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Strabismus for stdents Dr.Alahmady
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- 7. Because it affect on: Binocular Single Vision (BSV) AMBLYOPIA COSMOSIS Why srabismus is a dangerous disease ?
- 8. Binocular vision BSV simultaneous use of both eyes with bifoveal fixation Grades 1. Simultaneous perception 2. Fusion 3. Steriopsis
- 10. Amblyopia When the doctor sees nothing and the patient sees nothing, the diagnosis is amblyopia.”
- 11. Definition : unilateral or rarely bilateral decreases in best corrected visual acuity from vision deprivation and /or abnormal binocular interaction with no identifaible pathology of the eye or visual pathway
- 13. Diagnosis Snellens chart Crowdness phenomena Neutral density filter
- 15. Sequelae of strabismus Confusion simultaneous perception of superimposed dissimellar images by foveae Diplopia simultaneous perception of two images of same obgect in different positions amblyopia
- 17. Laws of ocular motility Agonist antagonist (same eye) Synergists (same eye same direction) Yoke muscle (contralateral synergists) Sherrington law of reciprocal innervation (++to agonist - Hering law equal innervation to yoke muscle
- 18. Visual axis (line of vision) Fovea to nodal point to point of fixation Normal single binocular vision intersect at object of re Anatomical axis From posterior pole to the center of cornea Angle kappa Between visual and anatomical axis =5
- 19. 19 Medial and lateral orbital walls 45 degree visual axis Anatomical axis Orbital Axis Angle Kappa
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- 22. 22
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- 24. Orthophoria perfect ocular alignment Heterotropia manifest deviation Esotropia Exotropia Hypertropia Hypotropia Heterophoria tendency to deviation when fusion blocked
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- 28. Anatomy Of The EOM WHAT ARE THE ACTIONS OEOM
- 31. MR LR IO SR SO IR SIX CARDINAL DIRECTIONS NINE DIAGNOSTIC POSITIONS
- 40. The two Oblique are Abductors The two Recti are Adductors The two Superiors are Intorters The two Inferiors are Extorters
- 41. Anatomy Of The EOM’s ORIGIN A COMMON TENDINOUS RING (ANNULUS OF ZINN)
- 42. Anatomy Of The EOM’s BLOOD SUPPLY EACH MUSCLE IS SUPPLIED BY TWO ANTERIOR CILIARY ARTERIES EXCEPT THE LATERAL RECTUS WHICH IS ONLY SUPPLIED BY ONE.
- 43. Anatomy Of The EOM’s NERVE SUPPLY THIRD: LPS, MR, IR, SR, IO FOURTH: SO SIXTH: LR
- 44. Ocular motility CN IV CN VI CN III CN III CN III CN III
- 45. Eye movement Three directions of eye movement Vertically ◼ Upward SR & IO ◼ Downward IR & SO Horizontally ◼ Abduction LR ◼ Adduction MR Torsionally ◼ Intorsion (rotate nasally) SO ◼ Extorsion (rotate temporally) IO
- 47. Woth four dot test
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- 49. 49 1. With the best refraction correction worn by the patient, place the Anaglyph glasses over the patient’s correction, with red filter over the right eye. 2. In a slightly dimmed room, turn on the flashlight and hold the Worth Test 3. Conduct the following monocular check first: a. Cover the right eye, ask how many dots does the patient see. They should report 3 green. b. Then cover the left eye and ask how many dots do they see now. They should report 2 red.
- 50. 50 ABNORMAL RESPONS If the patient reports only 2 red dots under binocular conditions, this indicates that they are suppressing the left eye. If the patient reports seeing 3 green dots under binocular conditions, then they are suppressing the right eye. If they report 5 dots, they are diplopic. The type of diplopia can then be determined by asking which side are the green dots. If the green dots are located on the right, the patient has a eso deviation; to the left, an exo deviation. If the green dots are reported above or below the red dots then a vertical deviation exists. A report of the green dots above the red dots would be seen with aright hyper deviation. With a report of 6 or more dots, one should question the patient’s reliability.