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Med 2 - Week 41 > Pediatric Ophthalmology > Flashcards

Pediatric Ophthalmology Flashcards

1
Q

When should the red-reflex be checked?

A
  • within the first week of life
  • at 2 weeks
  • every eye exam following that: 1, 2, 3, 6… months
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2
Q

When should the corneal reflex be added to the eye exam?

A

At 1 month

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3
Q

When should the cover/uncover test be added to the eye exam?

A

6 months

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4
Q

When should visual acuity testing be done in children

A

starting at around 2-3 years

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5
Q

What can an abnormal red reflex be a sign of?

A

can indicate a pre-cancerous lesion on the retina

- can lead to retinoblastoma if not treated

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6
Q

What can the cover/uncover test tell you?

A

if there is a tropia = aka a manifested strabismus

covering the “good” eye will cause the “bad” eye to redirect itself

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7
Q

What is the difference between a tropia and a phoria?

A

tropia = manifested strabismus or misalignment of the eye

phoria = latent deviation of the eye that is manifested when the “good” eye is covered and binocular vision is broken

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8
Q

What are the main “types” of tropias and phorias?

A

either eso = inverted or exo = everted with regards to the midline vision

or hyper = up, and hypo = down with regards to horizontal plane of vision

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9
Q

Besides the cover/uncover test, what 3 tests can be used to identify strabismus?

A

Hirshberg = looking for the corneal light reflex

Bruckner = looking for asymmetry in the red reflex

Krimsky = essentially the Hirschberg test, but with prisms employed to quantitate deviation of ocular misalignment by determining how much prism is required to centre the reflex

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10
Q

What is normal for a child’s vision at 1 month?

A

Appreciating light

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11
Q

What is normal for a child’s vision at 1-2 months?

A
  • making eye contact

- following a slow target

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12
Q

What is normal for a child’s vision at 3 months ?

A

demonstrates binocular coordination

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13
Q

What is normal for a child’s vision at 6 months?

A

reaches accurately for toys

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14
Q

What is normal for a child’s vision at 2 years?

A

Can match pictures

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15
Q

What is normal for a child’s vision at 3 years?

A

Can match letters

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16
Q

What is normal for a child’s vision at 5 years?

A

Determined by the Snellen chart

17
Q

What are the 3 types of refractive errors?

A

myopia: “near sightedness”

Hyperopia = “far sightedness”

Astigmatism = uneven focussing of light on the retina

18
Q

What are 2 ways to slow myopia progression in children?

A
  • outdoor play

- atropine drops

19
Q

What are the 4 types of esotrophic strabismus?

A
  1. pseudoesotrophia
  2. infantile esotrophia
  3. accommodative
  4. non-accommodative/acquired
20
Q

What are the 3 types of exotrophic strabismus?

A
  1. pseudo
  2. intermittent
  3. convergence insufficiency
21
Q

What are 4 features of infantile esotropia? when does it present?

A

Presents before 6 months

  • cross fixation
  • nystagmus
  • larger deviation
  • can alternate
22
Q

What is the treatment for infantile esotropia?

A

early surgery

23
Q

When does accommodative esotropia present? What are 2 features?

A

Presents between 6 months to 7 years. average is 2.5 years

  • intermittent at initial presentation
  • have hyperopic refraction sometimes due to cycloplegia = paralysis of the ciliary muscle of the eye
24
Q

What are 2 treatment options for accommodative esotropia?

A
  1. glasses

2. surgery for residual deviation

25
Q

When does intermittent exotropia present? Wheat are some features on history and exam?

A

Presents before 5 years old

  • worse with fatigue, distance vision
  • will close eyes in the sun
26
Q

What are 3 treatment options of intermittent exotropia?

A
  1. glasses
  2. surgery
  3. patching
27
Q

What are 4 possible causes of vertical strabismus ?

A
  1. 4th nerve paresis
  2. Monocular elevation deficiency
  3. Brown syndrome
  4. “Trapdoor” fracture in the floor of the orbit
28
Q

What is the most common cause of monocular visual impairment from childhood to middle age?

A

Amblyopia = aka lazy eyes

29
Q

What % of the population are affected by amblyopia?

A

2-5%

30
Q

What are 3 causes of amblyopia?

A
  1. strabismus
  2. anisometropia, ametropia
  3. visual deprivation
31
Q

What 2 conditions need to be met to diagnose amblyopia?

A
  1. Visual acuity of < 20/40 even when corrected

2. > or = 2 line VA difference between eyes

32
Q

What is the most common type of amblyopia?

A

Strabismic amblyopia

33
Q

What is anisometropic amblyopia?

A

caused by unequal refractive error leading to one eye being chronically defocused relative to the other

34
Q

What is amertropic amblyopia?

A

Large degree of refractive error

35
Q

How do you treat amblyopia?

A

Make the amblyopic eye work harder

  • fix any deficits that might be preventing it to work
  • patch or blur with lenses/drops in the good eye

Med 2 - Week 41 (2 decks)

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