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This 4-year-old girl had a cyst removed from her brain at age 2 years.  It was benign and she has done very well since then except for the esotropia.  Immediately after her surgery the right eye was noted to turn in.  The parents have observed this but are seeking medical care from an ophthalmologist now for the first time.   The girl’s vision is OD 20/80 and OS 20/20.  She denies diplopia.  Her refraction after cycloplegia is OD +1.25 +0.25 X 90 and OS  +1.50.  Her media are clear and the fundus is normal in each eye.

1.	The first thing to do for this child is:
	a. prescribe the full cycloplegic refraction b. put atropine in the right eye and pilocarpine in the left eye three times a week and recheck vision in a month c. patch the nasal half of the left lens of a pair of plano loaner glasses, have the girl wear these glasses full time and re-check vision in a month d.  prescribe pleoptic exercises e. none of the above
2.	When amblyopia therapy is completed consider:
	a. prism therapy b. orthoptic exercises c. surgery d.  Botox to the left eye e. none of the above
3.	This child would benefit most from:
	a. a recession of the right medial rectus and resection of the left lateral rectus an appropriate amount b. Jensen procedure in the right eye c. a full tendon transfer shifting the superior and inferior recti of the right eye to the lateral rectus d.  a Hummelscheim procedure e. none of the above

For answers to the above, click here on or after February 20, 2007.