Eyes Flashcards
Is eyelid oedema normal?
Yes some degree is seen after birth, resolves over the first few days.
Is dysconjugate eye movement normal?
In the first few MONTHS of life this may be normal particularly when the infant is falling asleep or just waking up. When the infant wakes this should resolve when the infant focuses.
It may be ABNORMAL if the dysconjugate movement is fixed (ie one eye always fall in/out compared to the other)
What are dacrocystoceles?
BLUEISH NODULES below the medial canthi (inner eye corner).
Caused by obstruction at both ends of the NASOLACRIMAL duct (carries tears to the nose).
It is possible that they cause complete obstruction to the nasal passages therefore if the dacrocystoles are bilateral, internal nasal examination is recommended.
What is dacrostenosis?
Blocked tear duct. Resulting in discharge from the eyes. Common in newborns where the opening of the tear duct hasn’t developed fully yet. 50% resolve within first few weeks, the second 50% resolve within months. Often not noticeable at birth as babies don’t produce tears until a few weeks old.
Not a problem unless signs of infection.
Why may there be red patches in the eye?
Breakage of blood vessels during delivery called a SUBCONJUNCTIVAL Heamorrhage.
Limited to the sclera (eye white) not the coloured iris.
Does not affect vision, resolves spontaneously in a few days.
Often found alongside facial bruising.
How May a iris cyst be identified?
They are extremely rare. Reddish/blue discolouration of the eyelid. Redness of the sclera Retinal light reflex not visible Red discolouration over the iris. Opacity of the pupil
May resolve spontaneously over months
How May gonococcal conjunctivitis present? What action is required?
Copious thick milky discharge.
Oedema of eyelids.
The discharge will ooze out if pressure applied to the eye.
It is an emergency as the bacteria can erode through the cornea. NNU, IV Abx, frequent eyewashes.
What may be the underlying cause of hazy bilateral corneal opacities?
Congenital glaucoma (damage to the optic nerve)
What is Peter’s Anomaly? How May it present?
Problems at the front of the eye. Hazy cornea (clear area in front of iris/pupil)
No retinal reflex due to opacity.
How May congenital cataracts present?
Opacity occurs BEHIND the pupil.
The entire circumference of the pupil can be seen.
Retinal Red reflex NOT seen.
A less dense cateract may not be visibly cloudy but still red reflex will not be obtained.
Immediate paediatric referral, to preserve sight!
