Developmental delay and learning disability Flashcards
What is the other word for squint?
Strabismus
What is a squint?
A misalignment of the visual axes. This means both eyes are not directed at an object at the same time. There is no defect in the extra ocular muscles.
What is a pseudo squint?
When there is not squint present, but something can give the impression of misaligned eyes, for example epicanthic folds may partially cover the nasal sclera, giving rise to the appearance of a squint
What is a manifest squint?
A squint that is present when the eyes are open and being used so that when one eye views the object of interest, the other eye is deviated. This may be constant or intermittent when the squint is only present some of the time
What is a latent squint?
A squint that is present only when the use of the two eyes together is interrupted (for example by covering one eye) - the is an extra ocularmuscle imbalance but the eyes do not deviate most of the time.
What is another term of manifest squint?
A tropia
What is the another term of latent squint?
A phoria
What is the name for a horizontal squint, in which the eyes towards each other (towards the midline)?
Esotropia/esophoria (convergent squint)
What is the name for a horizontal squint in which the eyes look away from each other (laterally)?
Exotropia/exophoria (divergent squint)
What is the name given to a vertical deviation squint in which the eyes move upwards?
Hypertropia
What is the name given to a vertical deviation squint in which the eyes look downwards?
Hypotropia
What is the name when an eye rotates around the visual axis?
Cyclotorsional
What is the name for a non-paralytic squint (this is the most common type of squint in children)?
Concomitant or comitant
What does concomitant mean?
The degree of deviation does not vary with the direction of gaze - there is a normal range of external ocular movements, and a constant angle of squint between the two eyes.
How can a latent squint be identified?
It can be difficult to diagnose, sometimes there is a decrease in visual acuity in the affected eye, so eye
What is the most common type of squint?
A concomitant convergent squint
What is the aim of treatment for squints and what are the options?
The aim of treatment is to get the weaker, squinting eye, ‘trained up’ to prevent amblyopia.
- Corrective refractive error : wear glasses
- Eye patch wearing on the good eye, to train the weaker eye
- Eye muscle exercises
- Eye muscle surgery if large squint and above measures failing
When must a child with a squint be seen by an ophthalmologist as opposed to a orthoptist?
If the squint is:
- Divergent
- Paralytic
- Persistent beyond age of 12 months
What is amblyopia?
Permanent loss of visual acuity in an eye that has not received clear images in the sensitive period of visual development (up to age 7). Most commonly due to squint, but may also develop with refractive errors and cataracts
What do the majority (95%) of children with Down syndrome have in terms of genetic changes?
Trisomy 21
2% Robertsonian translocation and 2% mosaicism
What are the clinical features of Down syndrome? (9)
- Usually present at birth
- Generalised hypotonia and marked head lag
- Flat occiput and short neck
- Characteristic facial features
- Mildly short stature
- Intellectual impairment
- Typical limb features
- Congenital heart disease (40%)
- GI problems - Hirschsprung’s disease, duodenal atresia/stenosis
What are the facial features associated with Down syndrome? (6)
- Small low-set ears
- Up-slanting eyes
- Prominent epicanthic folds
- Flat facial profile
- Protruding tongue
- Brushfield’s spots - whitish in colour, in the iris (develop later)
What are the most rare diseases/conditions associated with Down syndrome? (5)
- Congenital leukaemia - AML most common
- Mild pancytopenia
- Neutropenia
- Transient abnormal myelopoiesis
- Polycythaemia
