17. • ABNORMAL FINDINGS:
oExtraocular Muscle Dysfunction
o Pseudostrabismus has the appearance of strabismus because of
epicanthic fold but is normal for a young child.
oAsymmetric Corneal Light Reflex: Strabismus is true disparity of
the eye axes. This constant malalignment is also termed tropia
and is likely to cause amblyopia.
o Esotropia-Inward turning of the eye.
o Exotropia Outward turning of the eyes.
18. Cover
Test:
Uncovere
d eye-If it
jumps to
fixate on
designate
d point, it
was out of
alignment
before
(i.e., when
you cover
the
stronger
eye [C1],
the
weaker
eye now
tries to
fixate [ C
2]).
Phoria-
Mild
weakness,
apparent
only with
the cover
test and
less likely
to cause
amblyopia
than a
tropia but
still
possible.
Covered
eye-If this
is the
weaker
eye, once
macular
image is
suppresse
d, it will
drift to
relaxed
position
(D1).
As eye is
uncovered
-If it
jumps to
reestablis
h fixation
(D2),
weakness
exists.
Esophoria
-Nasal
(inward)
drift.
Exophoria
-Temporal
(outward)
drift.
19. CONT…….
• Diagnostic Positions Test
• Paralysis apparent during movement through six cardinal positions of
gaze.)
• If eye will not turn: Indicates dysfunction in cranial nerve
• Straight nasal III
• Up and nasal III
• Up and temporal III
• Straight temporal VI
• Down and temporal III
• Down and nasal IV
20. Periorbital Edema:
Lids are swollen and puffy. Lid tissues are loosely connected, so excess fluid is
easily apparent.
This occurs with,
local infections
crying and systemic conditions such as congestive
Heart failure
Renal failure
Allergy, hypothyroidism (myxedema).
