DISORDERS OF THE EYE Flashcards
What is amblyopia often referred to as?
Lazy eye.
Why is early detection and treatment of eye diseases important in children?
Because amblyopia is preventable and should be addressed early to avoid permanent vision impairment.
What is the approximate vision of newborns?
20/400.
What visual milestone is expected in infants aged birth to 4 weeks?
Face-following.
At what age do infants begin visual-following?
3 months.
What is a common visual behavior of newborns?
Eyes may appear uncoordinated or strabismic and they appear to stare at objects or faces less than a foot away.
By what age do infants begin eye contact with caregivers?
6-8 weeks.
At what age do children begin to recognize their own face in the mirror?
11-12 months.
What visual milestones are expected by 18-24 months?
Focus on near and far objects, point at body parts, and scribble with crayons.
When does vision typically near 20/20?
3-4 years.
At what age can children usually recognize and recite the alphabet?
4-6 years.
What is the recommended age for red reflex examination?
Newborn to 3 months.
What are abnormal findings in the red reflex that require referral?
Absent, white, dull, opaque, or asymmetric red reflex.
What is the goal of vision screening in children?
To identify amblyopia or risk factors for amblyopia to prevent permanent visual impairment.
What conditions require urgent referral to an ophthalmologist?
Abnormal red reflex, severe eye pain, sudden loss of vision, or suspected severe eye injury.
What are semi-urgent referral conditions?
New onset of strabismus, diplopia, severe ptosis, or visual acuity 20/200 or worse.
What method is used to test for misalignment of the eyes in children?
Cover testing.
What does the corneal light reflex test evaluate?
The position of light reflection on the cornea to check for misalignment.
What is the main purpose of subjective visual acuity testing?
To assess each eye’s vision separately using charts or symbols.
What abnormalities can be detected during eye screening?
Cataracts, strabismus, glaucoma, refractive errors, ptosis, tumors, or neurologic diseases.
When is subjective visual acuity testing usually successful?
In children aged 3 years and older.
How is structural abnormality of the eyes evaluated in children?
By external inspection.
What tools are used for vision testing in young children?
Figures, letters, tumbling E, Lea symbols, and vision testing machines.
What indicates failure during alternate occlusion testing?
Failure to object equally when covering each eye.
What are examples of structural abnormalities that can be detected by external inspection?
Drooping eyelid (ptosis) and small or enlarged eyeballs.
Why is the corneal light reflex test important?
It detects off-center reflections, which may indicate misalignment of the eyes.
What is a recommended age for visual acuity testing using figures or symbols?
3-4 years.
What does an abnormal result in the cover test indicate?
Misalignment of the eyes or strabismus.
What are the expected findings during red reflex testing in a healthy child?
Equal and bright red reflex in both eyes.
What are examples of abnormal corneal light reflex findings?
Pseudoesotropia, displaced temporal reflex in esotropia, and displaced nasal reflex in exotropia.
What is the method for vision screening at every well-child visit?
Inspection of eyes, pupils, and red reflex with a flashlight.
What is ophthalmia neonatorum?
“An inflammatory condition of the ocular surface occurring during the 1st month of life due to chemical or bacterial causes.”
What causes chemical ophthalmia neonatorum?
“Mild irritation and redness secondary to silver nitrate use , occurring within the first 24 hours of life.”
What is the treatment for bacterial ophthalmia neonatorum caused by Neisseria gonorrhea?
“Ceftriaxone at 28-50 mg/kg IV or IM is the drug of choice.”
What are the symptoms of bacterial ophthalmia neonatorum caused by Neisseria gonorrhea?
“Marked chemosis, copious discharge, rapid ulceration, and possible corneal perforation.”
How is bacterial ophthalmia neonatorum caused by Neisseria gonorrhea diagnosed?
“Gram stain and culture of conjunctival exudate showing Gram-negative diplococci.”
What are the symptoms of Chlamydia trachomatis conjunctivitis in neonates?
“Mild swelling, hyperemia, papillary reaction, and minimal to moderate discharge.”
How is Chlamydia trachomatis conjunctivitis treated in neonates?
“Erythromycin ointment for ocular involvement or oral erythromycin at 50 mg/kg per day in 4 doses for systemic involvement.”
What is the cause of viral conjunctivitis in neonates?
“Occurs within the first 2 weeks of life, with minimal conjunctival hyperemia and watery discharge.”
How is viral conjunctivitis in neonates treated?
“Supportive care with cold compress, artificial tears, and
topical antibiotics for secondary bacterial infection.”
What infections are included in TORCH syndromes?
“Toxoplasma,
others(HIV, syphilis)
Rubella,
Cytomegalovirus,
Herpes simplex virus
What is the classic triad of symptoms for congenital toxoplasmosis?
(R-I-H)
1. Retinochoroiditis (atrophy, gliosis & pigmentation)
2. Intracranial calcifications
3. Hydrocephaly
What ocular manifestation is seen in congenital toxoplasmosis?
