Vision abnormalities: The Daily PANCE Blueprint

Home Vision abnormalities: The Daily PANCE Blueprint

Strabismus: The Daily PANCE Blueprint

A 4-year-old male is brought to the clinic because the parents have noticed that one of his eyes occasionally “drifts inward,” especially when he is tired. The child does not complain of pain but has difficulty focusing on objects at a distance. On exam, the light reflex is asymmetrical on the corneas. A cover/uncover test confirms misalignment of the eyes. Which of the following is the most appropriate next step in management to prevent long-term complications?

A. Immediate surgical correction
B. Occlusion therapy of the unaffected eye
C. Observation only
D. Topical antibiotic therapy
E. High-dose IV steroids

Answer and topic summary

The answer is B. Occlusion therapy of the unaffected eye

Strabismus is a condition defined by eye misalignment; one eye is essentially abnormally deviated from normal visual access. It can be caused by genetics, perinatal lesion, or an uncorrected refractive error. Clinical features may include decreased or double vision. The Hirschberg test, or the cover/uncover test, can help with the diagnosis. Treatment can include visual training therapy, correcting refractive errors, occlusion (wearing an eye patch on the unaffected eye), or even surgery. Complications of untreated strabismus include irreversible amblyopia or lack of binocular vision.

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Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint EENT ⇒ Vision abnormalities ⇒ Strabismus

Also covered as part of the Pediatric EOR topic lists

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