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III. Vision of Children > Anterior Segment (F) > Flashcards

Anterior Segment (F) Flashcards

1
Q

What are the possible causes of preseptal cellulitis in children?

A 
o Spread of infection
o Hordeolum
o Conjunctivitis
o Ethmoid sinus infection
o Trauma, laceration to skin
o Insect bite
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2
Q

What is the pediatric dosing for augmentin in children?

A
  1. under 12 wks old: 30 mg/kg/day q12h with 125mg/5mL suspension
  2. over or equal to 12 wks old: 25 to 45 mg/kg/day q12h with 200/5 or 400/5 mg/mL suspension
  3. 40kg use adult dose: 875mg PO BID x 10 days
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3
Q

What are the signs of preseptal cellulitis in children?

A 
o Unilateral
o Erythema
o Edema
o Tender/painful
o WARM to the touch
o Ptosis
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4
Q

What are the solutions involved in treatment of bacterial conjunctivitis?

A
  1. polytrim
  2. Gentamycin (>1 mo)
  3. Tobramycin (> 2 mo)
  4. Moxeza (> 4 mo)
  5. Azasite (>1 yr)
  6. Ciloxan, Ocuflox, Quixin, Zymaxid, Vigamox, Besivance (> 1 yr)
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5
Q

What is the type of Juvenile Idiopathic Arthritis with 5 or more joints involved called? 1. What is the percentage of JIA cases? 2. What is the likelihood of uveitis? 3

A
  1. polyarticular
  2. 40%
  3. 5%
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6
Q

Why is screening for JIA involvement so important related to uveitis?

A
  1. 75% of children with severe uveitis experience vision loss (from complications) (Band keratopathy, cataract and secondary glaucoma)
  2. 12% will develop permanent and profound vision loss
  3. This is preventable through early diagnosis and treatment!!
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7
Q

What is the cause of phlyctenulosis? 1. What are the signs and symptoms? 2

A
  1. delayed hypersensitivity rxn to bacterial, fungal, or parasitic antigens or TB
  2. red, watery, painful, photophobic eye, Raised white/yellow nodule, Pannus
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8
Q

What are the corneal signs of Reis-Bucklers’ Dystrophy?

A 
o Fine, reticular formation at Bowman’s
o Most dense centrally
o Irregular epithelium
o Loss of corneal sensation
o Corneal erosions (RCE)
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9
Q

What is the management of dacryocystitis?

A
  1. Oral antibiotics, same as with preseptal cellulitis (Augmentin)
  2. If causing concurrent conjunctivitis: Polytrim
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10
Q

What are benign tumors of endothelium and anastomosing, blood-filled channels? 1. What is the epidemiology? 2. When do they reach maximum size? 3

A
  1. hemangioma
  2. females, caucasians
  3. 12 to 18 months
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11
Q

What is the type of hemangioma that is red and superficial? 1. Type that is purple and deeper? 2

A
  1. capillary

2. cavernous

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12
Q

What are the ointments involved in treatment of bacterial conjunctivitis?

A
  1. Erythromycin (birth)
  2. Gentamycin (> 1 mo)
  3. Tobramycin (> 2 mo)
  4. Ciloxan (>1 yr)
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13
Q

What is the treatment for preseptal cellulitis in children?

A
  1. augmentin
  2. cefuroxime
  3. azithromycin if PCN allergy
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14
Q

What are the signs and symptoms of bacterial conjunctivitis in children?

A
  1. Redness
  2. Crusting of eyelids
  3. Goopy discharge
  4. Swollen eyelids*
  5. Begins unilateral and turns bilateral in 24-48 hours
  6. Conj injection
  7. Mucopurulent or purulent discharge
  8. Papillary reaction
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15
Q

What are the signs and symptoms of congenital glaucoma?

A 
o Epiphora
o Photophobia
o Blepharospasm
o Irritability
o Buphthalmos (K diam > 12)
o Corneal edema
o Haab’s striae
o Elevated IOP (>25-30mmHg)
o Glaucomatous ON atrophy
o Increased axial length
o Myopia (often aniso)
o Reduced acuity
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16
Q

When does Reis-Bucklers’ Dystrophy present? 1. What is the prognosis? 2

A
  1. 1st decade

2. visually devastating

17
Q

What is the ocular management of a congenital cataract?

