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Ophthalmology 142 > Paediatric Glaucoma > Flashcards

Paediatric Glaucoma Flashcards

1
Q

What are the classifications of paediatric glaucoma?

A

Primary & secondary.

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2
Q

What is Aniridia?

A

A condition where there is a lack of formation of iris tissue.

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3
Q

What is the sub-classification of secondary paediatric glaucoma?

A

Congenital conditions, acquired ocular diseases, acquired systemic disorders.

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4
Q

Name two conditions of acquired ocular diseases which cause secondary paediatric glaucoma.

A

Uveitis & Post-Cataract surgery.

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5
Q

What is the sub-classification of primary paediatric glaucoma?

A

Primary congenital glaucoma.

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6
Q

Name three conditions under congenital conditions which cause secondary paediatric glaucoma.

A

Aniridia, Axenfeld-riegler syndrome (ARS), Peters anomaly.

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7
Q

What is Axenfeld-riegler syndrome?

A

A condition where there is a malformation of the iris tissue.

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8
Q

What does Aniridia cause which leads to glaucoma?

A

It elevates the IOP hence leading to glaucoma.

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9
Q

What is the effect of high pressure (IOP) on a child’s eye and why?

Aside from being the risk factor & causing glaucoma.

A

Effect
* It pushes out the sclera and enlarges the eye (buphthalmos)
* It causes descement’s membrane in cornea to rupture, causing Haab striae
* It lengthens the axial length of the eye, causing patient to be more myopic
* It causes disc cupping
Reason
A child’s eye is still growing thus it is more elastic than an adult’s eye

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10
Q

How does a high IOP cause disc cupping?

A

High IOP damages the optic nerves which leads to the loss of individual nerve cells. When there’s a substantial loss of nerve cells, size of optic disc grows, leading to an optic nerve cupping.

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11
Q

What are the signs & symptoms of glaucoma in kids < 3 years old?

three signs/symptoms.

A
  • lacrimation (watery eyes)
  • photophobia
  • blepharospasm (shutting of one eye)
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12
Q

What are the signs & symptoms of glaucoma in kids > 3 years old?

four signs/symptoms

A
  • nystagmus
  • strabismus
  • progressive myopia
  • poor VA
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13
Q

What is Uveitis?

A

Inflammation of the uvea.

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14
Q

Name one condition of acquired systemic disorders that causes secondary paediatric glaucoma.

A

Sturge-Weber syndrome.

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15
Q

What is Sturge-Weber syndrome?

A

It is a facial cutaneous vascular malformation (extra blood vessels in the face, which can happen in the eyes too)

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16
Q

What are the sub-classifications of primary congenital glaucoma?

A
  • Neonatal
  • Infantile
  • Late onset/recognised
  • Juvenile open angle glaucoma
17
Q

What is the approximate age for neonatal primary congenital glaucoma?

A

0-1 month.

18
Q

What is the approximate age for infantile primary congenitial glaucoma?

A

> 1 month to 2 years.

19
Q

What is the approximate age for late onset primary congenital glaucoma?

A

> 2 years.

20
Q

What is the inheritance of primary congenital glaucoma?

either autosomal dominant/recessive or X-linked etc.

A

Autosomal recessive.

21
Q

What does glaucoma cause?

Differs from effects of high IOP.

A
  • progressive optic nerve damage
  • visual field defects
  • change in the optic nerve head
22
Q

How can Axenfeld-reigler syndrome & Peters anomaly cause glaucoma?

extra information.

A

The syndrome can affect the development of anterior chamber/trabecular meshwork.

23
Q

What is the inheritance of Axenfeld-riegler syndrome?

Autosomal recessive/dominant, X-linked.

A

Autosomal dominant.

24
Q

What are the features of Axenfeld-riegler syndrome?

A
  • Thinning of the iris
  • Correctopia (larger/extra pupil)
  • Systemic features/facial abnormalities
  • Posterior embryotoxon (schwalbe’s line is displaced anteriorly)
25
Q

Aniridia is often associated with?

A

Kidney tumours.

26
Q

Uveitis is often associated with?

A

Juvenile idiopathic arthritis.

27
Q

How does uveitis cause glaucoma?

A

Trabecular obstruction which then leads to trabeculitis & peripheral anterior synechiae.

28
Q

What is the treatment for uveitis?

A

Steroids.

29
Q

What are the causes for Post-Cataract Surgery glaucoma?

A
  • congenital malformation (abnormal lens formation which then leads to abnormal angle formation)
  • surgical factor which distorts the anatomy
30
Q

How does Sturge-Weber cause glaucoma?

A

There is a malformation of the vascular channels.
Fluid drains through episcleral veins so there is an increased pressure in the episcleral vein. The high pressure causes less gradient for the fluid to leave so high IOP to outflow.

Ophthalmology 142 (2 decks)

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