ophtho Flashcards
i arm stands for?
inspection
acuity
red reflex
motility
inspection consists of what?
symmetry, tilt, redness and squinting
part of the exam that consists of pupillary responses and use of eye charts?
acuity
this is bruckner test
red reflex
this is hirchberg test
motility assesment
when does visual acuity improve the most?
during the first 3-4 months of life
when the corneal light reflex is uncentered it is generally?
strabismus
when there is a dull reflex it is generally?
glaucoma
when its a yellow or white reflex it is?
retinoblastoma
normal visual development is a dependent on what 2 things?
- proper eye alignment
2. equal visual stimulation
the most common cause of decreased vision during childhood
amblyopia
what are pathologic conditions that cause a blurred visual image resulting in amblyopia
opacification, uncorrected refractive error, significant differences between the eyes (anisometropia),
what is the best management for amblyopia?
early detection and early intervention
3 neonatal conjuntivitis pathogens
Neisseria gonorrhoea
chlamydia trachomatis
HSV
chemical conjunctivitis is caused most by?
1% silver nitrate caused by prophylaxis to n. gonorrhoea
is neonatal chemical conjuncivitis a dangerous emergency?
no, it is self limited and lasts for less than 24 hours
N. gonorrhea
- onset
- cellularity
- tx
- 2-4 days old
-gram neg diplococci - IV cefoxatime and topical
+tx parents
c. trachomatis
- onset
- cellularity
- tx
- 4-10 days old
- cytoplasmic inclusion bodies (+ dirt fluorescent antibody
- oral erythyromycin + tx. parents
HSV
- onset
- cellularity
- tx
- 6 days -2 weeks
- multinucleated giant cells
- IV acyclovir and topical triflourothymidine
how can corneal abrasion be diagnosed?
flourescein staining
what are causes of corneal abrasion
trauma
bacterial corneal ulcer (gono)
HSV keratitis
conjunctivitis w/ lymphadenopathy
viral conjunctivitis
conjunctivitis w/ positive culture of staph aureus
blepharitis
conjunctivitis w/ eosinophils on conjunctival scrapings?
allergic
treatment for bacterial conjunctivitis?
topical polymyxin B, tmp smx, gentamicin, tobramycin, erythromycin
what virus causes pharyjgoconjunctival fever
adenovirus 3,7
is viral conjunctivitis unilateral or bilateral?
bilateral
treatment for viral conjunctivitis?
cool compresses and topical NSAID drops
what is the difference between keratoconjunctivitis and pharyjgoconjunctival fever? what is the same?
keratoconjunctivitis does not have URI.
keratoconjunctivitis is caused by adenovirus 8,9,37
what strand of HSV causes primary ocular HSV w/ multiple vesicular lesions
HSV type 1
what type of hypersensitivity reaction is allergic conjunctivitis?
TYPE 1
what is treatment of allergic conjunctivitis?
cromolyn and topical antihistamines
where does nasolacrimal duct obstruction occur?
Hasner’s valve
what is the management of NLD obstruction
observation, massage, antibiotics and probing
this is a swelling of the nasolacrimal sac
amniotocele
what color is the swelling that occurs in amniotocele (dacryocele)
bluish swelling
amniotocele + infection tx?
iv antibiotics and urgent NLD probing
amniotocele no infection tx?
massage
ocular trauma associated w/ child abuse?
retinal hemorrhage
damage to and loss of corneal epithelium?
corneal abrasion
what is management of corneal abrasion?
protective shield patch, topical antibiotic and refer to optho if associated with contact lens
blood within the anterior chamber
hyphema
most common cause of hyphen?
blunt trauma
increased ocular pressure occurring at or soon after birth
congenital glaucoma
what is normal intraocular pressure in infants?
10-15 mm Hg
what is exceeding intraocular pressure in infants
30 mm Hg
how is congenital glaucoma different then adult glaucoma
causes nerve injury and expands size of the eye because eye wall is still elastic
what is reduced in glaucoma?
outflow of aqueous humor
true or false
surgery is always required in congenital glaucoma?
true
Retinopathy of prematurity
proliferation of vessels seen in premature infants exposed to oxygen
management of retinopathy of prematurity
opthalmic evaluations biweekly
retinal cryotherapy + laser therapy if severe
who should have a dilated opthalmoscopic exam at 4-6 weeks?
infants born at gestation age of 28 weeks or less weighing less than 1500 g
this refers to a white pupil?
leukocoria
what chromosome mutation results in retinoblastoma?
mutation/deletion on both alleles on long arm of chromosome 13
“TWO HIT”
what are 3 clinical features of retinoblastoma
calcification within tumor
white pupil
strabismus
strabismus
misalignment of the eyes
refers to eye turned nasally
esotropia
refers to eye turned laterally
exotropia
this results in false appearance of strabismus
prominence of epicentral folds
what happens if strabismus occurs later than 5 years?
diploplia
follicular conjunctivitis, neovascularization and nasal discharge are all caused by?
c. trachomatis conjunctivitis
do you patch the deviated eye or the normal eye in strabismus?
patch the normal eye so the deviated eye can gain strength
at what age should visual acuity test be given?
age 3 w/ snellen chart or tumbling E
