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?

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?

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

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?

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?

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?

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?

Deafness is associated with which of the following ocular findings?

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?

Which of the following statements best describes developmental dyslexia?

A 4-month-old boy is brought in for evaluation because of visual inattention and nystagmus. His pupils do not respond to light and he has a refractive error of +4.00 OU. Both fundi appear normal. What condition would this represent?

X-linked congenital stationary night blindness is usually associated with which refractive error?

A 4-month-old infant girl is noted by her parents to have the unusual appearance of her right eye showing a temporally located retrolental mass. The otherwise healthy child was born 3 weeks prematurely with a birth weight of 5 pounds 6 ounces. Your examination reveals a normal left eye. The right eye demonstrates shallowing of the anterior chamber and a clear crystalline lens, as well as the retrolental and retinal abnormalities, such as a retinal fold extending from the optic disc to the retinal periphery. Examinations of the parents and an older sibling are unremarkable. What is the most likely diagnosis?

A 3-year-old boy with a history of congenital esotropia surgically corrected at age 12 months has visual acuity of 20/30 with both eyes open, but only 20/60 when each eye is tested monocularly using an occluder. What is the most likely reason for this discrepancy?

what is correct regarding Delayed visual maturation?

Which one of the following is a complication of intralesional corticosteroid injection in adnexal and orbital capillary hemangiomas?

A child with unilateral traumatic cataract presents for treatment 9 months after the initial injury. After successful cataract extraction, the child is found to have severe deprivation amblyopia. The best visual prognostic outcome would be expected if the child acquired the traumatic cataract at which of the following ages?

A 5-year-old boy has an ophthalmologic eye examination after failing a preschool vision screening. The examination reveals bilaterally subluxated lenses, with one lens down and in, and the other up and out. The child is tall for his age, with long, thin fingers and hyperextensible finger joints. Both parents are normal and the family history is unremarkable. What is the most likely diagnosis?

A 5-year-old boy has an ophthalmologic eye examination after failing a preschool vision screening. The examination reveals bilaterally subluxated lenses, with one lens down and in, and the other up and out. The child is tall for his age, with long, thin fingers and hyperextensible finger joints. Both parents are normal and the family history is unremarkable. What is the best first step for visual rehabilitation?

A 5-year-old boy has an ophthalmologic eye examination after failing a preschool vision screening. The examination reveals bilaterally subluxated lenses, with one lens down and in, and the other up and out. Which of the following should be done?

A 3-year-old boy is found to have decreased vision secondary to bilateral amblyopia. Which of the following is the most likely finding on cycloplegic retinoscopy?

A 3-year old boy presents for evaluation becuase his parents believe the child has intermittent esotropia. The examination is consistent with 15 prism diopters of intermittent esotropia at distance and near. Which of the following is the most appropriate initial therapy?

which of the following is associated with Leber's hereditary optic neuropathy.

A 3-month-old infant has a history of a difficult birth with prolonged hypoxia. The child is noted to have severe neurologic impairment, including poor visual response. The ocular examination demonstrates no apparent visual fixation responses. Wandering ocular movements are present, but are not typical of nystagmus. The remainder of the examination, including assessment of the pupils, retina, and optic nerve, appears normal. Which of the following is the best method for predicting the visual outcome?

A 2-year-old boy presents with a history of crossing of his left eye that has been noted by his parents over the past 3 months. Examination reveals a dense total cataract in the left eye. The anterior segment is otherwise normal. The right eye is normal. Both pupils react normally. The past medical history is unremarkable. What should be the next step?

A 9-year old boy presents for further evaluation of leukocoria (white pupil) in the right eye, which was first noted by the child’s parents in a recent photograph. The child is otherwise healthy and his past medical history is unremarkable. Examination reveals the presence of abnormal retinal vessels with yellow subretinal exudates in the child’s right eye. The patient’s left eye appears to be normal on examination. Which of the following is the most likely cause of the patient’s condition?

A 13-year old female presents with asthenopia, blurred near vision, and difficulty reading. On examination, the patient is noted to have an exophoria at near, a remote near point of convergence, and poor near fusional convergence amplitudes. Which of the following is the most appropriate next step in treatment?

