Test 8

.1. Dissociated vertical deviation (DVD): a. is pathognomonic of infantile esotropia b. is usually unilateral c. causes hypertropia on adduction d. can not be explained with Hering's law e. accurate measurement is important to produce a predictable surgical outcome answera.F   b.F   c.F  d.T   e.F DVD is frequently seen in congenital esotropia but is not pathognomonic for the condition.  It is usually bilateral although the extent may be asymmetrical DVD does not obey Hering's law and hence the word dissociated in DVD It is variable and difficult to measure; Therefore, the surgical outcome is also unpredictable.   2. Spasm of the near reflex may be confused with accommodative esotropia. Features suggestive of      spasm of the near reflex include: a. myopic shift is common b. variable esotropia is a feature c. miosis is a common feature d. on attempted lateral gaze, miosis can occur. e. the esotropia is worse for near than distant answera.T   b.T   c.T   d.T   e.F Spasm of the near reflex causes rounding of the lens and therefore increased refractive power and a myopic shift. Miosis is common so is miosis on sttempted lateral gaze. Esotropia is worse for near than distant in accommodative esotropia. 3. True statements about exotropia include: a. congenital exotropia is less common than congenital esotropia b. the most common cause of constant exotropia is decompensated intermittent exotropia c. intermittent exotropia seen in childhood usually disappear as the child grows older d. high AC/A ratio is seen in intermittent exotropia e. amblyopia is common in patients with intermittent exotropia answera.T   b.T   c.F   d.T   e.F Congenital exotropia is uncommon. Most constant exotropia begins as intermittent exotropia. Intermittent exotropia tends to persist into adult childhood High AC/A ratio is common in intermittent exotropia in order to fuse images at close work Amblyopia is rare in intermittent exotropia.   4. Convergence insufficiency: a. can occur in the presence of normal accommodation b. causes exophoria at near c. can be treated with a base-in prism d. can be treated with a base-out prism e. can be treated with plus lenses answera.T   b.T  c.T   d.T   e.T Both base-in prism and plus lenses can be used to relieve the symptom of convergence insufficiency.  Base-out is used to stimulate fusional convergence.   5. The following are true about spectacle prescription in childhood: a. without cycloplegia, the refraction tends to be underestimated in a child with     hypermetropia b. anisometropic amblyopia is commoner in hypermetropia than in myopia c. overcorrection of myopia may lead to problem with reading d. hypermetropia of 2-3 D is common in children  e. hypermetropia in children tends to decrease with age answera.T   b.T   c.T   d.T   e.T Overcorrection of myopia induces accommodation which in turn limit the amount of accommodation for near work. A low degree of hypermetropia is common in children which tends to decrease as the eye elongates with age.

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