BV 10 - Inconcomitant deviation

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  1. How is a palsy compensated for?
    • head tilt
    • fusional amplitude - if enough to overcome
    • sx in adults/suppression in kids
  2. How can head posture change?
    • develop of comitance¬†
    • discomfort too great
    • suppression of image
    • extension of fusional amp
    • improved ocular movement
  3. Past pointing?
    • with paretic eye fixation
    • ask px to quickly point to an objecting in the direction of the paretic muscle
    • px will point beyond object
  4. What is contracture?
    • contracture occurs when theres is increased resistance against passive stretching of the muscle
    • muscle fibres atrophy as a result
  5. How to treat/prevent contracture?
    alternate day patching
  6. How does muscle sequelae occur?
    • 1. overaction of ipsilateral synergist
    • 2. contraction of contralateral antagonist
    • 3. 2ndy inhibition of contralateral antagonist
  7. What are the factors that aid in the development of muscle sequelae?
    • increased duration
    • greater limitation of movement with paretic eye will affect ipsi ant
    • forced fixation of paretic eye will decrease muscle sequelae - ipsi ant
  8. How to differentiate between a congenital and acquired palsy?
    • congenital:¬†
    • suppression¬†
    • diplopia is intermittent
    • sometimes amblyopic
    • head posture slightly abnormal
    • initiate tx right away
    • AF/EC

    • acquired:
    • spontaneous recovery
    • abnormal head tilt
    • diplopia in all fields
    • noncomitant
    • no suppression/amblyopia
    • no AC/EF
Card Set
BV 10 - Inconcomitant deviation
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