Paediatric Ophthalmology Flashcards

1
Q

What is amblyopia?

A

Vision development disorder (lazy eye)

  • eye fails to achieve normal visual acuity
  • poor development of binocular visual pathways
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2
Q

What are some of the causes of amblyopia?

A

Squint
Refractive error
Obstruction to visual axis e.g. cataract, ptosis

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3
Q

How is amblyopia managed?

A

Occlusion treatment (patch) to good eye

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4
Q

What is a squint? What are the other words for it?

A

Abnormality of the co-ordination of eye movements

- aka strabismus, tropia

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5
Q

What are the two main types of squint?

A

Convergent squint –> esotropia

Divergent squint –> exotropia

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6
Q

What does a convergent squint look like and what causes it?

A

Affected eye turned in

- may be no cause or due to hypermetropia

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7
Q

What does a divergent squint look like?

A

Affected eye turned out

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8
Q

Which type of squint is most common in children?

A

Convergent (esotropia)

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9
Q

What are some other causes of squint?

A
Congenital
Hypermetropia
CN palsies
Muscle problems e.g. Browns, myasthenia gravis
Orbital problems e.g. blowout fracture
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10
Q

What is a pseudo squint?

A

Wide epicanthic folds can give the appearance of squint

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11
Q

How is a squint diagnosed?

A
Corneal reflection (reflection of light falls symmetrically if no squint AND 
Cover test (movement of uncovered eye to take up fixation as other eye is covered)
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12
Q

How is a squint managed?

A

3 O’s:

  • Optical –> correct refractive errors with glasses
  • Orthoptic –> patch good eye to treat amblyopia
  • Operations (if other methods are successful)
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13
Q

What is the surgical option for squint management?

A

Recession + resection of rectus muscles to align eyes for cosmesis

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14
Q

What should be done if a child has no/abnormal red reflex?

A

Urgent referral

- must be checked at newborn screening exam

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15
Q

What are the causes of an altered colour of red reflex (pale yellow)?

A

Asymmetrical camera shot (most common)
Retinoblastoma (rare childhood cancer)
Coloboma

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16
Q

What is a coloboma?

A

Hole in one of the eye structures

17
Q

What are the causes of an opacity in the red reflex?

A

Cataract

18
Q

What are the causes of no/black red reflex?

A

Retinoblastoma
Retinal detachment or dysplasia
Retinopathy of prematurity

19
Q

What are the 2 causes of sticky eyes in infancy?

A

Chlamydia conjunctivitis

Blocked nasolacrimal duct

20
Q

How does chlamydia conjunctivitis present?

A

Sticky + red eye in the first 10 days of life

21
Q

How is chlamydia conjunctivitis treated in a newborn?

A

Swab
Erythromycin
Contact traces

22
Q

How does a blocked nasolacrimal duct present?

A

Sticky, watery, uninflamed eye

23
Q

How is a blocked nasolacrimal duct diagnosed?

A

Delayed fluorescein dye disappearance

24
Q

How is a blocked nasolacrimal duct treated?

A

Bathe and massage sac
Resist repeated topical antibiotics
Most resolve within a year