3.3.1 Eye Disorders vision childhood Flashcards
Every child who presents with an eye problem needs what?
Visual acuity assessed
What is Sheridan single matching test? Vs. linear matching
- Single letter then they point to it
- linear matching with crowding aged 4
What is strabismus?
Misalignment of two eyes, only one eye directed at object of regard
commonly called cross-eyed, lazy eyed, etc.
Normal to have cross eyes?
In first 4months of life, babies may cross and uncross
What kind of strabismus do we worry about?
Constant strabismus
What is pseudostrabismus?
- Broad flat bridge of nose
- epicanthic folds
-look at the reflections in the eye, usually symmetrical
What is esotropia?
Eyes turning in
What is accommodative esotropia?
Usually age 2-2.5, focusing on books, gets eyes turning in to focus
What is exotropia?
One eye drifts out
Different kinds of exotropia?
Intermittent
Constant
What are causes of paralytic strabismus?
3,4,6 nerve palsies
True strabismus can be associated with what serious pathology?
Intraocular
Intracranial
What is a warning sign in a baby for eyes?
Constant exotropia
- often associated with neurological problems
- often poor vision in 1 eye
How does paralytic strabismus present?
Student onset
Diplopia
Aetiology of paralytic strabismus?
-Congenital
-acquired
Viral
Trauma
Increased ICP
What is an eye disorder than can cause head tilt?
4th nerve palsy
3rd nerve palsy in kids?
Pstosis, eye drifts out
Rare
Can be congenital - can be viral: very rare
Likely tumour, refer and MRI
Paralytic strabisbus key points for DDx and Ix?
Intracranial disease
MRI/MRA
What is Duane syndrome
Abnormal innervation of lateral rectus
What is Brown’s syndrome?
Superior oblique doesn’t pass through trochlea freely
Strabismus can be associated with that intraocular pathology?
Retinoblastoma
Cataract
Toxoplasmosis
What is the gold standard for strabismus?
Cover/uncover test
Ocular movements
Needs to fixate on something, then cover the good eye, usually the affected eye will take up fixation, then when you uncover the bad eye will turn out or in again
What is the cover test for?
Intermittent exotropia
Ophthalmoscope useful for?
Red reflex
Optic disc/retina
Risk factors for strabismus
Family Hx Low birthweight Drug/alcohol Cataract/retinoblastoma Neurological Craniofacial
When to refer to ophthalmologist?
Constant strabismus Sudden onset Restricted movement Unequal red reflex Underlying eye pathology Intracranial pathology
When is the sensitive period for amblyopia?
Birth to 8 years
Types of amblyopia?
Unilateral: form deprivation, strabismus
Bilateral
3 aetiology of amblyopia?
Strabismus
Refractive
Deprivational: ptosis/cataract
Management of amblyopia?
Early diagnosis
Age 0-8
Management of amblyopia?
Correct refractive
Correct cataract/ptosis
Occlude better eye
Patching one eye how long?
2 hours in mild moderate
4 hours a day for severe
Can patch an 8 year old
Must have Compliance with patching
Do you grow out of strabismus?
Nope
