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My Own Deck > Paediatrics > Flashcards

Paediatrics Flashcards

1
Q

What are the traditional tests used to assess a child’s VA?

A

Snellen/Logmar
Jay’s
Cardiff cards (forced choice)

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2
Q

What VA is considered to be normal?

A

6/9.5

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3
Q

At what astigmatic power is considered to be normal for a child?

A

20% have ~1-2D

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4
Q

What is Amblyopia?

A

Disruption in the visual development

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5
Q

What key feature is found if a px presented with amblyopia?

A

> 2 lines difference b/w 2 eyes

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6
Q

What are the 3 main causes of amblyopia?

A
  1. Refractive
  2. Strabismic
  3. Structural
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7
Q

At what VA would an amblyopic be presenting with?

A

<6/12 AFTER refraction

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8
Q

When is it most appropriate to refer an amblyopia child?

A

<7yrs

>2 lines difference AFTER refraction

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9
Q

What are the possible management options for amblyopia?

A

Occlusion
Optical penalisation
Atropine
(Successful for <7yrs)

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10
Q

When do you NOT prescribe an rx to a child?

A

If Asxs and Vision better than 6/9.5

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11
Q

When is it indicted to prescribe an rx to a child?

A

Symptomatic
Vision
Strabismus

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12
Q

When is a cycloplegic refraction performed?

A

<6yrs
Reduced vision
Squint

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13
Q

What is a strabismus?

A

Misalignment of the 2 eyes

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14
Q

What features are present in an SOT?

A 
Worse looking Near
Hyperopic 
Loss of binocular function 
Cause Ambly
Asxs
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15
Q

What features are present in XOT?

A 
Worse at Far
Mild myopia 
Normal binocular function
Ambly RARE
Sxs: HAs, blinking
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16
Q

When is it essential to refer for SOT and XOT?

A

SOT- Any variable or constant SOT, Patching/surgery maybe required

XOT- Constant, sxs, only sx surgery (most monitored)

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17
Q

Before a squint surgery takes place, what must be done before?

A

Vision sorted 1st!
Full spectacle adaption
Patching…. then surgery!

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18
Q

What is a nystagmus?

A

Wobbly eyes uncontrolled

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19
Q

What are the common causes of nystagmus?

A 
IDIOPATHIC
Albinism 
Achromatopsia
Aniridia 
Lever cong amarausis
Cone dystrophy 
Congenital/idiopathic
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20
Q

What 4 aspects could potentially cause nystagmus?

A

Meds- toxic, alcohol, thiamine
Neurological- MS, tumour CVA
Ocular- sensory, cataracts, trauma
Physiological

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21
Q

What features are assessed in nystagmus?

A 
Amplitude 
Biggest 
Conjugate 
Direction 
AHP
Frequency
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22
Q

Whats features are suspicious in nystagmus?

A 
ACQUIRED 
Vz
Disconjugate 
Oscillopsia 
Hearing loss
Reversal of dev. Milestones 
Ataxia weakness
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23
Q

When is it necessary to refer urgently when presented with a nystagmus?

A

New
Oscillpsia
Vz

If none of these features present- routine referral

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24
Q

What would give rise to Red eyes?

A

Infection
FB
Allergy

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25
Q

What is blepharitis?

A

Staphylococcal skin flora interferes with oil at lid margin

26
Q

When are the sxs for chronic blepharitis worse?

A

Worse in the AM

27
Q

What signs maybe present in blepharitis in children?

A

Chalazion
Red eye
Crusty lid
Dry eye

28
Q

How is blepharitis treated?

A

Makeup wipes

29
Q

When is blepharitis referred to the HES?

A

Any corneal changes

30
Q

What conditions are associated with allergy?

A

Asthma
Eczema
Ptosis

31
Q

What are the signs and sxs of allergy?

A

Itchy
Lid papillae
Sticky AM

32
Q

What advice would you give to reduce an allergy?

A

Cold compress and OTC antihistamines

33
Q

What are the sxs if the px has a foreign body?

A

Photophobic
Painful
Watery

34
Q

What is the difference in viral and bacterial infectious conjunctivitis signs?

A

Viral- watery, puffy

Bacterial- sticky

35
Q

What are the 3 blinders found in children?

A

Cataracts
Uveaitis
HSK

36
Q

What is the cause of cataracts in children?

A

Idiopathic- congenital

37
Q

What other disease processes occur with cataracts in children?

A

Chromosomal
Infection
Metabolic

38
Q

What is the 1st sign of reduced vision?

A

Uveitis

39
Q

What key aspects do we look out for in uveitis?

A

Posterior synachiae

Keratitic precipitate

40
Q

What else can uveitis cause?

A

Cataracts

41
Q

What is uveitis commonly associated with?

A

JIA- Juvenile idiopathic atheritis

42
Q

How is cataracts managed in children?

A

Infancy- 6-8/52 old
Sxs- surgery indicated
Asxs- no surgery indicated

43
Q

What is the criteria for referral to the HES in young children with the blinders?

A

Causing amblyopia- urgent

44
Q

How is HSK referred?

A

Urgently HES

45
Q

What are the killer conditions that maybe found in children?

A

Retinoblastoma
Papilloedma
Optic disc drusen

46
Q

What conditions maybe normal to see in children?

A

Bergmeister papilla

Mylinated nerve fibres

47
Q

What is retinoblastoma and what are the potential signs?

A 
Rare malignant tumour (fatal)
Signs...
Leukocoria 
Strabismus 
Poor vision
48
Q

What is the referral route for a retinoblastoma?

A

Urgent referral to HES same day

49
Q

What can papilloedema sometimes be confused with?

A

Drusen

50
Q

What are options dusc drusen made up of?

A

Buried colloid bodies (lump under disc)

51
Q

What features are included in optic disc drusen?

A 
Disc vasc remains visible 
Elevation confined to OD
No exudate
Small cupless discs 
No venous congestion
52
Q

What is myelinated nerve fibres?

A

Fatty content nerve to brain

53
Q

What is ON Coloboma?

A

A defect in the retina and choroid

54
Q

What aspects would be considered when referring for swollen discs?

A

Symptoms
Associated signs
Incidental findings

55
Q

What are the associated signs for swollen discs?

A

6th NP
Color vision loss
Disc Haemmorage

56
Q

What sxs would suggest a disc swelling?

A

HAs
Dip
Unwell- referred by GP
Appointment made by parents for specific reason

57
Q

What should be included in the referral for swollen discs?

A 
Dip 
CV
Pupils
NV
Prev documentation 
HAs/sickness
58
Q

What are the main causes for a child who can’t see?

A

Refractive error
Accom problem
Undiagnosed ambly
No specific cause

59
Q

What is included in an eye exam for children?

A

Stereoacuity
Cyclo refraction
Recheck VA after cyclo
Tes t @ 3m not 6m

60
Q

What cerebral VI problems would a child be experiencing?

A 
Using vision for a long term
Copying from board 
Problems c VF
Problems finding way around placs
Problems with visual search and noisy places
61
Q

Who would need referring in relation to cerebral VI?

A

Brain injury
Probs using vision
No tx- solution strategies to help make seeing easier

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