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How is a palsy compensated for?
- head tilt
- fusional amplitude - if enough to overcome
- sx in adults/suppression in kids
How can head posture change?
- develop of comitance
- discomfort too great
- suppression of image
- extension of fusional amp
- improved ocular movement
- with paretic eye fixation
- ask px to quickly point to an objecting in the direction of the paretic muscle
- px will point beyond object
What is contracture?
- contracture occurs when theres is increased resistance against passive stretching of the muscle
- muscle fibres atrophy as a result
How to treat/prevent contracture?
alternate day patching
How does muscle sequelae occur?
- 1. overaction of ipsilateral synergist
- 2. contraction of contralateral antagonist
- 3. 2ndy inhibition of contralateral antagonist
What are the factors that aid in the development of muscle sequelae?
- increased duration
- greater limitation of movement with paretic eye will affect ipsi ant
- forced fixation of paretic eye will decrease muscle sequelae - ipsi ant
How to differentiate between a congenital and acquired palsy?
- diplopia is intermittent
- sometimes amblyopic
- head posture slightly abnormal
- initiate tx right away
- spontaneous recovery
- abnormal head tilt
- diplopia in all fields
- no suppression/amblyopia
- no AC/EF