tag:blogger.com,1999:blog-6504496555839203608.post4865104878378096321..comments2023-10-15T22:45:46.451+08:00Comments on Syah's Optometry Blog: Pediatric Optometry Case 2 : 3 yr old/F/CThe Travelerhttp://www.blogger.com/profile/04326376327284497514noreply@blogger.comBlogger54125tag:blogger.com,1999:blog-6504496555839203608.post-81329281622433426502011-01-04T23:21:14.428+08:002011-01-04T23:21:14.428+08:00@HANNAN
rilek la hannan,
we'll discuss the a...@<a href="#c694686631431820159" rel="nofollow">HANNAN</a><br /><br />rilek la hannan,<br /><br />we'll discuss the actual Dx and Mx tomolow!azuwannoreply@blogger.comtag:blogger.com,1999:blog-6504496555839203608.post-52215617552835554312011-01-04T23:18:28.147+08:002011-01-04T23:18:28.147+08:00@eli aimi
aiyo sebut pandai la, aku sekolah kat n...@<a href="#c7508314106927693264" rel="nofollow">eli aimi</a><br /><br />aiyo sebut pandai la, aku sekolah kat nigeria wei..<br /><br />warp = kuih koci<br /><br />hoho....'that's a warped'<br /><br />Eli, i'm not referring to you lah... tak da @Eli aimi pomm.azuwannoreply@blogger.comtag:blogger.com,1999:blog-6504496555839203608.post-6946866314318201592011-01-04T22:25:32.155+08:002011-01-04T22:25:32.155+08:00If I'm not mistaken, stability should be consi...If I'm not mistaken, stability should be considered if only involve the refractive error...But, in this case, it involves alignment problem...<br />HMMMMMM.....still curious about the management :-/HANNANnoreply@blogger.comtag:blogger.com,1999:blog-6504496555839203608.post-12997794635930296442011-01-04T22:16:51.983+08:002011-01-04T22:16:51.983+08:00If on the first visit the patient already showed 2...If on the first visit the patient already showed 25-30 PD deviation, do we still need to hold the prescription???HANNANnoreply@blogger.comtag:blogger.com,1999:blog-6504496555839203608.post-75083141069276932642011-01-04T22:12:28.128+08:002011-01-04T22:12:28.128+08:00@azuwan
what warp? haha..warped laa..aiyoh nak la...@<a href="#c942272987609469717" rel="nofollow">azuwan</a><br /><br />what warp? haha..warped laa..aiyoh nak laugh on me tp salah.<br /><br />i know i just stated my answer because im a late comers. n cofused too.eli aiminoreply@blogger.comtag:blogger.com,1999:blog-6504496555839203608.post-75540550373623518462011-01-04T21:15:15.207+08:002011-01-04T21:15:15.207+08:00@The Traveler
ok, baik la.@<a href="#c675523725006685110" rel="nofollow">The Traveler</a><br /><br />ok, baik la.azuwannoreply@blogger.comtag:blogger.com,1999:blog-6504496555839203608.post-6755237250066851102011-01-04T20:29:07.723+08:002011-01-04T20:29:07.723+08:00please conclude the Mx...for basic exotropia, what...please conclude the Mx...for basic exotropia, what is the best treatment option?<br /><br />please answer this question classThe Travelernoreply@blogger.comtag:blogger.com,1999:blog-6504496555839203608.post-42616862798191149782011-01-04T17:28:27.928+08:002011-01-04T17:28:27.928+08:00@azuwan
Read DVD too...@<a href="#c942272987609469717" rel="nofollow">azuwan</a><br /><br />Read DVD too...The Travelerhttps://www.blogger.com/profile/04326376327284497514noreply@blogger.comtag:blogger.com,1999:blog-6504496555839203608.post-9422729876094697172011-01-04T17:13:06.544+08:002011-01-04T17:13:06.544+08:00that's a warp.
