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Peds > Eyes > Flashcards

Eyes Flashcards

1
Q

How do you encourage an infant to open their eyes?

A
  1. dimly lit room
  2. hold infant upright, suspended under its arms
  3. have parent hold infant over a shoulder
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2
Q

In a newborn, eyelids may be swollen or edematous, accompanied by conjunctival inflammation and drainage as a consequence or what?

A

routinely administered antibiotics

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3
Q

What would redness, hemorrhage, discharge, or granular appearance indicate?

A
  1. infx
  2. allergy
  3. trauma
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4
Q

What is hypertelorism?

A

Widely spaced eyes

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5
Q

What is another name for Coloboma?

A

Keyhole pupil

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6
Q

What are the symptoms of a coloboma?

A

Loss of pupil function and often associated with other congenital abnormalities

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7
Q

What are white specks in a linear pattern around the circumference of the iris called?

A

Brushfield spots

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8
Q

What do brushfield spots suggest?

A

downs syndrome

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9
Q

What two types of strabismus’ are there?

A
  1. Exoptropic = eye deviated outward

2. Esotropic = eye deviated inward

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10
Q

How can a strabismus be corrected?

A

proper lens’

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11
Q

What tests do you perform to find out it is a stabismus?

A
  1. corneal light reflex (hirschbergs test)
  2. cross-cover test
  3. cover-uncover test
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12
Q

When performing a corneal light reflex aka hirschberg’s test how far away is the penlight when looking for symmetrical reflection from each cornea?

A

30 cm

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13
Q

What is the result of a corneal light reflex with a pseudostrabismus?

A

symmetrical

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14
Q

Who arre pseudostrabismus’ most commonly found in?

A

Asian and african american populations

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15
Q

When do pseudostrabismus’ usually disappear by?

A

1 year old

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16
Q

What condition has an asymmetrical light reflex?

A

strabismus

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17
Q

What test is being performed when the pt. stares at penlight and doctor covers one eye and observes the uncovered eye for movement?

A

Cross-cover test

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18
Q

What are the possible findings for the cross-cover test:

  1. Normal = ?
  2. Exotropic eye = ?
  3. Esotropic eye = ?
A
  1. Normal = no movement
  2. Exotropic eye = Moves lateral to midline
  3. Esotropic eye = Moves medial to lateral
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19
Q

What test is being performed with pt. stares at the penlight and the doctor covers one eye and then observes as it is uncovered?

A

cover-uncover test

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20
Q

What are the findings for the cover-uncover test:

  1. normal = ?
  2. Exotropic = ?
  3. Esotropic= ?
A
  1. normal = no movement (remains fixed on light)
  2. Exotropic eye = moves lateral
  3. Esotropic eye = Moves medial
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21
Q

What is paralytic Strabismus?

A

Impairment of extraocular muscles or their nerve supply

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22
Q

What is nonparalytic strabisumus?

A

no muscle weakness, and pt. can focus with either eye but not both simultaneously

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23
Q

What is a concern with nonparalytic strabismus?

A

developing amblyopia

24
Q

What is amblyopia?

A

reduced vision in an eye that appears strucurally normal

25
Q

What is characterized by congenital non-progressive horizontal ophthalmoplegia (inability to move the eyes)?

A

Duane’s syndrome

26
Q

What is primarily affected with duane syndrome?

A
  1. abducens nerve
  2. abducens nucleus
  3. lateral rectus muscle
27
Q

What is absent or hypoplastic in pts. with duane syndrome?

A

the abducens nucleus and nerve

28
Q

Which type of Duane syndrome is there an absent to markedly restricted abduction and adduction and retraction of the globe and narrowing of the palpebral fissure on attempted adduction?

A

Type 3

29
Q

Pt. with what type of Duane syndrome more commonly have upshoot and downshoot of affected globe on attempt to adduct the eye?

A

Type 1 and 2

30
Q

Upon shining a bright light at the infant’s eyes (optical blink reflex) what should be the reaction?

A

quick closure of eyes and dorsiflexion of the head

31
Q

Through what degrees can you expect an infant to focus and track through?

