Paediatric Pathology

Question 1

Most common childhood anterior eye conditions

Answer 1

• allergic eye conditions
• conjunctivitis
• chlazion/hordeolum
• cataract

Question 2

Which antihistamines can be prescribed to children

Answer 2

• Loratadine licences from age 2
• piriton/chlorphenamine licensed from age 6
• sodium cromoglicate, no minimum age but minimum age 6 for opticrom

Question 3

In babies, what 2 types of infection should be suspected and when

Answer 3

• chlamydia trachomatis, incubation 5-14 days
• neisseria gonorrhoeae, incubation 2-5 days

Question 4

Managment for conditions previous card

Answer 4

• urgent referral to ophthalmologist due to risk of sight threatening sequelae and need for systemic tx

Question 5

2 most common conjunctival infections in children

Answer 5

• bacterial conjunctivitis
• adenoviral conjunctivitis

Question 6

Chalazion managment

Answer 6

• most self resolve, treat any associated blepharitis and advise hot compresses
• refer if not resolving, recurrent or astigmatism

Question 7

Hordeolum management

Answer 7

• normally hot compress and lid hygiene
• may prescribe topical antibiotics if copious discharge

Question 8

Symptoms/signs of undiagnosed cataract

Answer 8

• strabismus
• nystagmus
• clumsy behaviour
• cataract on ret

Question 9

Management in childhood cataracts

Answer 9

• urgent referral if not previously diagnosed in an infant
• if discharged from HES refractive correction
• IOL then needs multi focal lenses only in affected eye
• if cataract in situ then full refractive correction and assess accommodative function

Question 10

What could a white reflex suggest

Answer 10

Retinoblastoma
Cataract

Question 11

Most common childhood posterior eye conditions

Answer 11

• optic disc hypoplasia
• ocular albinism
• foveal hypoplasia
• retinopathy of prematurity
• autosomal dominant optic atrophy

Question 12

5 most common causes of blindness

Answer 12

• cortical visual impairment
• retinopathy of prematurity
• optic nerve hypoplasia
• albinism
• optic atrophy

Question 13

What is optic disc hypoplasia

Answer 13

• reduced number of nerve fibres in the optic nerve
• rare

Question 14

Signs/symtpoms of disc hypoplasia

Answer 14

• nystagmus
• decreased VA if severe loss
• may be asymptomatic
• an RAPD if unilateral and severe
• sluggish pupils if bilateral.
• smaller disc

Question 15

Papilloedema signs/symptoms

Answer 15

• headache, worse in morning
• nausea
• vomiting
• diplopia
• pulsation tinnitus
• swollen optic disc
• reduced vision
• absence of venous pulsation

Question 16

Papillodoema differential diagnosis

Answer 16

• tilted disc
• disc drusen
• peripappiliary myelinated nerve fibres
• crowded discs in hyperopia patients

Question 17

What is autosomal dominant optic atrophy

Answer 17

• hereditary disorder
• presentation in first and second decade of life
• colour vision disorders
• VA 6/60 or above
• symmetrical VA loss
• temporal wedge atrophy

Question 18

Signs/symptoms of retinoblastoma

Answer 18

• white pupil
• strabismus
• associated painful red eye with secondary glaucoma
• dome shaped white elevations
• while elevation of retina which project into the vitreous
• subretinal mass causing an overlying retinal detachment

Question 19

Retinoblastoma management

Answer 19

• urgent referral

Question 20

Retinal dystrophies in childhood

Answer 20

• Stargardt macular dystrophy
• best vitilliform macular dystrophy
• retinitis pigmentosa
• usher syndrome
• leber congenital amaurosis
• bardet-biedl syndrome

Question 21

Signs of optic albinism

Answer 21

• poor VA
• foveal hypoplasia
• translucent pinkish blue iris
• nystagmus
• lack of fundus pigmentation
• abnormal VEPs
• strabismus

Question 22

Ocular albinism management

Answer 22

• photochromic lenses for everyday use
• sunglasses for summer
• advise use of hats with brim
• low vision aids
• referral if previously undiagnosed