“Retinochoroiditis with a scar, atrophy, gliosis, and pigmentation.”
What is the treatment for congenital toxoplasmosis?
“Systemic pyrimethamine, sulfadiazine, trisulfapyrimidine, and folinic acid.”
What are the eye findings in congenital rubella?
“Glaucoma, cataract, microphthalmos, and salt-and-pepper retinopathy.”
What is the definitive diagnosis for congenital rubella?
“Serologic evidence and virus isolation from pharyngeal swabs.”
What are the ocular manifestations of congenital cytomegalovirus?
“Cataract, microphthalmos, optic nerve anomalies, and retinochoroiditis.”
What is the treatment for congenital cytomegalovirus?
“Intravenous antiviral agents.”
What are the features of neonatal herpes simplex virus (HSV) infection?
(CK-CR)
“Conjunctivitis, keratitis, cataracts, and retinochoroiditis,
often acquired during vaginal delivery.”
What is the treatment for neonatal HSV infection?
“Acyclovir 20 mg/kg IV three times daily, with careful monitoring of hydration and renal function.”
What are the ocular manifestations of congenital syphilis?
“Interstitial keratitis, progressive corneal edema, vascularization, and ‘salmon patch’ appearance.”
What is a congenital cataract?
“A lens opacity present at birth that may interfere with normal visual development and cause amblyopia.”
What systemic conditions are associated with congenital cataracts?
“Down syndrome, galactosemia, diabetes, Wilson’s disease, and rubella.”
What is the treatment for visually significant congenital cataracts?
“Surgery including lensectomy, with early intervention to prevent amblyopia.”
What is persistent hyperplastic primary vitreous (PHPV)?
“A disorder of primary vitreous and hyaloid vascular system development, characterized by fibrous membranes behind the lens.”
What are the complications of congenital cataract surgery?
“Re-opacification of the visual axis , pseudophakic glaucoma, and strabismus.”
What is the definition of primary congenital glaucoma?
Primary congenital glaucoma refers to a group of disorders that present within the first 2 years of life with buphthalmos, corneal edema, tearing, and characteristic changes in the anterior chamber angle.
What is glaucoma?
Glaucoma is a neuropathy of the optic nerve associated with increased intraocular pressure (IOP), visual field loss, and end-stage blindness.
What is buphthalmos, and in which age group does it occur?
Buphthalmos is an enlarged eye caused by increased IOP; it occurs in infants less than 3 years old due to distensibility of immature collagen.
What are Haab’s striae?
Haab’s striae are horizontal or curvilinear lines on the cornea caused by breaks in Descemet’s membrane and corneal endothelial healing.
What is the most common cause of glaucoma in infancy?
Primary congenital glaucoma.
What are secondary glaucomas caused by in infancy?
Secondary glaucomas are caused by inflammation, trauma, or surgery to the eye during infancy.
What is aphakic glaucoma?
Aphakic glaucoma occurs after cataract surgery and is the second most common form of glaucoma in infancy.
What are the common clinical signs of congenital glaucoma?
Signs include buphthalmos, corneal edema, tearing, increased IOP, enlarged corneas, and optic disc changes.
What diagnostic tool is used for early damage detection in congenital glaucoma?
Optical coherence tomography is used to measure nerve fiber layers for early damage detection.
What is the treatment of choice for primary infantile glaucoma?
Surgery, including goniotomy, trabeculotomy, and trabeculectomy.
What medication is the first-line treatment for lowering IOP in congenital glaucoma?
Timolol 0.25% or 0.5% applied topically twice daily.
What are the five stages of retinopathy of prematurity (ROP)?
Stage 1: Demarcation line;
Stage 2: Ridge;
Stage 3: Ridge with extraretinal fibrovascular proliferation;
Stage 4: Partial retinal detachment;
Stage 5: Total retinal detachment.
What is the zone system used for in ROP?
The zones divide the retina into 3 concentric circles (Zones 1, 2, and 3) to describe the location of ROP.
What is ‘plus disease’ in ROP?
Plus disease is an aggressive form of ROP characterized by dilation of veins and tortuosity of arteries in the posterior pole.
What is the primary risk factor for ROP?
Birth weight, with the highest risk in infants weighing less than 750 g.
What study defined the threshold for ROP treatment?
The CRYO-ROP study defined the threshold for ROP treatment.
What is the most common outcome of ROP?
Regression is the most common outcome, though it may lead to refractive errors and retinal detachment.
What are the treatments for severe ROP?
Treatments include laser photocoagulation, cryotherapy, and intravitreal anti-VEGF injections (e.g., bevacizumab).
What are the sequelae of ROP regression?
Sequelae include myopia, cataract, glaucoma, strabismus, and retinal detachment.
What nutritional factor is correlated with ROP prevention?
Good nutritional support and maintaining normal IGF-1 levels correlate with ROP prevention.
