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Binocular Vision > Peads - External eye - Alistair > Flashcards

Peads - External eye - Alistair Flashcards

1
Q

What does the external Eye cover?

A
  1. Eyelids
  2. Conjunctiva
  3. Cornea
  4. Orbit
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2
Q

What age is a child?

A

0-16

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3
Q

How do we know is the px has Microphthalmia or exophthalmos?

A

Measure the cornea size. The normal size is around 11.5mm

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4
Q

what should we do when working with children?

A
  1. Talk to the child! do no ignore them
  2. Do not touch children (pedo)
  3. Attitude
  4. Be on the same level as them.
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5
Q

when does the baby have their first eye exam?

A

24-48 hours! This is a general exam and looking for abnormalities

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6
Q

When is the next check?

A

6-8 weeks.

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7
Q

When does the orthoptist check visions?

A

4.5-5 years for a full work up

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8
Q

What happens during the neonatal eye exam? (25-48 hours after birth)

A

1.Look for Redness
2. Size and symmetry of the globe, cornea and pupil
3. Clarity of the cornea and lens
4. Family queries

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9
Q

what does a coloboma of the iris look like?

A
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10
Q

What is ptosis?

A

Dropping of the eyelid

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11
Q

What is epicanthus?

A

Vertical fold of the skin over the innner canthus

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12
Q

What is telecanthus?

A

This is increased distance between the inner canthi

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13
Q

what is hypertelorism?

A

Increase inner and outer canthal distances ; the orbits set wider apart.

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14
Q

How can we classify ptosis?

A
  1. Congenital
  2. Neurological
  3. Myogenic
  4. Mechanical
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15
Q

What to consider with congential ptosis?

A

Is it isolated or due to another problem

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16
Q

What neurological problems causes ptosis?

A
  1. 3rd nerve
  2. Marcus Gunns
  3. Horners
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17
Q

What myogenic problems causes ptosis?

A
  1. Myasthenia G
  2. Progressive external opthalmoplegia
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18
Q

NOTE : what is progressive external opthalmoplegia?

A

slow Loss of function to the EOM/ eye lids

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19
Q

What are the consequences of Ptosis?

A
  1. Vision
  2. Refractive status - can induce astig
  3. Amblyopia
  4. CHP
  5. Cosmesis
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20
Q

What causes congential ptosis?

A

Dystrophy/ dysgenesis of levator palpebrae superioris

Image shows the abnormal lavtaor muscle:

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21
Q

What are some features of congential ptosis?

A
  1. uni or bilateral
  2. Absence skin crease
  3. Lid lag on downgaze
  4. SR weakness often
22
Q

What does absent eyelid crease indicate?

A

Congential Ptosis. Due to abnormal insertion of the levator tendon

23
Q

Reminder :What is marcus gunn ptosis classified as?

A

Neurological probelm

24
Q

What happens during marcus gunn ptosis?

A

If the child moves their jaw in a particular direction, the eye lid will shoot up. (can be seen by asking the px eat something)
Watch this : 10 second vid:
https://www.youtube.com/shorts/HJiTim6WhLM

25
Q

Why does marcus gun ptosis occour?

A

Abnormal connection with the 3rd and 5th (trigeminal) cranial nerve

26
Q

what does MG cause?

A

This will casue bilateral ptosis.

27
Q

What are some features of horners syndrome?

A
  1. Ptosis : less then 2mm (sutble)
  2. Heterochromia - only congential
  3. Enophthalmos
  4. Anhidrosis
  5. Lower IOP (subtle)
28
Q

What does ptosis in one eye in 3rd nerve palsy mean?

A

One muscle is affected in the nucleus or the orbit

29
Q

How can we manage the ptosis?

A
  1. Refer for medical condition
  2. Manage RX and amblyopia
  3. Manage CHP
  4. Surgery : the urgency is governed by the impact on the child
30
Q

what age is the best for ptosis surgery if, not affecting their vision?

A

4-5 years old for cosmosis, as you get a better long term result with this age

31
Q

What eyelid lumps may present?

A
  1. Inflammatory
  2. Stasis
  3. Tumour
  4. Hamartoma
  5. Haemangioma
32
Q

What can cause inflammatory lumps?

A
  1. Meibomian cyst
  2. Hordoleum
  3. Molluscum contagisum
33
Q

NOTE: what is Molluscum contagisum?

A

lump casued by virus.
Eyelid lesions
Self limiting

34
Q

what is Haemangioma?

A

This is a collection of small blood vessels. Known as a vascular birthmark.
Tends to resolve 5-7 years.

(However, parents may not be happy with hearing it is self limiting so we can limit the amount of blood going thorugh them using —-> Propanolol)

35
Q

what does a coloboma of the eyelid look like?

A
36
Q

What is a dermoid?

A

Associated with coloboma : The tissue that was meant to go on the eyelid, was misplaced and inserted on the eye

37
Q

Why may infants get epiphoria?

A

Due to blocked nasolacrimal systems.

38
Q

what are the features of blocked nasolacrimal systesms?

A
  1. Epiphoria
  2. Discharge
  3. But they are not red eyes!
39
Q

How to treat blocked nasolacrimal glands?

A
  1. self limiting
  2. Massage the lacimal sac (parents)
  3. Consider a syringe / probe under genral anestetics if it does not resolve.
40
Q

What is opthalmia neonatorum?

A

This is conjunctivitis within the first 4 weeks of birth

41
Q

What causes Ophthalmia neonatorum?

A
  1. Chlamydia Trachomatis : both eyes and starts in 2 weeks time
  2. Neisseria gonorrhoea: 4-7 days and corneal penetration
  3. Herpes simplex
42
Q

Why can Neisseria gonorrhoea cause blindess?

A

Corneal penetration microbes

43
Q

what are the symptoms of conjunctivitis?

A
  1. Bilateral
  2. redness and discharge
  3. itchiness (Not severe pain)
  4. vision is not affected
44
Q

What causes conjunctivitis?

A
  1. bacterial or viral
  2. Allergic
  3. Trauma
    We treat based upon these
45
Q

what are some tips with red eye in infants?

A
  1. Blocked nasolacrimal ducts do not cause red eye
  2. Conjunctivitis is Bilateral
  3. Do not forget about congential glaucoma
  4. Any lumps ect, think of Tumour of eyelids
46
Q

What is phlyctenular conjunctivtis?

A

This is an immunological mechanism. Due to staphlycococal lid disease.

47
Q

What is vernal disease?

A

1.This is an allergic response.
2. Cobble stone appearance : large papillae
3. IgE and IgG found in tears
4. We give steroids

48
Q

Is herpes simplex in babies bilateral or unilateral?

A

Mostly bilateral.

49
Q

What does herpes simplex cause?

A

Affects skin and eyes.
Dendricit ulcers are uncommon in children

50
Q

What is band shaped keratopathy?

A

This is when the eye has gone through a shit ton of stuff… recurrent uveitis, glaucoma ect
…
and it will cause calcium deposits to form on the cornea

51
Q

What does red eyelid indicate?

A

It can be a cellulitis, under the eyelid. We should refer as it can casue meningitis

52
Q

NOTE : he said the details on the slide for cellulits is not important

A

he said alot of the things on each slide were not important tbf- Aliya :)

Binocular Vision (30 decks)

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