Code(Credit) :CUTM1799 (3+2+0)

Objective

This course provides knowledge on both strabismus & non strabismus binocular vision anomalies, its classification, etiology, necessary investigations, diagnosis and management.

Learning outcome

SYLLABUS & SESSION PLAN

Module I (9 hrs)

Neuro-muscular anomalies- Classification and etiological factors;

Integration of the motor and sensory system into binocular vision; Anatomy of Extra Ocular Muscles - Rectii, Obliques and LPS, Innervation & Blood Supply; Physiology of Ocular movements - Center of rotation, Axes of Fick, Action, Laws of ocular motility - Donder’s and Listing’s law, Sherrington’s law, Hering’s law;

Factors affecting Heterophoria & Heterotropia ;

Module II (8 hours)

Horizontal strabismus ;

Esotropia - classification,  investigations, diagnosis, management  & treatment ;

Exotropia - classification,  investigations, diagnosis, management  & treatment ;

A - V phenomenon, Microtropia ;

Practice: 4 prism base out test; Krimsky test; modified krismky ;

Module III (9hrs)

Vertical strabismus - classification,  investigations, diagnosis, management  & treatment ;

Torsional strabismus - classification,  investigations, diagnosis, management  & treatment ;

Practice: Maddox wing; Maddox rod; Double Maddox rod ;

Module IV (8hrs)

Paralytic Strabismus - Acquired and  Congenital ;

CN III, IV, VI plasies -nerve pathways, clinical  characteristics, investigations, management  & treatment ;

Practice: Bielschowsky park 3 step test ;

Module V (8hrs)

Restrictive Strabismus- Musculo fascial anomalies; Mobius syndrome; Brown Superior oblique sheath  syndrome; Duane’s retraction syndrome; Strabismus fixus; Congenital muscle fibrosis ;

Module VI (6hrs)

Binocular investigations for differential diagnosis - History and symptoms, Compensatory head Posture; Diplopia Charting; Hess chart; synoptophore; Cover test; Forced duction test; forced generation test etc ;

Practice: Diplopia charting; Hess screen; Cover/Uncover test; Alternate cover test; 9 gaze prism ;

Module VII (8hrs)

Non-Strabismic anomalies - Accommodation & Convergence ;

Types of accommodation & its methods of measurement, Anomalies of accommodation – aetiology and management ;

Components of Convergence & its methods of measurement, Anomalies of Convergence – aetiology and management ;

Practice: AC/A & CA/C ratio; NRA & PRA; NPA & NPC; NFV & PFV; AF & VF; Dynamic retinoscopy

Textbooks/References:

1. Scott B Steinman; Barbara A Steinman; Ralph P Garzia: Foundations of binocular vision _a clinical perspective, 2000, New York : McGraw-Hill publishers

2.Pradeep Sharma: Strabismus simplified, First edition,1999, Modern publishers.

3.Fiona J. Rowe: Clinical Orthoptics, second edition, 2004, Blackwell Science Ltd

4.Gunter K. V.Nooden: Binocular vision & Ocular motility_ Theory and management of strabismus, Sixth edition, 2002, Mosby Company

5.Mitchell Scheiman; Bruce Wick: Clinical Management of Binocular Vision Heterophoric, Accommodative, and Eye Movement Disorders, 2008, Lippincot Williams & Wilkins publishers

BOOKS:

Clinical Orthoptics-Fiona J. Rowe (3rd edition)Mitchell Scheiman OD, Bruce Wick OD PhD-Clinical Management of Binocular Vision_ Heterophoric, Accommodative, and Eye Movement Disorders-LWW (2013)Strabismus_Binocular_Vision_and_Ocular_Motility_VNoorden