An infant girl presents for evaluation with epiphora, blepharospasm, and photosensitivity. On examination, the infant is noted to have corneal clouding in the right eye, and the right cornea appears to be enlarged. Which of the following is the most likely cause of this patient’s condition?

A 12-year old male presents with asthenopia, blurred near vision, and difficulty reading. On examination, the patient is noted to have an exophoria at near. The patient also has a remote near point of convergence, and poor near fusional convergence amplitudes. Which of the following is the most likely diagnosis?

A 3-year old boy presents for evaluation with a three week history of intermittent esotropia. On sensorimotor exam there is 20 prism diopters of esotropia at distance and near. Cycloplegic retinoscopy reveals +4.00 D hyperopia in each eye. Which of the following is the most appropriate next step in treatment?

A 10-month old, full-term gestation, and previously healthy child, presents for further evaluation of leukocoria (white pupil) in his left eye, which was first noted by the child’s parents in a recent photograph. A CT scan shows evidence of a mass with localized calcification in the left eye. Which of the following is the most likely cause of the patient’s condition?

A 2-year old child is found to have a painless mass located superotemporal to the globe, which is unattached to the overlying skin. The mass is mobile, smooth, and nontender. The child is diagnosed with a dermoid cyst, and the diagnosis is supported on CT scan, which shows a well-circumscribed lesion with a low-density lumen. Which of the following is the most appropriate next step in treatment?]]

A 4-year old girl presents for evaluation of esotropia. The child is found to have 20/25 vision at distance and near. Corneal light reflex tests and cover testing results are normal. Which of the following is the most likely diagnosis?

Superior Oblique muscle palsy (fourth or trochlear nerve palsy) is the most common isolated cyclovertical muscle palsy encountered by ophthalmologists. Which of the following conditions is the most common cause of acquired superior oblique muscle palsy?

An 8-year-old boy presents for evaluation with a 3-day history of fever, lethargy, headache, eye pain, and eyelid edema. The child’s past medical history is significant for sinusitis. On examination, the child appears uncomfortable. He is found to have 20/20 vision with his right eye and 20/40 vision with his left eye. Although the patient has full ocular motility with his right eye, there is proptosis and limitation of ocular motility with his left eye. The child also expresses pain in his left eye on ocular motility examination. Which of the following is the most appropriate initial step in treatment?

Which one of the following is expected with stereopsis testing in a 12-year-old girl diagnosed with well-controlled intermittent exotropia?

A 21-year-old woman presents with exotropic Duane's syndrome. Which one of the following surgical options is most likely to benefit this patient?

A 16-year-old girl presents with acute, bilateral eye pain, redness, and globe prominence, right > left, with mild ptosis of the right upper eyelid. Both eyes have restricted motility in all fields of gaze. Blood testing reveals normal T3, T4, TSH, WBC, CRP, and ANA. Which of the following orbital CT findings would be most consistent with her presentation and lab results?

A 4-year-old girl is found to have distance visual acuity of 20/50 in each eye. Cycloplegic retinoscopy reveals +6.50 hyperopia in her right eye and +6.00 hyperopia in her left. She is also found to have 10 prism diopters of esophoria at distance and near. The remainder of the eye exam is unremarkable. Which one of the following is the most likely cause of the patient’s decreased vision?

A 6-month-old girl presents for evaluation of esotropia, which has been present since birth. Examination reveals 40 prism diopters of esotropia. The patient is also noted to cross-fixate. Which one of the following is the most appropriate initial therapy?

A 3-year-old girl has an esotropia of 20-prism diopters (PD) in primary position, 15 PD in upgaze, and 30 PD in downgaze. In addition to operating on the medial rectus muscle in each eye, which of the following is an appropriate treatment for her V-pattern?

An otherwise healthy 6-month-old child is diagnosed with a 2-mm epibulbar dermoid tumor of his left eye. The child is playful and appears asymptomatic. Which of the following is the most appropriate next step in the management of this patient?

A 1-year-old boy with a prior unilateral catarct in his left eye presents for evaluation. His cataract was diagnosed at birth and he underwent lensectomy. Exam findings are consistent with severely decreased vision in his left eye. What is the most likely cause?

A 2-week-old girl is referred for evaluation of an abnormal red reflex OS. Examination reveals a dense, posterior, 6-mm central lenticular opacity OS with normal retinal examination. Cycloplegic retinoscopy reveals +2.00 sphere hyperopia in each eye. What step should be considered next?

