Ophthalmology Flashcards
When does optic nerve myelination complete?
2 years old
When does eye development begin?
5th week of gestation
At 30 weeks what can the eye do?
Response to light, pupils reactive (some may not be reactive until 32 weeks)
When does conjugate horizontal gaze develop? Conjugate vertical gaze?
Horizontal - at birth for full term
Vertical - 2 months of age
What causes leukocoria?
Leukocoria = white reflex
- Most common cause: cataracts
- Less common: retinoblastoma, coloboma, ROP, retinal detachment, vitreous hemorrhage, intraocular inflammation
What causes ptosis?
Dysfunction of levator palpebral muscle (cranial nerve III)
What is the most common area involved in ROP?
Zone 3
What does threshold ROP mean?
50% progression to stage 5 (retinal detachment)
ROP zone I or II with at least 5 contiguous clock hours (or 8 total), with plus disease
What babies get ROP screening?
All < or = to 32w0d OR bw < or = 1500g
Some over 32w0d with resp instabiliy
When does ROP screening occur?
4-6 weeks of age or 31-32 weeks cga, whichever is later
What treatment does threshold disease require?
Laser or cryotherapy within 2-3 days
What is a coloboma?
Defect in iris of the eye (pupil abnormally shaped)
Associated with trisomy 13 and deletion 13q
What trisomy has hypotelorism? Hypertelorism?
Hypotelorism: trisomy 13 (also small eyes and coloboma), meckel gruber, williams
Hypertelorism: trisomy 8, apert, deletion 13q, digeorge, noonan
What is most common cause of conjuctivitis in 1st month of life?
Chlamydia (treat with oral erythromycin)
Occurs in 1/2 of colonized mothers
When does gonorrhea conjunctivitis occur?
2-5 days of age, prevented with erythromycin at birth. Copious, purulent drainage. Treat with cephalosporin
What congenital infection has highest incidence of chorioretinitis?
Toxo - 80-90% of infants will have b/l chorioretinitis
CMV - second (20%)
What syndromes are associated with glaucoma?
Sturge Weber and Stickler
When does visual evoked potential reach adult level?
6 months
What congenital infection is most likely to give cataracts?
Rubella (50% of infants will have bilateral catarcts)
Also seen in HSV, varicella, and toxo
What is inheritance pattern of isolated congenital cataract?
Autosomal dominant (accounts for 25% of infants with cataracts)
What is the most common cause of neonatal seizures? Second most common?
- Global cerebral hypoxic ischemia (40%)
2. Focal cerebral hypoxic ischemia (17-18%)
What is the mortality rate and neurodevelopmental outcome for neonatal seizures?
Mortality: 10%
Disability: 54%
