Neuro-ophthalmology & Squint · NEET PG Preparation Ophthalmology
A 3-year-old child has esotropia that is greater at near than at distance. After full cycloplegic correction of hypermetropia, a significant near eso…
Practice question from Neuro-ophthalmology & Squint (NEET PG Preparation Ophthalmology), with the correct answer and a step-by-step solution.
hard · MCQ · Q-8082F8
A 3-year-old child has esotropia that is greater at near than at distance. After full cycloplegic correction of hypermetropia, a significant near esotropia persists, while the distance deviation is minimal. What is the most appropriate optical treatment?
- A.Occlusion of the dominant eye only
- B.Bifocal spectacles with an appropriate near additionCorrect answer
- C.Immediate bilateral medial rectus recession
- D.Plus lenses for distance only
Solution
Persistent near esotropia despite full hypermetropic correction suggests a high accommodative convergence-to-accommodation ratio. A bifocal near addition reduces accommodative demand and therefore decreases accommodative convergence at near.
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