A

60 degrees

32
Q

How do you assess visual acuity of an infant?

A

grossly examine by observing infant’s preference for looking at certain objects

33
Q

How do you assess visual acuity of a child?

A

Observe playing with toys (stacking, building, or placing objects inside of others) if performed well visual difficulties are unlikely

34
Q

At what age are children usually able to cooperate with a snellen chart exam?

A

3 years old

35
Q

What does a snellen E chart result of 20/25 + 2 mean?

A

Child can read all on the 20/25 line plus two letters from the 20/20 more difficult line

36
Q

What is a good way to explain the snellen E chart to kids?

A

point which way the legs are pointing

37
Q

What could a difference (even slight) on visual acuity between eyes indicate?

A

amblyopia

38
Q 
What is the anticipated visual acuity of the following ages:
3 y/o = 
4 y/o = 
5 y/o =
6 y/o =
A

3 y/o = 20/50
4 y/o = 20/40
5 y/o =20/30
6 y/o =20/20

39
Q

When should the red reflex be elicited?

A

in every newborn, performed from birth on

40
Q

What does the red reflex test observe for?

A
  1. opacities
  2. dark spots
  3. whit spots w/in the circle of red glow
41
Q

What does an abnormal or “white” reflex indicate?

A
  1. congenital cataracts

2. retinoblastoma

42
Q

What eye condition requires a full metabolic, infectious, systematic and genetic workup?

A

Congenital cataracts

43
Q

What are some common causes of congenital cataracts?

A
  1. infectioius diseases (toxoplasmosis, rubella (MC), cytomegalovirus, and herpes
  2. hypoglycemia
  3. trisomies
  4. prematurity
44
Q

What is the MC infectious disease to cause congenital cataracts?

A

Rubella

45
Q

What is a congenital malignant tumor in a child <2 y/o?

A

Retinoblastoma

46
Q

What is the initial sign of a retinoblastoma?

A

“white” reflex

47
Q

What is seen on a fundoscopic exam with a pt. that has a retinoblastomoa?

A
  1. ill defined mass arising from the retina

2. chalky-white areas of calcification

48
Q

You should defer a fundoscopic examination until the child is __ - __ old unless patient presentation suggests a need.

A

2-6 months

49
Q

In what condition are blood vessels straightened and diverted temporally and cicatrical changes may be severe?

A

Retinopathy of prematurity

50
Q

With a retinopathy of prematurity what is there and increased risk of?

A
  1. retinal detachment
  2. Glaucoma
  3. Blindness
51
Q

Retinal findings on a supine fundoscopic exam appear “upside down” T/F

A

True

52
Q

What are the 3 screening methods for newborns to 3 months and what would require further evaluation?

A
  1. red reflex; asymmetric
  2. corneal light reflex; Asymmetric
  3. inspection; structurally abnormality
53
Q

What are the 5 screening methods for a pt. 6 months old - 1 year, and what findings would require further evaluations with these screenings?

A
  1. Red reflex; Evaluation Abnormal or Asymmetric
  2. Corneal light reflex; Asymmetric
  3. Differential occlusion; Failure to object equally to covering each eye
  4. Fix and follow with each eye; Failure to fix and follow
  5. Inspection; Structural abnormality
54
Q

What are the 5 screening methods for a pt. ~3 years old, and what findings would require further evaluations with these screenings?

A
  1. Visual acuity; <20/50; 2 lines of difference between the eyes
  2. Red reflex; Abnormal or asmmetric
  3. Corneal light reflex; Cover-uncover; Asymmetric/ocular refixation movements
  4. Stereoacuity; Failure to appreciate random dot stereogram
  5. Inspection; structural abnormality
55
Q

What are the 5 screening methods for a pt. ~5 years old, and what findings would require further evaluations with these screenings?

A
  1. Visual acuity; 20/30 or worse
  2. Red reflex; Abnormal or asymmetric
  3. Corneal light reflex; cover -uncover; Asymmetric; ocular refixation movements
  4. Sftereoacuity; Failure to appreciate random dot stereogram
  5. Inspection; structural abnormality

Peds (4 decks)

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