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Peds Fall 2020 > Anterior Seg > Flashcards

Anterior Seg Flashcards

1
Q

Capillary Hemangioma

  • What is it?
  • Most common ___
  • Ratio females to males
  • Location
  • Appearance?
  • __% present at birth, ___% by 6 months.
  • Rapid growth in the first ___ years of life.
  • Most have spontaneous regression. When to expect 30% regression and 70% regression.
A

Benign, soft tissue tumor composed of blood vessels.
Most common orbital tumor in childhood.
Females: males 3:2
Located on palpebral conj or upper lid.

Bright red mass, blanch on pressure. May bleed spontaneously.

30% present at birth, 100% by 6 months.
Rapid growth in first 5 years.
Regresses 30% by age 3. 70% by age 7 without tx.

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2
Q

What visual concerns should we worry about with capillary hemangioma?

A

Amblyopia. 25-60%. cased by occlusion of visual axis by lid or induced corneal astigmatism.

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3
Q

Capillary Hemangioma Tx

A

Correct ref error and tx for amblyopia.
steroid injection?
Oral beta blocker? For vasoconstriction.
Surgery

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4
Q

How to tx chalazion/Hordeolum

A

Topical steroid
Oral antibiotics
or surgery
Hot compress 6-8x per day. Do not pop–> infection.

Chronic: omega 3

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5
Q

1kg = how many lbs

A

2.2 lbs

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6
Q

1tsp = how many ml

A

5ml

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7
Q

Preseptal cellulitis

A

Infection of anterior portion of the eyelid.
S pneumonias most common.

Will see normal VA, EOMs, and pupils.

Oral antibiotic.

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8
Q

Orbital cellulitis

A

Will see decreased VA, APD and EOM restrictions. Proptosis with swollen lid.

IV antibiotics.

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9
Q

Pediatric cataract. Better to be anterior or posterior?

A 
Anterior= better VA
Posterior= poorer VA
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10
Q

pediatric cataract. What is a visually significant size?

A

larger than 3mm in central visual axis.

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11
Q

Cause of bilateral pediatric cataract

A

idiopathic (60%)
Hereditary without systemic disease. Most AD. 30%
Metabolic systemic disease such as galactosemia.
Maternal infection

Galactosemia- oil droplet cataract. Not a true cataract. Remove galacitol from diet.

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12
Q

Cause of unilateral pediatric cataract

A

Idiopathic (80%)
Ocular anomalies such as uveitis 20%
Trauma 10%

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13
Q

Types of anterior cataracts

A

Anterior polar- small.

anterior pyramidal-conical.

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14
Q

Nuclear cataract

A

Located in the embryonic/fetal nucleus between the Y sutures.
Unilateral or bilateral
Often AD
Poor visual outcome. Central and big.

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15
Q

Posterior lenticonus cataract

A

Similar to keratoconus
Congenital thinning of posterior capsule with bowing of thinned area. Most unilateral.
Some may develop irreg astigmatism. Could lead to amblyopia.

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16
Q

Cortex cataract- Cerulean (blue dot)

A 
Blueish white opacities SCATTERED throughout lens cortex. Specks. 
AD
Genetic mutation found
Associated with down syndrome
No sx. Can be risky
17
Q

Peds cataract work up for unilateral and bilateral

A

Unilateral- may not require extensive systemic work up. History and physical. TORCHS titers. Toxo, rubella, HSV, syphalis.

Bilateral- Refer to pediatric ophthalmologist for surgery. More work up if no family history.

  • Urine testing
  • TORCHs titers
  • Metabolic disorder testing
18
Q

Infant Aphakia Treatment study

A

Infants with unilateral cataract studying.
tested IOL vs CL.
Grating acuity at 12 months, HOTV at 4.5 years.

Results: more complications with IOL- usually glaucoma. Pt should be left aphakic until full growth.

19
Q

Pediatric cataract treatment
Infants
Toddlers
School age

A

Infants- surgery. Earlier intervention is better.

Todders- Do surgery if vision is bad. If VA is ok, dilate pupil with Phenylephrine.

School age- If congenital and no prior tx, poor prognosis. If acquired, more conservative tx.

AKA make judgement call. Adults? Surgery if VA is worse than 20/40

20
Q

After cataract removal in peds

A

CLs after and IOL when older.
Amblyopia tx especially if unilateral.
Monitor for glaucoma.

21
Q

Ectopia lentísimo

A

Lens subluxation due to disorders that disrupt the microfibrils of the zonules.
May have reduced VA.

Marfans- mutation for fibrillin 1 gene. Cardiac complications. Pt is usually greater than a -3.00 myope. Polycarb lenses, avoid sports!

Homocystinuria- dsisroder or methionine catabolism. Can test for in urine.

22
Q

Congenital glaucoma

  • percentage
  • What causes it?
  • Symptoms
  • Percentage bilateral
  • Tx
A

50-70%
infant up to 2 years
Angle structures block aqueous outflow. Ciliary body and iris more anterior.

Tearing, photophobia, blepharospasm. Bulged eyes, myopia, corneal changes such as opacifications increased IOP.

66% bilateral

Tx with surgery or eye drops for life.

23
Q

Signs of childhood glaucoma(primary)

A 
High IOP. Over 21. 
Reproducible visual field deficit. 
Enlarged corneal diameter 
11+ in new borns 
12+ in infants 
13+mm in children older than 1

Increased ON cupping
Asymmetric CD ratio
Focal rim thinning

24
Q

Signs of traumatic glaucoma(secondary)

A

Chronic iritis. Glaucoma secondary to inflammation

Peds Fall 2020 (15 decks)

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