Pediatric ENT Flashcards
DDx for red eye, categories
Conjunctivitis, foreign body, trauma, infection, allergy, irritating noxious agents
painful eye ddx
foreign body, corneal abrasion, lacerations, acute infection, iritis, angle-closure glaucoma, trichiasis (inturned lashes), trauma
visual changes ddx
amblyopia, chemical burns, globe injury, alignment and mobility issues, illness, infection, allergy
ptosis ddx
defective levator muscles, myasthenia gravis, lid injuries, thrid nerve palsy, horner syndrome
anisocoria ddx
(unequal sized pupils)
horner syndrome
third nerve palsy, adie tonic pupil, iritis, trauma, medication
leukocoria ddx
retinoblastoma, retinopathy of prematurity, pupillary membrane, cataract, vitreous opacities, retinal detachment, toxocara infection, retinal dysplasia
What is toxocariasis?
A parisite that lives in dogs and cats and can be contracted from their feces.
- Many people don’t get sick but some get ocular toxocariasis, or visceral version.
What is retinoblastoma
Eye cancer that begins in the retina,, commonly affects young children.
S/sx: white reflex, strabismus
conjunctivitis
Bact: S. pneumo, Hflu, Moraxella, N. gonorrhoeae
Viral: adenovirus
S/sx: copious purulent or watery discharge, mild discomfort, no blurring of vision, redness
Tx: ophth erythromycin
dacryostenosis
Eti: blockage of tear ducts, up to 6% of newborns
S/sx: history of chronic or intermittent tearing and debris on the eyelashes. palpating lac sac may cause reflux of tears
Dacryocystitis
Eti: infection of lac sac by s. pnuemo, h flu, s aureus, strep p. P aeruginosa
S/sx: uniL. Pus may be expressed from tear sac, pain, swelling, tenderness, redness near sac.
Tx: warm compresses, or oral abx
Hyphema
Pooling or collection of blood in the anterior chamber of the eye.
Eti: Blunt trauma, sickle cell, blood dyscrasias
orbital or periorbital cellulitis
Eti: S. pneumo, hflu, moraxella, s aureus, GAS
S/sx: fever, proptosis, double vision, restriction of EOMs
Tx: amp/sulbact or cefotaxime
Hordeolum
infection of glands, usually by staph a.
S/sx: Pain, redness, swelling
Tx: warm compresses TID
- if unresolved I&D
Exophthalmos/proptosis
Eti: hyperthyroidism
S/sx: bluging eyes
Chalazion
Eti: Chronic inflammation of the meibomian gland
Ptosis
Eti: dysfunction of the levator muscle or superior rectus, horner’s etc. MYASTHENIA GRAVIS
Tx: surgical except for myastenia gravis
Blepharitis
Eti: inflammation of eyelid, staph most common
S/sx: crusty debris at the base of the lashes, erythema at the lid margins
Tx: lid scrubs with baby shampoo, topical abx
Congenital cataract
Eti: chromosomal syndrome
S/sx; leukocoria, poor fixation, strabismus, nystagmus, no red reflex
Tx: surgical removal
Keratitis
Eti: bacterial, HSV, fungal,amoebic
S/sx: hypopyon, pain, reduced vision, photophobia, corneal ulcers…
Tx: topical abx
Uveitis
Eti: idiopathic, immunologic (Ank, psoriasis, IBD, SLE) emds, infections
s/sx: hypopyon, unilateral pain, redness, photophobia, visual loss, iris nodules, abnormal funoscopic exam
Amblyopia
Lazy eye
Eti: unilateral or bilateral reduction in vision due to strabsimus, refraction errors and or visual deprivation
- Can only occur during the period of visual development
Tx; the early treatment the better, address underlying cause
strabismus
Misalignment of the eyes
-Eso, exo, hyper or hypotropia that is consistent or intermittent
Tx: early treatment increase chance of improving visual acuity
Cholesteatoma
Eti: Hypertrophy of inner ear from chronic infections or congenital
S/sx: Greasy looking mass or pearly white mass in retraction pocket of perforation, persistent, recurrent, foul-smelling drainage.
Dx: CT
Tx: surgical
