Pediatric Ophthalmology & Strabismus

Comprehensive Factual Review
Tuesday 3/18/08 - 7:00 AM to Noon
Section # Tu-101

Course Instructors

 

Module 1: Strabismus Basics
Alexander Khammar, MD

Terminology (prefixes – eso, exo, hyper, hpo; suffixes – phoria, tropia)

            Classification (phoria/tropia, comitant/incomitant, alternating/monocular, horizontal/vertical)

            Anatomy of extraocular muscles (Rectus, Oblique, LPS), Blood supply of EOM

            Motor Physiology (x, y & z axes of Fick, primary/secondary/tertiary actions, visual axis)

            Eye movements (ductions/version/vergence, Yoke muscles, Herring’s law, ACA ratio)

            Binocular vision (correspondence – ARC, NRC; Fusion; Stereopsis; confusion, diplopia)

            Sensory adaptation to strabismus (suppression & diagnostic tests, ARC, monofixation syndrome)

            Suppression tests (Red-glass, Worth 4-dot, Bagolini glass, 4D prism base-out, afterimage, amblyoscope)

            Amblyopia (types: strabismic, anisometropic, ametropic, deprivational; diagnosis, treatment)

            Tests of ocular alignment (cover, light-reflex, dissimilar image, dissimilar target)

            Psudostrabismus: positive/negative angle kappa

            ACA ratio (gradient/heterophoria method), 3-step test, prism adaptation test, worth 4-dot test

 

Module 2: Strabismus – ocular deviations

Nathalie Azar, MD

Esodeviations: Infantile (congenital), accommodative, non-accommodative, incomitant

            Exodeviations: Intermittent/constant exotropia, Duane retraction syndrome, Dissociated deviation,

                                    Convergence insufficiency

            A- and V- pattern horizontal strabismus

            Vertical deviations (inferior/superior oblique overaction, DVD, IO/SO palsy, double elevator palsy)

            Duane Syndrome, Brown syndrome

            3rd and 6th nerve palsy, Grave’s, CPEO, Mobius syndrome, internuclear ophthalmoplegia, SO myokymia

 

Module 3: Strabismus surgery & Nystagmus

Nathalie Azar, MD

Strabismus surgery

            Indications

            Procedures (weakening/strengthening/transpositions)

            Considerations in planning surgery (incomitance, prior surgery, visual acuity)

            Guidelines for strabismus surgery (esodeveiations, exodeviations, obliques)

            Complications of strabismus surgery

Nystagmus

            Nomenclature, Classification, Evaluation

            Congenital nystagmus (congenital motor, sensory defect, periodic alternating)

            Acquired nystagmus (spasmus nutans, see-saw, opsoclonus, downbeat)

            Treatment of nystagmus

 

Module 4: Pediatric Ophthalmology – External eye & Anterior segment

Kimberlee Curnyn, MD

Eyelids (cryptophthalmos, coloboma, ankyloblepheron, blepharophimosis syndrome, epicanthus)

            Lacrimal system (atresia of puncta, dacryocele, NLD obstruction: nonsurgical/surgical management)

            Cornea (micro/megalocornea, anterior segment dysgenesis, scleocornea dermoids)

            Iris abnormalities (aniridia, lisch nodule, JXG, iris heterochromia,

            Pediatric glaucoma (primary congenital glaucoma, secondary glaucomas)

            Pediatric cataracts. Ectopia lentis (Marfan, Homocystinuria, Weill-Marchesani syndrome)

            Pediatric uveitis: anterior (JIA, TINU), posterior (toxoplasmosis, toxocara, DUSN)

 

Module 5: Vitreous & Retina diseases/disorders

Benjamin Ticho, MD

Leukocoria: ROP – classification, management; Coats disease

            Hereditory retinal disease : Leber Amaurosis, achromatopsia, CSNB, Aicardi syndrome)

            Hereditory macular disease: Stargardt’s, Fundus flavimaculatus, Best vitelliform, familial drusen

            Hereditory viteroretinopathies: Retinoschisis, Stickler syndrome, FEVR, Norrie, Goldmann-Favre

            Systemic diseases with retinal manifestations: Albinism, Familial oculorenal syndrome, Gangliosidoses

            Optic disc anomalies: Morning glory anomaly, coloboma, tilted disc, ON hypoplasia, ON pit

            Optic atrophy: Dominant, Behr, Leber,; Optic neuritis, papilloedema, pseudotumor cerebri

            Orbital tumors: Primary malignant: Rhabdomyosarcoma

                                    Metastatic: Neuroblastoma, Ewing sarcoma, leukemia, histiocytosis X

                                    Benign tumors: hemangioma, Lymphangioma, AVM; Gliomas

            Intraocular tumors: JXG, Medulloepithelioma, Retinoblastoma

            Phakomatoses: Neurofibromatosis, Tuberous sclerosis, von Hippel-Lindau, Sturge-Weber syndrome

            Craniofacial malformations: craniosynostosis syndromes

Child abuse – shaken baby syndrome