A 6-week-old infant presents with a bluish mass in the medial canthus that has been present since birth (see the figure). A pediatric otorhinolaryngologist evaluated the patient and noted a mass lesion in the nose. What is the most likely diagnosis?

In the nonverbal patient, what method or test reveals amblyopia?

A 10-year-old child is diagnosed with bilateral papilledema. What clinical feature is most likely to develop in this patient?

A 4-year-old child presents for evaluation of a recent onset esotropia. What step should be considered next?

A 5-year-old girl with hydrocephalus is diagnosed with bilateral optic atrophy. What changes in her vision and findings are most likely to develop?

A 9-year-old boy with sickle cell trait is diagnosed with a 5-mm hyphema OD. He is coooperative during the examination, and intraocular pressures are 39 mm Hg OD and 12 mm Hg OS. What is the preferred first-line treatment?

A 12-year-old boy undergoes bilateral medial rectus muscle recessions for esotropia. At his postoperative visit, he is found to have widening of the palpebral fissure and an adduction deficit in the left eye. Ductions and versions are otherwise normal. He also is found to have 45 prism diopters of exotropia in primary position. What would be the preferred management?

Under anesthesia, a 6-month-old boy is found to have corneal diameters of 13 mm OD and 12.5 mm OS. Significant bilateral corneal edema is also present. Intraocular pressures (IOPs) are 33 mmHg OD and 29 mmHg OS. What would be the preferred first-line treatment?

A 10-year-old child has open angle glaucoma and asthma. Which of the following adrenergic agents is most appropriate for managing this patient’s glaucoma?

A 15-year-old boy has bilateral high myopia, a sensory exotropia, and a history of retinal detachment in the right eye requiring scleral buckling. He recently had a recession/resection muscle strabismus surgery in the right eye for his exotropia. On postoperative exam, his right eye has corneal edema and folds in Descemet’s membrane, and anterior inflammation. What is the most likely diagnosis?

An infant is diagnosed with optic nerve hypoplasia. What is the first evaluation to be ordered?

Which of the following is considered an ocular complication of strabismus surgery?

A 7-year-old patient is diagnosed with anisometropic amblyopia. Cycloplegic refraction is +2.00 OD, +7.00 OS. Which of the following is the most appropriate next step in treatment?

A patient with esotropia is suspected of having an abnormal accommodative convergence/accommodation (AC/A) ratio. Which of the following methods should be used to measure the patient’s AC/A ratio?

A 3-year old girl is diagnosed with strabismic amblyopia. Following cycloplegic refraction, the child is also noted to have hyperopia equal to +5.00 sphere in each eye. Which of the following is the most appropriate next step in treatment?

The day following a motor vehicle accident, a 24-year-old man is diagnosed with unilateral superior oblique palsy. He has a small right hypertropia in primary gaze. The deviation is fairly comitant, with minor torsional component. What is the preferred intervention?

What type of tropia is a usually a V-pattern strabismus?

In what disease or post-operative setting is the 3-step test most helpful for diagnosing isolated cyclovertical muscle paralysis?

When managing a vertical strabismus associated with thyroid eye disease, how should the timing of strabismus surgery be related to proptosis surgery?

Three days following strabismus surgery, a 6-year-old child develops increasing conjunctival injection and eyelid edema in one eye. The child has vision of 20/25 OU and his ocular motility is full. What is the most likely diagnosis?

patient has strabismus surgery with adjustable sutures under using local anesthesia consisting of sub-Tenon's lidocaine injection. During postoperative adjustment, the patient experiences a vagal attack. Which of the following is the preferred management of this adverse event?

In what condition are cyclopegic agents contraindicated during refraction?

What is a risk factor for herpes zoster ophthalmicus in children?

In what location does a dacryocele typically present as a bluish swelling?

A 4-year-old child develops post-traumatic uveitis in the right eye. The child is started on atropine eyedrops. What condition is a potential complication of this therapy?

A 13-year-old boy has blurry vision and diplopia when reading. He has a remote near-point of convergence. On alternate cover testing he has no distance deviation, but at near has an exophoria. What is his most likely diagnosis?

Using adjustable sutures for strabismus surgery is preferred for patients in what setting?