Approach to amblyopia and strabismus (pediatrics) Quiz: Ace Your Exams

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A 7-year-old boy is brought to the pediatrician by a parent for evaluation of visual disturbance. The parent reports noticing the child has been squinting and tilting his head to the right when watching TV for the past several weeks. The patient is otherwise healthy and takes no medications. Vital signs are within normal limits. Red reflexes are intact bilaterally. Visual acuity is 20/60 OD (right eye) and 20/20 OS (left eye). Examination reveals no evidence of eye deviation. Which of the following is the best next step in diagnosis?

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Intraocular pressure (IOP) measurement

Computed tomography (CT) of the brain

Magnetic resonance imaging (MRI) of the brain

Fundoscopic examination

Lumbar puncture