Incomitant Strabismus/Module 1: Clinical Investigations of Incomitant Strabismus

Enquiry overview

This enquiry will introduce students to the various clinical investigations utilised in assessing a patient with incomitant strabismus.

Upon completion of this module you will be able to safely perfrom clinical invistigations pertinent to patients with incomitant strabismus and to interpret, evaluate and synthesise the clinical outcomes in developing a diagnosis.

Below are the clinical outcomes of an orthoptic examination of Miss Jones who is experiencing diplopia. Miss Jones' clinical investigation will be utilised as the basis for developing your skills in this enquiry.

Patient Case Study

Hess Chart: Miss Jones

Miss Jones, aged 28, presents to an orthoptic clinic c/o intermittent, vertical diplopia. This is worse on left gaze and is improved with her head tilted to the left. 1/52 ago she suffered a headache, dizziness and vomiting on waking. Soon after, she developed diplopia, unsteadiness and vertigo.

GH: L sided brainstem CVA has been diagnosed.

POH: nil, suffers from occasional migraines. No glasses.

Obs: AHP head tilt L of 10-15 deg.

VA: R. 6/6 N5 L. 6/6 N5 Sn.

CT:		sm R HT/HT'. h.f.
		with AHP: R H/H' c good rec.

OM:		RIO2+ RSO1-
		L obliques seem OK
		mod. V pattern

PCT: (6m) (FL)		5∆ BD		18∆ BD
		3∆ BD	8∆ BD	14∆ BD
		2∆ BD		12∆ BD

BHTT: (6m)		On R tilt: R/16∆ BD (FL)
		On L tilt R/2∆ BD (FL)

Torsionometer: 4 deg. excyclo

Fundus: NAD

Topics and Learning Materials

This module is divided into 6 parts. Work through each individual section as per your timetable.

Part 1: Assessing Ocular Movements

Part 2: Measuring Strabismus

Part 3: Parks 3 Steps & BHTT

Part 4: Assessing Torsion

Part 5: Mapping Ocular Deviations

Part 6: Assessing Diplopia and BSV

Example
Hi Meri - here is the example!