Paediatric Ophthalmology Flashcards by Janaki Senthilkumar

Amblyopia

AKA lazy eye
Misalignment of eyes (strabismus), need of glasses (refractive error), disruption of light passing through eye (pediatric cataract)
leading to
reduced vision

How well did you know this?

Not at all

Perfectly

Signs & symptoms of amblyopia

Misaligned eyes
Squinting one eye
Bumping into objects
Other signs of poor depth perception
Head tilting
Double vision

How well did you know this?

Not at all

Perfectly

Treatment for amblyopia

glasses
patching
eye drops
surgery (sometimes)

How well did you know this?

Not at all

Perfectly

Prognosis of amblyopia

If recognized early (preschool yrs) = responds well

If recognized later (9-10 yrs later) = difficult to treat or might have permanent vision loss

How well did you know this?

Not at all

Perfectly

Strabismus

Misalignment of the eyes (constant or intermittent)

How well did you know this?

Not at all

Perfectly

Esotropia

Eyes turned inward

How well did you know this?

Not at all

Perfectly

Exotropia

Eyes turned outwards

How well did you know this?

Not at all

Perfectly

Hypertropia

Eyes turned upward

How well did you know this?

Not at all

Perfectly

Hypotropia

Eyes turned downwards

How well did you know this?

Not at all

Perfectly

Strabismus in adults result in

Double vision (diplopia)

How well did you know this?

Not at all

Perfectly

Treatment for Strabismus

eyeglasses
prisms
surgery
botox injection
eye-patching therapy

How well did you know this?

Not at all

Perfectly

Diplopia symptoms

Seeing an object in 2 different places (displaced in horizontal/vertical/diagonal)

How well did you know this?

Not at all

Perfectly

Treatment for diplopia

prism glasses
strabismus surgery
Botox injection

How well did you know this?

Not at all

Perfectly

Epiphora

Excessive crying

How well did you know this?

Not at all

Perfectly

Epiphora noted in infancy =

Blockage of tear drainage system
- improved by 6-12 months of age

How well did you know this?

Not at all

Perfectly

Treatment for childhood Epiphora

tear sac massage
eye drops
if persists = surgical probing of draining system

Droopy eyes in ptosis (childhood) causes

Blockage of light passing to retina in the back of eye & create significant astigmatism = produce blurry image in affected eye

chin-up head position

Glaucoma

High pressure -> damages optic nerve -> permanent vision loss

Signs & symptoms of paediatric glaucoma

cloudy cornea
tearing
frequent blinking
light sensitivity
redness of eye

Retinopathy of prematurity

Result from abnormal development of blood vessels in retina

Complications of ROP

strabismus
myopia
cataract
blindness from retinal detachment

Nystagmus

Involuntary, rhythmic oscillation of eyes (side to side, up & down or rotary)
- result from abnormal binocular fixation

Developmental abnormalities that result in vision loss?

Coloboma
microphthalmia (small eye)
optic nerve hypoplasia

Retinoblastoma

primary malignant Intraocular cancer developed from immature cells of retina
hereditary defect
OR
mutation in C13 gene 13q14 (retinoblastoma protein)

Signs & symptoms of retinoblastoma

- leukocoria (amaurotic cat’s eye) - deterioration of vision - red & irritated eye + glaucoma - faltering growth/delayed development - squint - eye enlargement - presence of red eye in only one eye & not the other = sign of retinoblastoma/white eye/cat’s eye

Macroscopic finding of retinoblastoma

- viable tumor cells found near vessels - zone of necrosis (avascular areas)

Microscopic finding of retinoblastoma

Undifferentiated = collections of small, round cells with hyperchromatic nuclei Differentiated = flexner-wintersteiner rosettes, homer wright rosettes & fleurettes

Treatment of retinoblastoma

1. Enucleation of eye 2. External beam radiotherapy 3. Brachytherapy 4. Thermotherapy 5. Laser photocoagulation 6. Cryotherapy 7. Chemotherapy (nanoparticulate)

DD of amaurotic cat’s eye reflex

- persistent hyperplastic primary vitreous - coats disease - toxocariasis - retinopathy of prematurity

Persistent hyperplastic primary vitreous

- congenital developmental anomaly

Cause of persistent hyperplastic primary vitreous

failure of the embryological, primary vitreous, and hyaloid vasculature to regress

Symptoms of persistent hyperplastic primary vitreous

- eye is shorter -> develops a cataract - whitening of the pupil

Coats disease

unilateral disease - abnormal development of vessels behind retina -> blood vessel abnormalities in the retina & retinal detachment -> mimic retinoblastoma

Toxocariasis

parasitic disease of the eye associated with exposure to infected puppies -> retinal lesion -> retinal detachment.

Retinopathy of prematurity

associated with low-birth-weight infants who receive supplemental oxygen in the period immediately after birth -> damage to the retinal tissue -> retinal detachment