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Ophthalmology > Paeds > Flashcards

Paeds Flashcards

1
Q

Name the longest to shortest rectii muscle?

A

SR, MR, LR, IR

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2
Q

Whats the largest rectus muscle?

A

MR

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3
Q

Which rectus muscle has the longest and shortest tendon lengths?

A

Longest - LR

Shortest - MR

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4
Q

Where is the origin of the four extraocular rectus muscles

A 
Annulus of Zinn. 
Tendinous ring (thickened periosteum) at the apex of the orbital cavity.
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5
Q

Blood Supply of

A) Superior rectus
B) Inferior rectus
C) Medial rectus
D) Lateral rectus
E) Superior oblique
F) Inferior oblique
A

A - Superior muscular branch of ophthalmic art, 2 anterior ciliary art.

B- Inferior muscular branch of ophthalmic art, Infraorbital art, 2 ant. ciliary art

C - Inferior muscular branch of ophthalmic art, 2 ant. ciliary art

D - Lacrimal artery

E - Superior muscular branch of ophthalmic art

F -Inferior muscular branch of ophthalmic art, Infraorbital art

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6
Q 
Movements of Eyes 
A) Superior rectus
B) Inferior rectus
C) Medial rectus
D) Lateral rectus
E) Superior oblique
F) Inferior oblique
A

A) Elevation, Intorsion (Inward/Medial Rotation), Adduction
B) Depression, Extorsion, Adduction
C) Adduction
D) Abduction
E) Depression, Intorsion, Abduction
F) Elevation, Extortion (Outward/Lateral Rotation), Abduction

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7
Q

Explain Eye movements

  1. Primary
  2. Secondary
  3. Tertiary
A
  1. Looking straight ahead
  2. Eye is directed (U, D, L, R)
  3. Eye is directed in oblique positions
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8
Q

Retinoblastoma is caused by the loss of function of which gene and where?

A

Loss of function of the Rb tumour suppressor gene on C13q14

2 separate mutations - Sporadically (Cell body loses Rb gene + Another mutation of cell body) 90%

Genetically - 2 Cell bodies missing Rb gene + mutation happens.

Leukocoria, Macroscopically seen as a white mass, Metastatic dissemination of retinoblastoma is via the blood stream

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9
Q

Define Leukocoria?

A

Normal white pupillary reflex. (White pupil)

Retinoblastoma
Cataracts
Retinal detachment 
Retinopathy of prematurity
Coats disease 
Retinal Astrocytic hamartoma 
Persistent fetal vasculature
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10
Q

What is the most common benign periorbital tumours of infants?

What visual issue can they cause?

A

Capillary Haemangioma

Possible ptosis, Reduced VA (due to amblyopia), Astigmatism

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11
Q

What syndrome is linked with Port wine stain affecting the face and eyes?

What visual issue can it cause?

A

Sturge weber ( Overabundance of capillaries near the surface of the skin. Blood vessels on the same side of the brain as the stain)

Choroidal haemangioma
Glaucoma
Seizures,

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12
Q

Describe ROP

Pathology, Treatment

A

Disorganised and excessive growth of retinal blood vessels in premature infants EXPOSED TO HIGH O2 concentrations.

When oxygen is removed - blood vessels start growing rapidly into the vitreous of the eye.

Tx: Laser photocoagulation from those presenting at Stage 3+ disease

3 - Extra retinal detachment
4 - Partial
5 - Total Retinal detachment

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13
Q

Who is at risk of ROP?

A

Premature babies <31W or Low birth weight <1.5kg

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14
Q

Define Coats disease?

A

Abnormal development of retinal blood vessels and retinal hard exudates.

Characteristic presentation - Xanthocoria (due to hard exudates)

Complications - RD (Hard exudates thicken the retina)

Tx: Manage hard retinal exudation, anti-VEGF through retinal laser, If RD consider scleral buckling

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15
Q

What signs do you get with optic nerve dysfunction?

