🌟 Cues

• Cornea, Sclera, Retina, Optic disc, Macula lutea
• Extraocular Muscles: CN VI, CN IV, CN III
• Blurred Vision Causes: Ocular, Extraocular
• Strabismus: Types and Treatment
• Amblyopia: Definition and Causes
• Binocular Single Vision: Definition and Grades
• Visual Field Defects: Locations and Types
• Pupillary Reflexes: RAPD and Testing
• Indications for Referral: Neuro-surgery, Pediatric Endocrinology
• Impact of Visual Disability: Psychological, Social, School Performance

🗒️ Notes

Eye Anatomy and Muscles:

• Cornea, Sclera (fibrous layer), Retina (nervous layer)
• Optic disc (blind spot), Macula lutea
• Extraocular muscles:
  • Lateral rectus muscle (CN VI)
  • Superior oblique muscle (CN IV)
  • Other eye muscles (CN III)

Blurred Vision and Headache Causes:

• Ocular: Errors of refraction, Glaucoma, Uveitis
• Extraocular: Increased ICP, Brain tumor, Acute hypertension, Diabetes complications

Strabismus (Squint):

• Misalignment of eyes
• Types: Accommodative & Non-accommodative
  • Esotropia, Exotropia, Hypertropia, Hypotropia
• Treatment: Refractive error correction, Ambliopia treatment (occlusion therapy), Surgical correction
• Case Example: Convergent squint (strabismus) and developing amblyopia.

Accommodative Esotropia:

• Occurs due to excessive hypermetropia
• Develops as a physiological response, usually between +2.00 and +7.00D
• Esotropia eliminated by optical correction; deviation present without glasses

Role of Orthoptist:

• Measures visual acuity, ocular movements, degree of squint
• Conducts eye investigations (ocular US), provides low vision aids

Amblyopia:

• Definition: Decreased visual acuity without pathology in eye/visual pathways
• Causes: Strabismic amblyopia, Anisometropic amblyopia, Stimulus deprivation
• Treatment: Occlusion of normal eye, Penalization (atropine)

Binocular Single Vision:

• Definition: Simultaneous vision with both eyes on an object
• Grades: Simultaneous perception, Fusion, Stereopsis

Visual Field Defects:

• Types and Locations:
  • Monocular visual loss (Optic nerve lesion)
  • Bitemporal Hemianopia (Optic chiasm lesion)
  • Homonymous Hemianopia (Optic tract lesion)
  • Quadrantanopia (Parietal or temporal radiation lesions)

Pupillary Reflexes:

• Relative Afferent Pupillary Defect (RAPD): Constriction response test
• Testing: Normal light response, positive RAPD if defect is present

Referral Indications:

• Neuro-surgery for cranial nerve palsies, Horner’s syndrome, Papilledema
• Pediatric Endocrinology for pituitary tumors: Treatment options include observation, medication, irradiation, or surgery

Impact of Visual Disability:

• Psychological: Depression
• Social: Shyness, timidity
• School Performance: Affects sensory and cognitive development
• Importance of social support from parents, teachers, and medical staff