Paeds Ophthalmology Flashcards
Types of refractive error with treatment
- myopia: short sightedness
Tx: concave lens/minus lens - hyperopia: long sightedness
Tx: convex lens/plus lens - astigmatism: cornea/lens not spherical
Tx: cylindrical lens
Presentation of refractive error
- squeezing eyes
- squint/strabismus
- headache
- tearing
- complains of tired eyes
Complication refractive error if untreated
- amblyopia (lazy eye)
Types of strabismus
- convergent squint/esotropia: eyes deviated inwards
- divergent squint/exotropia: eyes deviated outwards
Causes of squint
- muscle imbalance
- refractive errors
Signs of strabismus
- reduced visual acuity
- abnormal head posture
Treatment of amblyopia
- glass for refractive error
- surgery for cataract or ptosis
- patching therapy: close the good eye to encourage vision development in lazy eye (wear for 2-6 hours). Perform until 7 years old only.
Causes of cloudy cornea
- congenital glaucoma
- corneal dystophy
- birth trauma
- chemical injury
Features of congenital glaucoma
- poor vision
- reduced red reflex
- tearing
- buphthalmos (large eye)
- photophobia
- optic disc cupping
Complication of congenital glaucoma (if left untreated)
raised IOP that damages optic disc -> glaucomatous cupping -> optic atrophy
Differential dx for leucocoria
RCCPP
R- retinoblastoma
C- congenital cataract
C- coat’s ds
P- persistent hyperplastic primary vitreous (PHPV)
P- retinopathy of prematurity
Incidence of retinoblastoma
- mostly bilateral
- 90% < 3y
Features of retinoblastoma
- leucocoria
- strabismus
- poor vision
- orbital inflammation: redness, pain
- retinal detachment: exudative
Retinoblastoma on fundoscopic
- yellow cheesy material
- calcification
Etiology of cataract
- idiopathic
- traumatic
- ocular: aniridia, ROP
- systemic ds: torches infection, galactosaemia, hypoglycemia
- drug related: steroids
Types of cataract
Congenital
- nuclear cataract
- cortical cataract
- lamellar cataract
Acquire
- anterior subcapsular: atopic dermatitis
- oil droplet cataract: galactossaemia
- traumatic cataract: vossius ring
Coats ds on fundoscopic examination
- vascular exudation: leaky telangiectatic vessels
- exudative RD with cholesterol crystals
What is persistent hyperplastic primary vitreous? (PHPV)
- failure of embryological, primary vitreous and hyaloid vasculature to regress
Difference between preseptal and orbital cellulitis
Preseptal
- eye swelling with and without erythema
- +/- eye pain
- no pain with EOM
- no proptosis
- no fever
Orbital cellulitis
- eye swelling with and without erythema
- pain with EOM
- usually has proptosis
- usually has fever
Causes of tearing
- blocked nasolacrimal duct
- congenital glaucoma
Nasolacrimal duct obstruction
- causes
- clinical features
- mx
Causes
- late canalisation
- block by debris
Features
- tearing
- sticky eye discharge
- reflux of purulent material
- acute dacrocystitis
Mx
- digital massage
- probing
- surgery
