Paediatric Opthamology Flashcards
What may be a sign that a baby cannot see?
No response to smiles
Doesn’t reach for toys
Doesn’t notice mothers face
What could be use to objectively assess an infant’s vision?
What tool is used?
Preferential looking- if given a choice the baby will look at the more interesting stimulus
Teller cards are used- baby will look at the stripes rather than the blank side. The finer the stripes the better the vision
What is amblyopia?
Lazy eye- irreversible permanent reduction in the vision of one or both eyes
What is strabismus?
Strabismus is a squint- where there is asymmetry between the eyes and they do not point in the same direction
How does strabismus cause amblyopia?
Eyes do not converge properly and so this would cause double vision
Therefore the bad eye is suppressed and becomes lazy- leading to amblyopia
What causes amblyopia?
Anything that reduces visual stimulus
Strabismic Amblyopia- squinting eye becomes lazy
Ametropic Amblyopia- refractive error in one or both of the eyes
Form deprivation- ocular disease such as congenital cataract
What must be cone to correct ambylopia?
Correct any causes- e.g. congenital cataract, glasses
Patch the good eye forcing the child to use their bad eye
Atropine drops to blur vision are an alternative
What types of quint are there?
Convergent- eye looks in
Divergent- eye looks out
Vertical- deviation up or down (less common)
What are the treatment options for strabismus?
Corrective glasses
Patching over the good eye
Surgery
What is leukocoria?
White pupil- refer urgently
What is the most common cause of leukocoria?
Congenital cataract- refer urgently
What ocular problems must be checked for in new born children?
Congenital cataracts
Why must children with congenital cataracts be referred urgently?
Development issues- e.g. wont learn to smile if cant see it
Risk of developing ambylopia- form deprivation kind
What is the most common ocular cancer in children?
Retinoblastoma- absent red reflex
What is the treatment for retinoblastoma?
Systemic chemotherapy- highly responsive
Local Treatments- Laser, cryotherapy, radioactive plaque
Sometimes surgical removal
What might indicate a bacterial conjunctivitis over a viral conjunctivitis?
Bacterial conjunctivitis is often a sticky discharge
Viral conjunctivitis is often a water discharge, also likely to have pre-auricular lymphadenopathy
What associated illness is likely to be seen in a patient with viral conjunctivitis?
URTI
Often caused by adenovirus
What kind of lymphadenopathy may be seen in viral conjunctivitis?
Pre-auricular
How does allergic conjunctivitis present?
Bilateral red eyes
Stringy mucous
Itchy eyes
Associated with atopy- hay fever, eczema
What is the treatment for allergic conjunctivitis?
Topical anti-histamines and mast cell stabilisers
What is opthalmia neonatorum?
Any conjunctivitis within the first month of life
It’s is an emergency and can cause blindess
What is a main cause of opthalmia neonatorum?
Gonorrhoea
Also chlamydia
What is the management
Identify the organism- swabs for culture and NAAT
Systemic antibiotics depending on the cause
How might naso-lacrimal duct obstruction present?
Sticky eye but not red (red indicates infection)
What causes retinopathy of prematurity?
Retinal vasculature is not fully developed at birth- there is abnormal vasculature. Abnormal vessels are prone to bleeding, causing scar tissue to form which can lead to retinal detachment
It is associated with oxygen therapy
What is the treatment for retinopathy of prematurity?
Laser to reduce ischaemic stimulus due to poorly formed blood vessels causing distal ischaemia
