Final Exam Answers
Astigmatism - When the curvature of the cornea or the lens is uneven. The retina cannot
appropriately focus light from an object regardless of the distance.
Makes vision blurry close-up and far away.
Rarely can be caused by an alteration in the corneal sphere caused by a soft tissue mass or
hemangioma.
Nystagmus - Involuntary, rhythmic movements that may be pendular oscillations or jerky
drift of one or both eyes.
Movement is horizontal, vertical, rotary or mixed.
Classified as congenital (6wks-3 months) or acquired. Acquired nystagmus is always worrisome,
and requires prompt evaluation.
Cataracts - Partial or complete opacity of the lens of one or both eyes.
Most common cause of abnormal pupillary reflex.
Congenital or acquired.
Strabismus - A defect in ocular alignment or the position of the eyes in relation to each
other (lazy eye).
Visual axes are not parallel because the muscles of the eye are not coordinated. When one eye
is directed straight, the other deviates so one or both eyes appear crossed.
,May be hereditary or due to eye disorders such as neuroblastoma, trauma, neurological
dysfunction, craniofacial malformations, uncorrected hyperopia or accommodative
convergence.
Types of strabismus - Phoria- intermittent deviation in ocular alignment that is held latent
by sensory fusion.
The child can maintain alignment on an object.
Tropia - Consistent or intermittent deviation in ocular alignment.
They are unable to maintain alignment on an object of fixation.
Strabismus classification - Hyper (up) & hypo (down) for vertical strabismus
Exo (away) & eso (toward nose) for horizontal strabismus.
Cyclo: describes a rotational or torsional deviation
Clinical findings of strabismus - Intermittent esotropia in normal children 6 months to 4
years old who are ill, tired or when they are exposed to bright light or with sudden changes
from close to distant vision.
When one eye is affected, they fixate with the unaffected eye.
When both eyes are affected, the eye that is looking strait is the fixating eye.
The angle of deviation may be inconsistent in all fields of gaze
Persistent squinting, head tilting, face turning, over- pointing or awkwardness, decreased visual
acuity in one eye or nystagmus may be seen.
, Cataracts, retinoblastomas, anisometropia (unequal refractive errors in each eye), and severe
refractive disorders may be infrequently found.
Strabismus screening - The corneal light reflection technique and the cover-uncover and
alternating cover tests are used to screen for strabismus.
Asymmetry of the light reflex on the cornea indicates deviation in ocular alignment.
The cover-uncover test is used to discover tropias.
The alternating cover test detects phorias.
The photoscreener can also detect strabismus
Iritis - A form of uveitis, which involves the anterior portion of the uvea that includes the
iris and ciliary body.
Inflammation of the anterior uveal tract, characterized by the presence of leukocytes in the
anterior chamber of the eye, is called anterior uveitis and is synonymous with iritis.
Causes of Iritis - Associated with Crohn's disease, juvenile idiopathic arthritis, juvenile
spondyloarthropathies, ankylosing spondylitis, Reiter syndrome and psoriatic arthritis.
Can be caused by syphilis, tuberculosis, sarcoidosis, relapsing fever (borreliosis), and Lyme
disease.
Clinical findings of iritis - Injection
Photophobia
Pain
Blurred vision
Conjunctivitis
Episcleritis