now we already have the diagno...that's a warp.<br /><br />now we already have the diagnosis n management for the patient. no need to explain more.<br /><br />---tomorrow ur group will have one more patient having the same problem. referred from ORC as well. intermittent strabismus. plus, having vertical deviation----<br /><br />very interesting. 'Need to read on vetical deviation management'<br /><br />see you!azuwanhttp://azuwanmusa.wordpress.comnoreply@blogger.comtag:blogger.com,1999:blog-6504496555839203608.post-5703814606562774212011-01-04T11:07:59.326+08:002011-01-04T11:07:59.326+08:001. basic intermittent alternating XT? it can be me...1. basic intermittent alternating XT? it can be meh? because for me i would answer basic XT but more XT at near with low AC/A ratio. it is because the different of deviation is not more then 10pd. i miss a lot here and confused already..<br /><br />2. @ atikah interesting prevalence u got.adding my knowledge.<br /><br />3.since this child is 3 y.o and based on VA, we should monitor at least 3 months to check the VA and stability and if there is no improvement,we can give her vision therapy. if the vision therapy failed we would suggest her to do surgery because the value of tropia is more than 20pd.eli aiminoreply@blogger.comtag:blogger.com,1999:blog-6504496555839203608.post-8930361175708845492011-01-03T22:59:02.984+08:002011-01-03T22:59:02.984+08:00Wow..hot discussion..I'm just come back from H...Wow..hot discussion..I'm just come back from Hoya Visit..<br /><br />Basic= distance & near deviation are almost same<br />and of course basic XT fall under intermittentThe Travelerhttps://www.blogger.com/profile/04326376327284497514noreply@blogger.comtag:blogger.com,1999:blog-6504496555839203608.post-72164234694787305982011-01-03T18:47:35.681+08:002011-01-03T18:47:35.681+08:00for 2nd question,
AOA stated that more than 30% o...for 2nd question,<br /><br />AOA stated that more than 30% of children with hyperopia exceeds 4D develop Esotropia by the age of 3 yr old. thus, it shows mostly in paediatric there is Esotropia case rather than Exotropia. <br /><br />So, this is very uncommon among peadiatrics.rohailanoreply@blogger.comtag:blogger.com,1999:blog-6504496555839203608.post-21439745181498576522011-01-03T18:12:46.952+08:002011-01-03T18:12:46.952+08:00Gud job everybody..;;)
For Q1: i agree with the a...Gud job everybody..;;)<br /><br />For Q1: i agree with the answer: intermittent alternating exotropia basic type bcoz<br />-involve BE, n different deviation ~ 10PD<br /><br />For Q2:as mention by jaher, in our lectures stated that most of the infant case is esodeviation, rarely of exodeviation..eventhough, it is possible je sbnrnya..myb this pt is in that category.<br /><br />For Q3: management: <br />b4 prescribe, take consideration of 2ADS + M formula<br />estimated VA for 3yo is 6/9 -6/6 <br />so, b4 we prescribe, should monitor 1st at least 3 times visit (agree with rohaila)..<br />so next TCA should be 3/12.aiDaMaDiHanoreply@blogger.comtag:blogger.com,1999:blog-6504496555839203608.post-37543078542954511562011-01-03T18:10:31.194+08:002011-01-03T18:10:31.194+08:00wahhh...i can see some points there...
okke we gi...wahhh...i can see some points there...<br /><br />okke we giv some more time to those who do not try to answer yet...<br /><br />xnk comment...nk main dlu la... :D<br /><br />;) :X =(( :-/ 8-} :)] ~x( :-t b-( :-L <br />x( =))Kak Long (HaNiSaH)https://www.blogger.com/profile/18130790359354876215noreply@blogger.comtag:blogger.com,1999:blog-6504496555839203608.post-45023137480022059372011-01-03T18:00:18.574+08:002011-01-03T18:00:18.574+08:00yes, i think we should confirm the stability of he...yes, i think we should confirm the stability of her deviation after 3 visits. then, if the deviation stable at more than 20 prism diopter consider for surgery but if i'm not mistaken the surgery could only be done for the age 5 years old or more...<br /><br />group 1 pls correct me... :Drohailanoreply@blogger.comtag:blogger.com,1999:blog-6504496555839203608.post-4591756100243575212011-01-03T17:03:06.572+08:002011-01-03T17:03:06.572+08:00yup..monitor for 3 visit, every 1 month..if every ...yup..monitor for 3 visit, every 1 month..if every 3 visit, the stability of deviation is good, then the patient can be discharge..che nurnoreply@blogger.comtag:blogger.com,1999:blog-6504496555839203608.post-11982567415037044102011-01-03T16:32:50.411+08:002011-01-03T16:32:50.411+08:00from the results above,the answer for no 1 Questio...from the results above,the answer for no 1 Question is:<br />-intermittent alternating exotropia basic typeaiDaMaDiHanoreply@blogger.comtag:blogger.com,1999:blog-6504496555839203608.post-46976705596711768372011-01-03T16:29:05.423+08:002011-01-03T16:29:05.423+08:00:-O
- i think case hyperopia in paed, the refracti...:-O<br />- i think case hyperopia in paed, the refractive error should be confirmed stable after 3 visits, then we can prescribe if the vision improved with the RX given.rohailanoreply@blogger.comtag:blogger.com,1999:blog-6504496555839203608.post-77076199625774777832011-01-03T14:34:27.452+08:002011-01-03T14:34:27.452+08:00so as many of you already stated, the final answer...so as many of you already stated, the final answer would be basic intermittent alternating exotropia.??<br />i think i need to read more regarding this diagnosis..<br /><br />lastly the management would be??<br />to answer hanisah's question, the TCA for 3 years old patient would be 1/12 in order to monitor her stability & improvement of VA with current rx...then after there is some progression with the rx, we will monitor her again for the next 3 months..correct me if i wrong...<br /><br />is there any other home therapy for this patient other than prescribing rx???ayu hidayatinoreply@blogger.comtag:blogger.com,1999:blog-6504496555839203608.post-8481982930106838512011-01-03T14:24:32.279+08:002011-01-03T14:24:32.279+08:00tenet prob lg....huhuhu