A

Reduced colour vision, VA, RAPD

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16
Q

Tell me what ages visual acuity is tested for:

A) Cardiff Cards
B) Kay pictures
C) Sheridan-gardiner
D) Keeler LogMar or Snellen Chart

A

A - 6M to 2 yrs
B - 2yrs to 3yrs
C- 3yrs to 5yrs
D - Over 4 Years of age.
Snellen for literate children and adults.
Keeler LM for illiterate adults/pre-school children

17
Q

Differentials for Leukocoria?

PREDICT

A 
Persistant hyperlastic primary vitreous 
Retinoblastoma / ROP / RD
Endophthalmitis
Dysplasia of retina 
Inflammatory cyclitic membrane 
Congenital cataract/ Coat's disease 
Toxocaiasis
18
Q

Flexner-Wintersteiner Rosettes

Histological finiding in which condition?

A

Retinoblastoma

19
Q

What is amblyopia?

A

Unilateral decrease in VA caused by vision deprivation/abnormal binocular interaction. Defect in central visual processing.

“Loss of the ability to see clearly through one eye”

20
Q

3 Treatments for Amblyopia

A

Occlusion therapy - Patching of better eye <8

Penalisation - Using atropine to reduce VA of better eye

Medically - Dopamine (As an adjunct)

21
Q

3 Treatments for Amblyopia

A

Occlusion therapy - Patching of better eye <8

Penalisation - Using atropine to reduce VA of better eye (Blurs the eye via relaxation of muscles, dilation)

Medically - Dopamine (As an adjunct) - Increases contrast sensitivity in amblyopic eye only (dopaminergic neurons influence visual cortical plasticity)

22
Q

What are the types of Amblyopia?

A 
1 - Starbismic
2 - Anisometropic
3 - Stimulus deprivation 
4 - Ametropic 
5 - Astigmatic
23
Q

Explain a Congenital nasolacrimal system obstruction?

Define?
Treatment?

A

A relatively common condition causing excessive tearing or mucoid discharge from the eyes.

Usually affects <1Y , Blockage of the lacrimal drainage system (valve of Hasner/Tear ducts)

The membranous valve of Hasner opens spontaneously or with gentle massage of the nasolacrimal sac within the first 6 to 12 months of life.

> 12 months, the chances of spontaneously opening are less and nasolacrimal probing is indicated. Should multiple probings fail, silicon tube intubation can be tried/ DCR (dacryocystorhinostomy) surgery

24
Q

What is the main reason for pseudo-esotropia?

A

Epicanthal folds in infants.

These recede as the face matures.
Corneal light reflex is symmetrical in both eyes. [Asymmetry = True squint]

25
Q

What conditions are associated with cataracts in juveniles and young adults?

A

NF Type 2
Myotonic dystrophy
Atopic dermatitis

26
Q

Define
A - Yoke muscles
B - Synergists muscles
C - Agonist-antagonists muscles

A

A - Yoke muscles are pairs of muscles in different eyes which produce conjugate, directional gaze. (Gaze in the same direction)

B - Synergists are pairs of muscles in the same eye which move the eye in the same direction.

C - Agonist-antagonists are pairs of muscles in the same eye that move the eye in opposite directions

27
Q

Chromosomes affected for the following genetic conditions?

A - Retinoblastoma
B- Stargardt's
C- Myotonic dystrophy
D- Granular, Avellino, Reis-Buckler, and Lattice I dystrophies
E- Marfans
F- aniridia
G -Alagille syndrome
H- Behcet's disease
I - Birdshot chorioretinopathy
A 
A- 13q14
B- 1p
C- 19
D -5q
E -15
F -11p
G -20
H - HLAB51
I -HLA A29
28
Q

Left Eye is EXOTROPIC what will happen to right eye when the L.Eye is covered?

A

The right eye fixates, so the R. eye will NOT move when the left eye is covered. The image on the right will disappear

Exotropia - Causes crossed diplopia (right image comes from left eye and vice versa)

Esotropia causes uncrossed diplopia (right image comes from right eye, etc)

Ophthalmology (13 decks)

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