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What are the h&s steps for a strabismic evaluation?
- Signs and sx
- Parent/px goals
- school screening
- Hx of strab/angle
- 2nd opinion
- strab discovered
- change in mag/frequency
- Discovery of poor acuity
Signs and sx?
- Head tilt/turn
- increased blinking or rubbing eyes
- asthenopia if intermittent
- diplopia if recent onset
- type - trauma, vascular, pathology
- time of onset - photos useful
- <6-9M old difficult to get functional cure
- previous tx- interval between onset and tx
- number/age surgery
- which eye/muscle operated on
- post op results
- patching - eye, schedule, compliancy
What are 3 reasons contributing to crowding?
- 1. Contour interaction: cells response and inhibition
- 2. Abnormal eye movements: eyes cant fixate properly
- 3. attentional factors: other letters nearby
When will a neutral density filter decrease VA?
- amblyope: not by much
- pathological: by a lot
Adv and disav of psychometric chart?
- all rows and equal crowding
- all letters same size
- need 5/8 correct (=50% correct) to eliminate 25% guessing
- need to know directionality
- px needs to pay attention
Tests for young children?
- preferential looking
- broken wheel test
- NOT SPECIFICALLY FOR AMBLYOPIA