For this case, we should ...tenet prob lg....huhuhu<br /><br />For this case, we should consider age, acuity, accommodation, alignment and degree...<br />For 3 yo with power ~3 DS, usually we do not give prescription because the working distance is up to her arm length only...<br />Since the patient has alignment problem, (hyperopia and XT), full prescription should be given to avoid disturbing the emmetropization process...<br />So, for this case, instead of undercorrect the power, we should give full prescription power....<br />Am I correct????any other opinion????<br /><br />3/12 TCA is to monitor the acuity, alignment (deviation)and degree (refractive power)...<br />But, i've question for this group...How about the accommodation for this patient???...Is it normal for both eyes or it juz abnormal for RE only????HANNANnoreply@blogger.comtag:blogger.com,1999:blog-6504496555839203608.post-2439968402742699792011-01-03T13:39:38.659+08:002011-01-03T13:39:38.659+08:00fuyyo...basic intermittent atnernate exotropia...f...fuyyo...basic intermittent atnernate exotropia...fuyyyooo..so longgg..<br /><br />thanks azuwan...we should not ignore the stability of the RX...thanks for reminding me :)<br /><br />accommodation not involve zahirah...saya pon tersilap..urghhh! <br /><br />thanks guyss!! i learned alot!Unknownhttps://www.blogger.com/profile/03610079304172993262noreply@blogger.comtag:blogger.com,1999:blog-6504496555839203608.post-73464506172867998122011-01-03T11:36:29.658+08:002011-01-03T11:36:29.658+08:00sorry guys for missing the train yet again.
A ver...sorry guys for missing the train yet again. <br />A very happy new year to all. <br /><br />So conclusively the patient has basic intermittent alternatiing XT.<br /><br />Regarding issues mentioned by jaherah:<br />1. Yes accommodation component wasn't involved as mentioned and explained by nabilah. Furthermore patient is exo, and accommodation usually involved in eso cases (as in accommodative esotropia).<br /><br />2. VA is good since BE were well stimulated due to alternating nature of her exo. If the tropia is unilateral, than we anticipate a unilateral reduction in VA, the deviating eye have the worse VA. And this is not the case for this patient.<br /><br />3. Yes we shouldn't overlook the stability part. TCA 3/12 to re-perform refraction and assess stability. But sorry I cannot justify why, I just recalled that during paediatric class last time, Br Muzziman gave TCA 3/12 for stability monitoring. Correct me if I'm wrong will ya?<br /><br />4. Yes last option would be surgery.<br /><br />Crap I feel just like re-typing everyone's answer.nazaryna marzukinoreply@blogger.comtag:blogger.com,1999:blog-6504496555839203608.post-71394725253432622872011-01-03T09:18:15.997+08:002011-01-03T09:18:15.997+08:00answer for question zhrh
1)Does the AA involve? a...answer for question zhrh<br /><br />1)Does the AA involve? as we answered it, NO according to PCT with +3.00DS.<br /><br />2)the VA is good in BE because it is alternating XT, like Rohaila said..<br /><br />3)so, the managament is monitor closely 1month, to look for the stability..<br /><br />4) last option might be surgery if all optical theraphy or visual theraphy does not help..<br /><br />correct me if i;m wrong :)che nurnoreply@blogger.comtag:blogger.com,1999:blog-6504496555839203608.post-50267536293261216452011-01-03T00:41:00.167+08:002011-01-03T00:41:00.167+08:00DIAGNOSIS:
Intermittent basic alternating XT.
Cor...DIAGNOSIS:<br />Intermittent basic alternating XT.<br /><br />Correction:<br />NPC not NCT.<br />Reduce not recede.<br /><br />actually referred on the hyperopia notes by sir, we should consider age, acuity, accommodation, alignment and degree for hyperopic case.<br />if alignment does not involve, plus the refraction is +3.00 DS, the prescription of spectacles for this age is not necessary as the working distance is only up to her arm length.<br />so, since the patient is hyperopic and XT (alignment involved), so full correction is needed to avoid disturbing the emmetropization process. <br /><br />am i correct??? please correct me if i'm wrong....<br />thanx :)HANNANnoreply@blogger.comtag:blogger.com,1999:blog-6504496555839203608.post-48720468716664589622011-01-03T00:33:03.458+08:002011-01-03T00:33:03.458+08:00@azuwan : yeah...this is XT case...the ORC suspect...@azuwan : yeah...this is XT case...the ORC suspected her as having CI...but i think we should not too rely on it right... :D when the next visit?...it is the answer for management question...<br /><br />@rohaila : as u said...intermittent alternating XT...rihgt...as mentioned by che nur & hannan, it is Basic XT case...so, it is "Basic Intermittent AXT" case actually... :) gud job...<br /><br />now LETS FOCUS MORE ON QUESTIONS FROM ZAHIRAH... :)<br /><br />*hint : management for this visit, we asked the pt for follow up...1/52??... 2/52??... 1/12??... or 3/12??... and why?....Kak Long (HaNiSaH)https://www.blogger.com/profile/18130790359354876215noreply@blogger.com