squint

On occasion, it may be difficult to distinguish a moderate to severe abducens nerve palsy from Duane's syndrome. Which of the following is more characteristic of an abducens nerve palsy than of Duane's syndrome?

• Diplopia

• Esodeviation of 20 prism diopters in primary gaze

• Abnormal forced duction to abduction

• Palpebral fissure narrowing on adduction

A 3-year-old is found to have a refractive error of +3.00 +0.75 X 90 in both eyes. The child is given the full cycloplegic correction and returns with a residual deviation of 15 esotropia at distance and 25 esotropia at near. A second refraction reveals no change in the refractive error. What is the single best treatment now?

• Surgery

• +4.00 +0.75 x 90 for both eyes

• Miotics

• Bifocal eyeglasses

A 5-year-old girl complains of diplopia 1 week after surgery for exotropia. Visual acuity is 20/30 OU. Measurements reveal an esotropia of 15 prism diopters at distance and at near. About 1 week later, the patient no longer complains of diplopia. Vision is now 20/20 OD and 20/40 OS. A left esotropia at distance is 25 prism diopters and at near is 30 PD. What should the next choice of treatment be?

• Eyeglasses with prisms to correct the distance deviation only

• Full-time occlusion of the right eye

• Eyeglasses with +3.00 bifocals to correct the hypermetropia

• Observation

Which of the following is a common finding with ocular albinism?

• High refractive errors

• optic atrophy

• glaucoma

• iris hyperpigmentatiom

A 4-year-old girl has a 2-year history of wandering eyes when she is tired or ill. Her mother reports that the child tends to close her left eye when outdoors. Visual acuity testing using the linear E game reveals 20/20 OD and 20/40 OS. A cycloplegic refraction shows a refractive error of +2.00 +0.50 x 90 in each eye. The remainder of the eye examination is normal, with the exception of the motility and sensory examinations. The history of wandering eye in this otherwise normal child should suggest what diagnosis?

• Duane's syndrome

• Infantile esotropia

• Pseudostrabismus

• Intermittent exotropia

A 5-year-old girl complains of diplopia 1 week after surgery for exotropia. Visual acuity is 20/30 OU. Measurements reveal an esotropia of 15 prism diopters at distance and at near. What is the best option at this time?

• Full-time alternate occlusion

• wait and observe

• Full-time alternate occlusion

• atropine eye drops

A 5-year-old boy who had allogenic bone marrow transplantation 1 year ago for acute lymphocytic leukemia presents for routine eye examination. Which of the following is not an ocular complication of bone marrow transplantation?

• Retinal hemorrhage

• Iris heterochromia

• high refracttive error

• keratoconus

A 6-week-old infant was diagnosed with a left upper eyelid capillary hemangioma at birth. On examination, the patient is noted to have a large left upper eyelid capillary hemangioma and difficulty opening the left eyelids. This child is at risk for which of the following conditions?

• Metastatic disease and death

• amblyopia

• cataract

• congenital glaucoma

Deafness is associated with which of the following ocular findings?

• retinitis pigmentosa

• essential infantile esotropia

• intermittent exotropia

• capillary hemangioma

A 13-year-old boy presents with a 6-month history of headaches, blurred vision, and intermittent crossed diplopia at near. His symptoms occur almost every day and are worse when he is tired. Your examination reveals an uncorrected acuity in each eye of 20/20. On a distant accommodative target, he is orthophoric. On a target at 1/3 m, he has a 15-prism-diopter exophoria. His near point of accommodation is 8 diopters in each eye. His fusional convergence amplitudes are 16 prism diopters to break and 12 to recover at 1/3 m, and 4 prism diopters to break and 2 to recover on a target at 6 m. Cycloplegic refraction reveals +0.75 sphere OD and +1.00 sphere OS. What would the best treatment option be?

• Correction of the cycloplegic refractive error

• Glasses with base-in prisms

• Resection of both medial rectus muscles

• Exercises for convergence insufficiency