Abstract
It is not uncommon in an ophthalmologist’s office to have an anxious couple with the complaint of their child squinting occasionally. Confirming the presence or absence of deviation requires patience and a systematic approach. Even if obvious, the ophthalmologist should not comment on the deviation till completion of examination.
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Annexure 1: Sample Strabismus Case Sheet
Annexure 1: Sample Strabismus Case Sheet
Patient’s name
Age Sex Occupation
Address & Phone
Orthoptic Clinic registration number
Date of 1st Visit
Chief complaints
Brief history
Other relevant history
Family/Trauma/Perinatal/Past Treatment/Systemic
Findings on old photographs
Vision | With glasses | Without glasses | Glasses No. | Near vision with + 3.0 for amblyopes | ||
Distance | Near | Distance | Near | |||
RE | ||||||
LE |
Using glasses since
Present glasses since
Retinoscopy
(Atropine/Cyclopentolate/Tropicamide/without cycloplegia)
Deviation under cycloplegia
Fundus
Fixation
Any other ocular finding
Motor Assessment
-
1.
Anomalous head posture (AHP): (a) Face (b) Chin (c) Head
-
2.
Primary Ocular Direction: With glasses without glasses
-
3.
Ocular Deviation (by Hirschberg Corneal Reflex) FLE FRE
-
4.
Cover test
-
(a)
Nature of Deviation
-
Orthotropia
-
Phoria X or E
-
Tropia X(T), X(T)’, XT, XT’
-
E(T), E(T)’, ET, ET’
-
Preferential Fixation RE/LE/Either Eye
-
-
-
(b)
Amount of Deviation (confirmed with PCT)
-
FRE
-
FLE
-
Change without glasses
-
Change from up to downgaze
-
Near/distance disparity
-
AC/A ratio
-
-
(a)
-
5.
Ocular movements
(a) Versions (b) Limitation in ductions
-
6.
Proximal convergence (a) Objective (b) Subjective
Sensory Assessment
-
1.
Synoptophore
-
(a)
Simultaneous Macular Perception Yes/No
-
(b)
Fusion obtained at: (+): maintained till: recovery at: (−):
-
(c)
Stereopsis Yes/No
-
(d)
.
Angle | Subjective | Objective (by corneal reflex)* |
FLE | ||
FRE |
*Actually a part of motor assessment
-
2.
Worth Four Dot Test
-
3.
Randot Stereoacuity (a) Near (b) Distance
-
4.
Diplopia Chart
-
(a)
.
-
(a)
-
(b)
Quadrant of maximum diplopia
-
5.
Hess Chart
Diagnosis/Differentials
Special scores/tests for management planning & prognosis
-
1.
Binocular Potential Score
-
2.
Newcastle Control Score or Mayo Clinic Score for X(T)
-
3.
Prism Adaptation Test (a) Deviation(b) Binocularity
-
4.
Axial Length RE LE
Management Plan
Follow-up
(Abbreviations: FLE fixating with left eye, FRE fixating with right eye, X exophoria, E esophoria, X(T) intermittent exotropia, X(T)’ intermittent exotropia for near, XT exotropia, XT’ exotropia for near, E(T) intermittent esotropia, E(T)’ intermittent esotropia for near, ET esotropia, ET’ esotropia for near, PCT prism and cover test, AC/A Accommodative convergence/Accommodation, DV dextroversion, LV levoversion)
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Agrawal, S., Yadav, A., Singh, N. (2019). Clinical Evaluation of Strabismus. In: Agrawal, S. (eds) Strabismus. Springer, Singapore. https://doi.org/10.1007/978-981-13-1126-0_2
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DOI: https://doi.org/10.1007/978-981-13-1126-0_2
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