Ophtho Flashcards
Age that kids can fixate on objects
6 weeks
Age that kids can see color
2 months
Age that binocular vision with convergence ability starts
Age 3
Pendular nystagmus (equal velocity movements in both directions), intermittent head tilt, nodding/head bobibng
Spasmus nutans - self resolves
Loss of visual acuity due to active cortical suppresion of the vision of one eye
Ablyopia
Inward turning eye
Esotropia
Outward turning eye
Exotropia
Formal name for farsightedness
Hyperopia
- most children have this in mild form, most common refractive state seen in a 3 year old
Misalignment of one eye in relation to the other
Strabismus
Complications of untreated strabismus if not treated by age 6
Amblyopia (loss of use of nondominant eye and permanent loss of binocular vision)
At what age should you refer a patient for strabismus
4 months - can be normal up until then
Causes of pseudostrabismus
Extra skin that covers the inner corner of the eye, broad/flat nose, eyes set unusually close together or far apart
What should you screen for if you see a port wine stain
Glaucoma (commonly on the same side of the face)
Tearing lacrimation, photophobia, blepharospasm (excessive blinking), corneal clouding, redness, edema
Congenital glaucoma
What percentage of congenital cataracts are inherited
50% - often autosomal dominant
- Also assess for CMV, rubella, galactosemia
Cause/treatment of styes
- Inflammation or infection of sebaceous glands, often Staph (red and painful)
- Tx with warm compresses and possibly topical antibiotics, if no improvement then I&D
Cause of chalazion
Chronic inflammation (NOT INFECTION) of sebaceous gland around the eye, these are painless
Redness around the eye, vision is affected, proptosis, pain with eye movements
Orbital cellulitis
- Caused by spread of skin infections, insect bites, sinusitis, URI, dental infections
- Staph aureus is most common (but can also be HiB, strep, etc)
- May need CT
- Tx with IV antibiotics and ophtho consult
Redness around the eye without painful eye movements
Periorbital cellulitis (but can progress to orbital) - Treat with oral antibiotics
Photophobia, tearing, intermittent sharp pain on the eye
Corneal abrasion
- Can have irregular red reflex
- Diagnose with fluorescein stain
- Tx with topical antibiotics
Retina image: optic disc with waxy pallor in center, narrow arterioles coming off optic disc, retinal pigment deposition on periphery
Retinitis pigmentosa
Flame shaped hemorrhages on retina image
Retinal hemorrhages - NAT
Screening indication for ROP
- Birthweight < 1500 grams or GA less than 32 weeks
- Birthweight 1500-2000 grams with unstable clinical course
Screening is done at 31-34 weeks GA or 4-6 weeks after birth, whichever is later
Biggest risk factor for ROP
- Preemie (< 28 weeks) or VLBW (oxygen can contribute but not the biggest risk)
Retina image: broad thick ridge, avascular retina, site of neovascularization
Retinopathy of prematurity
What to do if presented with conjunctivitis and patient has contact lenses or recently took them out
Refer to ophtho
Causes of acute bacterial conjunctivitis
S. aureus, S. epidermidis, S. pneumoniae, M. catarrhalis, Pseudomonas (Hib if underimmunized)
- Treat with topical antibiotics but will resole on its own too
Severe extremely purulent discharge or pseudomembrane formation of the eye
N. gonorrhea or N. meningitidis conjunctivitis
- Requires IV antibiotics and ophtho referral
MCC viral conjunctivitis
Adenovirus
- No drops needed
- SUPER contagious
Viral vs allergic conjunctivitis
- Viral usually in one eye to start
- Allergic usually in both eyes
Systemic diseases that can start with conjunctivitis
- Kawasaki: non-purulent bacterial perilimbal sparing conjunctivitis
- Measles: exudative conjunctivitis
- JIA: uveitis
Buzzwords for needing referral to ophtho
- Pupil irregularity
- Significantly reduced visual acuity
Treatment of hyphema (collection of blood between cornea and iris after eye trauma)
- Ophtho referral
- Bed rest with head of bed at 30 degree angle
Blunt trauma to the eye, double vision when looking to one side, dysconjugate gaze to one side
Fracture of orbital wall or floor
