سئوال هفته

This 5-year-old boy was presented for examination with a history of having crossed eyes since birth. Visual acuity is OD 20/40 and OS 20/20. Refraction is +0.50 in each eye. The media are clear and the fundus is normal. Prism and cover measurements are 40 PD esotropia in the primary, increasing to 60 PD in downgaze and decreasing to 30 PD in up gaze.


1. This boy has the following:
a. “V” pattern esotropia
b. vertical Duane syndrome
c. refractive esotropia
d. overaction of the superior obliques
e. none of the above



2. What is a likely cause for this?
a. too much use of the eyes at near
b. bilaterally lax superior oblique tendons
c. inferior oblique palsy
d. vertical incomitance from amblyopia
e. none of the above



3. What workup would help you in planning for treatment of this condition?
a. superior oblique traction test
b. lateral versions
c. coronal CT of the orbit
d. Bielschowsky head tilt test
e. all of the above



Answers:
1. This boy has the following:
a -- “V” pattern esotropia
2. What is a likely cause for this?
b -- bilaterally lax superior oblique tendons
3. What workup would help you in planning for treatment of this condition?
e -- all of the above