthenia Gravis: Pathophysiology and Symptoms
What indicates a positive result in the ice pack test?
A noticeable improvement in eyelid droop or double vision after the ice pack is removed.
p.33
Differential Diagnosis of Diplopia
What are some potential causes of CN6 palsy?
Tumour, microvascular occlusion, trauma, aneurysm, raised intracranial pressure.
p.11
Management Strategies for Strabismus in Children
What is the significance of detecting strabismus early?
Early detection can lead to more effective management and treatment.
p.1
Definition and Classification of Strabismus
What is accommodative strabismus?
A type of strabismus that occurs due to focusing efforts, often seen in children who are farsighted.
p.10
Anatomy and Function of Cranial Nerves Related to Strabismus
What is the primary function of the extraocular muscles?
To control eye movements.
p.34
Management Strategies for Strabismus in Children
What is a common management strategy for CN6 palsy?
Prism glasses to help align vision and reduce diplopia.
p.16
Types of Esotropia and Exotropia
What is partially accommodative esotropia?
It partially corrects with glasses for hyperopia.
p.20
Clinical Presentation and Symptoms of Strabismus
What are common symptoms of adult strabismus?
Double vision, eye strain, and difficulty with depth perception.
p.37
Ocular Myasthenia Gravis: Pathophysiology and Symptoms
What are common ocular symptoms of Myasthenia Gravis (MG)?
Droopy eyelids and/or diplopia.
p.28
Clinical Presentation and Symptoms of Strabismus
What position may a patient with Cranial Nerve 4 palsy adopt to compensate for their condition?
Head tilt towards the unaffected side.
p.35
Ocular Myasthenia Gravis: Pathophysiology and Symptoms
What causes Ocular Myasthenia Gravis?
It is caused by an autoimmune response that disrupts communication between nerves and muscles.
p.24
Clinical Presentation and Symptoms of Strabismus
What are common symptoms of Cranial Nerve 3 palsy?
Ptosis, ophthalmoplegia, and dilated pupil.
p.2
Definition and Classification of Strabismus
What does phoria refer to?
Latent strabismus, present when breaking fusion.
p.35
Ocular Myasthenia Gravis: Pathophysiology and Symptoms
How is Ocular Myasthenia Gravis diagnosed?
Through clinical examination, blood tests for antibodies, and electrodiagnostic tests.
p.22
Differential Diagnosis of Diplopia
What muscular condition is associated with diplopia and involves thyroid dysfunction?
Thyroid Eye Disease (TED).
p.41
Thyroid Eye Disease: Characteristics and Management
What is a characteristic finding in the extraocular muscles in Thyroid Eye Disease?
Restriction of extraocular muscles in any pattern.
p.1
Definition and Classification of Strabismus
What is non-accommodative strabismus?
Strabismus that is not related to focusing efforts and does not improve with glasses.
p.31
Clinical Presentation and Symptoms of Strabismus
What is a common symptom of Cranial Nerve 6 palsy?
Diplopia (double vision).
p.31
Differential Diagnosis of Diplopia
What can cause Cranial Nerve 6 palsy?
Causes can include trauma, tumors, or increased intracranial pressure.
p.37
Ocular Myasthenia Gravis: Pathophysiology and Symptoms
What systemic symptoms are associated with Myasthenia Gravis?
Dysarthria, dyspnea, dysphagia, and muscle fatigue.
What are the main types of muscle tissue in the human body?
Skeletal, cardiac, and smooth muscle.
What is the function of the endocrine system?
To regulate bodily functions through hormones.
p.7
Definition and Classification of Strabismus
What is included in the past ocular history (POHx)?
Childhood strabismus, previous strabismus surgery, previous episodes of diplopia, lazy eye.
p.36
Ocular Myasthenia Gravis: Pathophysiology and Symptoms
Why is Myasthenia Gravis referred to as a 'big mimicker'?
Because it can mimic other conditions due to its symptoms.
p.16
Types of Esotropia and Exotropia
What defines non-accommodative esotropia?
There is no significant refractive error.
p.16
Types of Esotropia and Exotropia
What are some causes of esotropia?
CN6 palsy, thyroid eye disease, Myasthenia gravis, sensory ET (non-seeing eye such as retinoblastoma).
p.20
Management Strategies for Strabismus in Children
What are the management options for adult strabismus?
Options include glasses, prisms, vision therapy, and surgery.
