Pediatric Ophthalmology Flashcards
Concerning examination findings for children with strabismus include […] corneal light reflections and deviation on cover test.
Concerning examination findings for children with strabismus include asymmetric corneal light reflections and deviation on cover test.
How often should vision assessment be assessed in children?
At every well-child visit
infants are evaluated by observing fixation and tracking; cover-uncover tests assess for strabismus in older infants and children; visual acuity can be tested after age 3
Is allergic conjunctivitis typically unilateral or bilateral?
Always bilateral
Retinoblastoma is an eye cancer associated with a […] reflex, rather than the normal red reflex.
Retinoblastoma is an eye cancer associated with a white reflex, rather than the normal red reflex.
known as leukoria; this finding should prompt referral to an ophthalmologist for further evaluation
Treatment of strabismus includes patching or blurring of the […] eye.
Treatment of strabismus includes patching or blurring of the normal eye.
allows for strengthening of the deviated eye
What is the likely diagnosis in a child staying in a refugee camp that presents with inflammation and thickening of the tarsal conjunctivae bilaterally?
Trachoma
repeated or chronic infection causes inversion of eyelashes and scarring of the cornea
What is the likely diagnosis in a child that presents with pain with eye movements as well as fever, periorbital edema, ophthalmoplegia, and proptosis?
Orbital cellulitis
What is the likely diagnosis in a child with a history of asthma that presents with bilateral itchy, red eyes with watery discharge for the past several weeks?
Allergic conjunctivitis
IgE-mediated response to allergens; treatment involves avoidance of the triggering agent and topical agents (e.g. antihistamines, mast cell stabilizers)
What is the likely diagnosis in a child with a history of neurofibromatosis type 1 that presents with unilateral vision loss, proptosis, and optic disk pallor?
Optic pathway glioma
arises in ~15% of children < 6 years old with NF1
What is the most common predisposing factor for orbital cellulitis?
Bacterial sinusitis
due to proximity of the sinuses to the orbital space and the valveless orbital venous system
What is the next step in management for a 2-month-old infant that presents with intermittent strabismus?
Reassurance
intermittent strabismus is normal during the first 4 months of life
What is the recommended pharmacotherapy for trachoma?
Oral azithromycin
effective against Chlamydia trachomatis
What is the recommended treatment for Chlamydial conjunctivitis?
Oral macrolide
topical macrolides have a high failure rate
What is the recommended treatment for dacryostenosis?
Nasolacrimal sac massage
What is the recommended treatment for Gonococcal conjunctivitis?
Single dose of intramuscular 3rd generation cephalosporin (e.g. ceftriaxone)
What microorganism is involved in the pathogenesis of trachoma?
Chlamydia trachomatis (serotypes A, B, C)
Chlamydial infections can manifest in the eye, in the forms of inclusion conjunctivitis and trachoma, although each involves a different subtype of the bacteria. Inclusion conjunctivitis typically occurs in developed countries; in contrast, trachoma is primarily restricted to impoverished regions. While involving different serotypes, both diseases are caused by the same species of Chlamydia, illustrating the indiscriminate impact of C. trachomatis.
[…] is caused by obstruction of the nasolacrimal duct and results in crusting of the eye lashes and tearing.
Dacryostenosis is caused by obstruction of the nasolacrimal duct and results in crusting of the eye lashes and tearing.
[…] refers to intermittent or constant ocular misalignment.
Strabismus refers to intermittent or constant ocular misalignment.
may have nasal deviation (esotropia) or, less commonly, temporal deviation (exotropia)
Chlamydial conjunctivitis typically presents […] - […] days after birth with mild eyelid edema and […] discharge.
Chlamydial conjunctivitis typically presents 5 - 14 days after birth with mild eyelid edema and watery discharge.
[…] conjunctivitis typically presents 5 - 14 days after birth with mild eyelid edema and watery discharge.
Chlamydial conjunctivitis typically presents 5 - 14 days after birth with mild eyelid edema and watery discharge.
Gonococcal conjunctivitis can be prevented with prophylactic topical […] ointment soon after birth.
Gonococcal conjunctivitis can be prevented with prophylactic topical erythromycin ointment soon after birth.
mandatory in most parts of the United States; this will not prevent Chlamydia conjunctivitis
[…] conjunctivitis can be prevented with prophylactic topical erythromycin ointment soon after birth.
Gonococcal conjunctivitis can be prevented with prophylactic topical erythromycin ointment soon after birth.
mandatory in most parts of the United States; this will not prevent Chlamydia conjunctivitis
Gonococcal conjunctivitis typically presents […] - […] days after birth with marked eyelid edema and […] discharge.
Gonococcal conjunctivitis typically presents 2 - 5 days after birth with marked eyelid edema and purulent discharge.
[…] conjunctivitis typically presents 2 - 5 days after birth with marked eyelid edema and purulent discharge.
Gonococcal conjunctivitis typically presents 2 - 5 days after birth with marked eyelid edema and purulent discharge.
