3.3.1 Eye Disorders vision childhood

Question 1

Every child who presents with an eye problem needs what?

Answer 1

Visual acuity assessed

Question 2

What is Sheridan single matching test? Vs. linear matching

Answer 2

• Single letter then they point to it

- linear matching with crowding aged 4

Question 3

What is strabismus?

Answer 3

Misalignment of two eyes, only one eye directed at object of regard

commonly called cross-eyed, lazy eyed, etc.

Question 4

Normal to have cross eyes?

Answer 4

In first 4months of life, babies may cross and uncross

Question 5

What kind of strabismus do we worry about?

Answer 5

Constant strabismus

Question 6

What is pseudostrabismus?

Answer 6

• Broad flat bridge of nose
• epicanthic folds

-look at the reflections in the eye, usually symmetrical

Question 7

What is esotropia?

Answer 7

Eyes turning in

Question 8

What is accommodative esotropia?

Answer 8

Usually age 2-2.5, focusing on books, gets eyes turning in to focus

Question 9

What is exotropia?

Answer 9

One eye drifts out

Question 10

Different kinds of exotropia?

Answer 10

Intermittent

Constant

Question 11

What are causes of paralytic strabismus?

Answer 11

3,4,6 nerve palsies

Question 12

True strabismus can be associated with what serious pathology?

Answer 12

Intraocular

Intracranial

Question 13

What is a warning sign in a baby for eyes?

Answer 13

Constant exotropia

• often associated with neurological problems
• often poor vision in 1 eye

Question 14

How does paralytic strabismus present?

Answer 14

Student onset

Diplopia

Question 15

Aetiology of paralytic strabismus?

Answer 15

-Congenital
-acquired
Viral
Trauma
Increased ICP

Question 16

What is an eye disorder than can cause head tilt?

Answer 16

4th nerve palsy

Question 17

3rd nerve palsy in kids?

Answer 17

Pstosis, eye drifts out

Rare
Can be congenital - can be viral: very rare
Likely tumour, refer and MRI

Question 18

Paralytic strabisbus key points for DDx and Ix?

Answer 18

Intracranial disease

MRI/MRA

Question 19

What is Duane syndrome

Answer 19

Abnormal innervation of lateral rectus

Question 20

What is Brown’s syndrome?

Answer 20

Superior oblique doesn’t pass through trochlea freely

Question 21

Strabismus can be associated with that intraocular pathology?

Answer 21

Retinoblastoma
Cataract
Toxoplasmosis

Question 22

What is the gold standard for strabismus?

Answer 22

Cover/uncover test
Ocular movements

Needs to fixate on something, then cover the good eye, usually the affected eye will take up fixation, then when you uncover the bad eye will turn out or in again

Question 23

What is the cover test for?

Answer 23

Intermittent exotropia

Question 24

Ophthalmoscope useful for?

Answer 24

Red reflex

Optic disc/retina

Question 25

Risk factors for strabismus

Answer 25

``` Family Hx Low birthweight Drug/alcohol Cataract/retinoblastoma Neurological Craniofacial ```

Question 26

When to refer to ophthalmologist?

Answer 26

``` Constant strabismus Sudden onset Restricted movement Unequal red reflex Underlying eye pathology Intracranial pathology ```

Question 27

When is the sensitive period for amblyopia?

Answer 27

Birth to 8 years

Question 28

Types of amblyopia?

Answer 28

Unilateral: form deprivation, strabismus | Bilateral

Question 29

3 aetiology of amblyopia?

Answer 29

Strabismus Refractive Deprivational: ptosis/cataract

Question 30

Management of amblyopia?

Answer 30

Early diagnosis | Age 0-8

Question 31

Management of amblyopia?

Answer 31

Correct refractive Correct cataract/ptosis Occlude better eye

Question 32

Patching one eye how long?

Answer 32

2 hours in mild moderate 4 hours a day for severe Can patch an 8 year old Must have Compliance with patching

Question 33

Do you grow out of strabismus?

Answer 33

Nope