• When was the onset of the turn?
The onset is important as it can help to classify the strabismus. If the squint is present before the age of one then it could be known as infantile esotropia, this is idiopathic and can occur up the age of six months, due to the imbalance of the eye muscles. If a squint has presented itself in children who are 2years old or older, then this could just be as simple as uncorrected refractive error. As uncorrected refractive error can induce strabismus, this is due to the poor focusing factors. Accommodative esotropia, this tends to happen to children when they start to explore near work.
• Is the squint present all the time?
Is the squint present all of the time? If yes, then this could be because of a mechanical problem. If the squint isn’t present all of the time, then I would use follow up questions …show more content…
When the child is looking at a distance target the esotropia decreases.
Cover test with glasses- When doing a near/ distance cover test, there is no manifest strabismus. The esotropia fully corrects with the hyperopic prescription.
Accommodative esotropia with convergence excess
Cover test without glasses- When looking at near target the esotropia will increase. When looking at distance target, the esotropia would decrease.
Cover test with glasses, there is no manifest strabismus, reduced esotropia or orthophoria.
Accommodation, convergence and the AC/A ratio
As I applied cyclopentolate for my refraction, this has stop any accommodation/convergence. Therefore, I would have to ensure that when the child returns to lift their glasses, that I measure the accommodation and convergence. This should be done with/without glasses. A convergence/accommodative insufficiency can also be the reason in which the blurred vision can occur. The convergence would also increase as the hyperopia