Opthalmology

Question 1

Causes of Ptosis

Answer 1

Failure of eyelid to completely rise (CN3)

1) 13q deletion
2) Fanconi
3) Fetal alcohol
4) Mobius
5) Noonan
6) Smith lemmili opitz
7) WAGR

NOT ROP??

Question 2

Causes of cataracts

Answer 2

1) congenital infections (rubella is cataracts BUT CMV and toxo is chirioretinitis)
2) metabolic dz (galactosemia)
3) genetic (smith-Lemli-optiz)

Question 3

Development of eye:
1) when does it begin
2) when are pupils reactive to light
3) optic nerve myelination complete

Answer 3

1) week 5
2) 30-32 weeks (after IVH risk so shouldn’t try looking in they eyes until 30 weeks)
3) 24 months of age

Question 4

When do these happen:
1) conjugate horizontal gaze
2) visual fixation
3) conjugate vertical gaze
4) visual following
5) visual evoked potential

Answer 4

1) term birth
2) 2 months
3) 2 months
4) 3 months
5) 6 months

Question 5

Long term consequence of ROP

Answer 5

1) strabismus

Question 6

Causes of glaucoma

Answer 6

1) congenital (auto recessive) is most common.

Secondary:
1) homocysteinuria
2) sturge-Webber
3) stickler
4) rubella
5) ROP

Question 7

ROP screening guidelines

Answer 7

<32 weeks OR 1500g

@ 31-32 weeks PMA OR in 4-6 weeks (pick the later time so an infant born at 23 weeks is screened in 8 weeks (31w PMA) but an infant born at 30 weeks is screened in 4 weeks at 34w PMA)

Question 8

What is ROP plus disease?
Threshold ROP?

Answer 8

Plus: any stage/severity when vessels appear thickened/tortuous

Threshold: how much plus disease is seen in zones 1 and 2 with 5 contiguous clock hours or 8 total clock hours. There is high risk for detachment so needs to be Lasered.

Question 9

Causes of conjunctivitis and timing

Answer 9

1) chemical 1 day 2/2 silver nitrate
2) bacterial 1-2 days (staph is MC)
3) NG “goes first 2-5 days” ➡️ cephalosporin
4) CT “comes later 5-14 days”➡️erythromycin
5) HSV