Counsel a family on a new diagnosis of accommodative esotropia and amblyopia — OSCE

OSCE communication and shared-planning station: explaining a new diagnosis of accommodative esotropia with amblyopia in a young child, the meaning of the cycloplegic refraction and the hyperopic glasses, the amblyopia-first treatment sequence (occlusion or atropine penalisation), the realistic timeline and the rationale for possible surgery, in plain language that builds adherence while addressing fear.

osce communication and shared decision-making2 min readVerification in progress

Prompt

The parents of a three-year-old girl bring her in because the right eye has been turning inward over three months and is now constant. Cycloplegic refraction shows moderate hyperopia, the right eye has reduced acuity, and the diagnosis is accommodative esotropia with right amblyopia. The parents are anxious: they have read online that she will need an operation, they worry the glasses will make her eyes lazy, and they are sceptical that patching will work. Counsel them on the diagnosis, the glasses, the amblyopia therapy and the plan.

Candidate brief

You have eight minutes to counsel the parents of a three-year-old given a new diagnosis of accommodative esotropia with right amblyopia, confirmed on cycloplegic refraction showing moderate hyperopia. Use a structured, honest, empathic approach that explains the diagnosis, the glasses, the amblyopia therapy and the plan, and that builds adherence. ^[1] ^[5]

References4Show

[1]Donahue SP Clinical practice. Pediatric strabismus. N Engl J Med, 2007.PMID 17347457
[5]Lembo A; Serafino M; Strologo MD; et al Accommodative esotropia: the state of the art. Int Ophthalmol, 2019.PMID 29332227
[9]Pediatric Eye Disease Investigator Group A randomized trial of atropine vs. patching for treatment of moderate amblyopia in children. Arch Ophthalmol, 2002.PMID 11879129
[11]Holmes JM; Clarke MP Amblyopia. Lancet, 2006.PMID 16631913

Counsel a family on a new diagnosis of accommodative esotropia and amblyopia — OSCE

osce communication and shared decision-making2 min readVerification in progress

Candidate brief

References4Show

[1]Donahue SP Clinical practice. Pediatric strabismus. N Engl J Med, 2007.PMID 17347457
[5]Lembo A; Serafino M; Strologo MD; et al Accommodative esotropia: the state of the art. Int Ophthalmol, 2019.PMID 29332227
[9]Pediatric Eye Disease Investigator Group A randomized trial of atropine vs. patching for treatment of moderate amblyopia in children. Arch Ophthalmol, 2002.PMID 11879129
[11]Holmes JM; Clarke MP Amblyopia. Lancet, 2006.PMID 16631913