A
  1. surgically removed (6wks old if unilateral, 10 if bilateral)
  2. Contact lenses
  3. Glasses with bifocal!!
  4. Amblyopia treatment
18
Q

What is the management for a hemangioma?

A
  1. Monitor for involution (90% involute by age 9)
  2. Steroid injection
  3. Laser
  4. Surgical excision
19
Q

When does Posterior Polymorphous Dystrophy present? 1. What is the prognosis? 2

A
  1. early childhood

2. does not affect vision

20
Q

What is the extra fold of horizontal skin that stretches across the anterior lid margin and the lashes become vertically misdirected called? 1. What is the treatment? 2

A
  1. epiblepharon

2. Monitoring for spontaneous resolution with age and maybe surgery

21
Q

What are the possible causes of red eye in children?

A
  • Conjunctivitis
  • Bacterial
  • Viral
  • Vernal
  • Allergic
  • Abrasion
  • Erosion
  • Phylctenulosis
22
Q

What are the ocular sequelae of a congenital cataract?

A

o Aphakic glaucoma
o Amblyopia
o Nystagmus
o Strabismus

23
Q

What is the cause of nasolacimal duct obstruction?

A

failure to complete nasolacrimal duct patency

24
Q

What is the type of Juvenile Idiopathic Arthritis with 4 or less joints involved called? 1. What is the percentage of JIA cases? 2. What is the likelihood of uveitis? 3

A
  1. Pauciarticular
  2. 50%
  3. 20%
25
What are the signs of viral conjunctivitis?
``` o Pink, hyperemic conj o Watery discharge o Follicular reaction o (+) PAN o Edematous lids ```
26
What is the epidemiology and timing of congenital glaucoma? 1. What is the treatment? 2
1. more male than female and 80% diagnosed by age 1 | 2. refer for surgery
27
What is the type of Juvenile Idiopathic Arthritis with systemic involvement called? 1. What is the percentage of JIA cases? 2. What is the likelihood of uveitis? 3
1. systemic onset 2. 10% 3. no uveitis
28
What is the treatment for viral conjunctivitis? 1. When can the child go back to school? 2
1. warm/cool compresses | 2. after eye stops watering (3 to 7 days)
29
How long are children contagious following bacterial conjunctivitis?
for 24 after taking medication
30
What are the signs of dacryocystitis?
o Erythema o Edema of lower lid over lacrimal sac and canalicula o Tearing o Regurgitation of purulent material on palpation of lacrimal sac
31
What is an eye infection transmitted during vaginal birth called? 1. What is the prophylactic treatment given? 2
1. ophthalmia neonatorum | 2. erythromycin and silver nitrate
32
What is the critical sign of viral conjunctivitis? 1. Allergic? 2. Vernal? 3 Microbial? 4
1. follicles 2. itch and watery discharge 3. itch and ropy discharge 4. purulent discharge
33
What is the management of phlyctenulosis?
1. Treat the staph bleph with lid scrubs, topical/oral Ab | 2. Treat the phlyctenule with steroids (pred forte or tobradex)
34
What is the management for nasolacrimal duct obstruction?
1. nasolacrimal massage (5 reps QID) usually takes care of it 2. antibiotics drops if infection 3. OMD probing at 6 to 10 months old
35
What are the signs of Posterior Polymorphous Dystrophy?
gray haze at the level of Descemet's
36
What are the things to look for to rule out orbital cellulitis when thinking it is preseptal?
proptosis, EOM restrictions, reduced acuity, fever
37
What is an acute infection of the diffuse lid tissue anterior to the orbital septum called?
preseptal cellulitis
38
What are the most common organisms involved in bacterial conjunctivitis in children?
1. Haemophilus influenza (gram neg) | 2. Streptococcus pneumoniae (gram pos)

III. Vision of Children (19 decks)

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