Newborn Eye Exam

Question 1

What muscle is responsible for eyelid

1. Opening
2. Closure

Answer 1

1. Levator palpebrae

2. Orbicularis oculi

Question 2

Myopia

Answer 2

Eyeball is too long
The image is formed before the retina
Nearsighted (need a negative lens)

Question 3

Hyperopia

Answer 3

Eyeball is too short
The image is formed behind the retina
Farsighted

Question 4

Eyes at birth

Answer 4

Axial hypermetropia (too small because it needs to grow and then not have a refractive error)
Eye reaches its adult size by 14 years of age
Vision is 20/1200 - can fix a face within 1 meter

Question 5

When is the period of development of visual acuity

Answer 5

Birth to 3-5 years old

Question 6

When is the period where deprivation can cause amplyopia

Answer 6

A few months to 7 or 8 years of age

Question 7

When is the period during which recovery from amblyopia can be obtained

Answer 7

Time of deprivation to the teenage years (even into adult years)

Question 8

Subconjunctival hemorrhages

Answer 8

Common after natural delivery (breakage from pressure during delivery)
Redness confined to the limits of the sclera
Usually does not represent ocular trauma
Asymptomatic, does not affect vision
Resolves spontaneously in several days

Question 9

3 signs on physical of strabismus

Answer 9

Head tilt
Asymmetric red reflex
Strabismus apparent with head straight

Question 10

Asymmetric blink

Answer 10

Apparent 1st or 2nd day of life
Signs include incomplete blink, nasolabial fold flattening, and inability to move lips on the affected side
From compression of facial nerve (forceps birth)
Common and often goes away on its own in days
Lubricate cornea until it does

Question 11

2 compensatory maneuvers for ptosis

Answer 11

Chin up

Brow lift

Question 12

Marcus Gunn jaw winking

Answer 12

Abnormal connection between 3rd and 7th cranial nerve

When you move your jaw it makes your eyelid lift (normally has ptosis)

Question 13

Nasolacrimal duct obstruction

Answer 13

Very common
Often from membranous obstruction at the valve of Hasner at the distal end of the nasolacrimal duct
Signs: increased tear lake, mucus/mucopurulent discharge, tearing, reflux with pressure
Treat with massage or probing

Question 14

Dacryocele

Answer 14

Tear duct is blocked at both ends
Must consider hemangioma, dermoid cyst, or encephalocele
Lacrimal probing
Give systemic antibiotics and acute surgical decompression is often necessary

Question 15

Triad of glaucoma

Answer 15

Photophobia
Tearing
Red eye

Question 16

Signs of glaucoma

Answer 16

Corneal edema associated with lacrimation and photophobia
Big eyes, can be cloudy
Optic disc cupping

Question 17

Dysconjugate eye movements

Answer 17

Eyes appear to move independently
Normal in the first few months
Eyes may transiently appear crossed or divergent
Noticeable when infant is tired

Question 18

Causes of retinal hemorrhages

Answer 18

Normal birth (should resolve in first few weeks)
Child abuse (shaken baby syndrome)
Major trauma
Systemic disease