Paediatric Ophthalmology

Question 1

At what age does the visual system of a child stop developing?

Answer 1

6 years

Question 2

Who should be referred urgently?

Answer 2

Babies with abnormal red reflexes

Question 3

What is amblyopia?

Answer 3

Reduced vision in one eye due to a degraded retinal image. Sensitive period.
Poor development of binocular pathways

Question 4

What causes amblyopia?

Answer 4

Squint
Refractive errors, anismetropia, hyperopia
Obstruction to visual axis, cataract, ptosis

Question 5

What muscle issues can cause a squint?

Answer 5

Restrictive
Duanes
Browns
Fibrosis
Myashtenia gravis

Question 6

Describe hypermetropia and esotropia?

Answer 6

Increase accommodative effort for near

Overaccommodation and over convergence

Question 7

Describe recession squint surgery?

Answer 7

Reattach muscle posterior to insertion, weakens muscle

Question 8

Describe resection squint surgery?

Answer 8

Excise a segment of muscle (strengthens muscle)

Question 9

In a baby, what may an alteration of the red reflex be caused by?

Answer 9

Asymmetrical camera shot
Retinoblastoma
Coloboma

Question 10

What may an opacity in the red reflex be?

Answer 10

Cataract

Question 11

Wha may a black reflex or simply no red reflex be?

Answer 11

Retinoblastoma
Retinal detachment
Dysplasia

Question 12

What are two causes of sticky eyes in infancy?

Answer 12

Chlamydial conjunctivitis

Blocked nasolacrimal duct

Question 13

What is the presentation and treatment for chlamydial conjunctivitis?

Answer 13

Sticky + red eyes for first 10 days post birth

Swabs, erythromycin, contact traces

Question 14

What is the presentation of a blocked nasolacrimal duct?

Answer 14

Sticky + white eye for 2 months

Question 15

How do you treat a blocked nasolacrimal duct?

Answer 15

Resist repeated top. antibiotics
Bathe and massage sac
Syringe and probing if failing to resolve