Paediatric Pathology Flashcards
Most common childhood anterior eye conditions
- allergic eye conditions
- conjunctivitis
- chlazion/hordeolum
- cataract
Which antihistamines can be prescribed to children
- Loratadine licences from age 2
- piriton/chlorphenamine licensed from age 6
- sodium cromoglicate, no minimum age but minimum age 6 for opticrom
In babies, what 2 types of infection should be suspected and when
- chlamydia trachomatis, incubation 5-14 days
- neisseria gonorrhoeae, incubation 2-5 days
Managment for conditions previous card
- urgent referral to ophthalmologist due to risk of sight threatening sequelae and need for systemic tx
2 most common conjunctival infections in children
- bacterial conjunctivitis
- adenoviral conjunctivitis
Chalazion managment
- most self resolve, treat any associated blepharitis and advise hot compresses
- refer if not resolving, recurrent or astigmatism
Hordeolum management
- normally hot compress and lid hygiene
- may prescribe topical antibiotics if copious discharge
Symptoms/signs of undiagnosed cataract
- strabismus
- nystagmus
- clumsy behaviour
- cataract on ret
Management in childhood cataracts
- 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
What could a white reflex suggest
Retinoblastoma
Cataract
Most common childhood posterior eye conditions
- optic disc hypoplasia
- ocular albinism
- foveal hypoplasia
- retinopathy of prematurity
- autosomal dominant optic atrophy
5 most common causes of blindness
- cortical visual impairment
- retinopathy of prematurity
- optic nerve hypoplasia
- albinism
- optic atrophy
What is optic disc hypoplasia
- reduced number of nerve fibres in the optic nerve
- rare
Signs/symtpoms of disc hypoplasia
- nystagmus
- decreased VA if severe loss
- may be asymptomatic
- an RAPD if unilateral and severe
- sluggish pupils if bilateral.
- smaller disc
Papilloedema signs/symptoms
- headache, worse in morning
- nausea
- vomiting
- diplopia
- pulsation tinnitus
- swollen optic disc
- reduced vision
- absence of venous pulsation
Papillodoema differential diagnosis
- tilted disc
- disc drusen
- peripappiliary myelinated nerve fibres
- crowded discs in hyperopia patients
What is autosomal dominant optic atrophy
- hereditary disorder
- presentation in first and second decade of life
- colour vision disorders
- VA 6/60 or above
- symmetrical VA loss
- temporal wedge atrophy
Signs/symptoms of retinoblastoma
- 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
Retinoblastoma management
- urgent referral
Retinal dystrophies in childhood
- Stargardt macular dystrophy
- best vitilliform macular dystrophy
- retinitis pigmentosa
- usher syndrome
- leber congenital amaurosis
- bardet-biedl syndrome
Signs of optic albinism
- poor VA
- foveal hypoplasia
- translucent pinkish blue iris
- nystagmus
- lack of fundus pigmentation
- abnormal VEPs
- strabismus
Ocular albinism management
- photochromic lenses for everyday use
- sunglasses for summer
- advise use of hats with brim
- low vision aids
- referral if previously undiagnosed
