Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Ophthalmology > Paediatric Ophthalmology > Flashcards

Paediatric Ophthalmology Flashcards

1
Q

Visual acuity testing in newborn - types and their general process

A

Fix and follow
Spinning baby test
Preferential looking
Visual evoked potentials

Pre-verbal so look at eye movements

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Visual acuity testing in newborns - what is fix and follow test?

A

Use pen torch / silent toy
Move slowly from left to right (immature eye movements)
See if child fixes and follows target
Record as ‘fixes and follows’

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Visual acuity in newborns - what causes child not to follow in fix and follow test?

A

Can’t see
Not interested
Drowsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Visual acuity in newborns - what is spinning baby test?

A

Spin child and observe nystagmus
There will be nystagmus in opposite direction to rotation if child can see
There will be post rotational nystagmus after stopping spinning
If nystagmus persists - severely visually impaired

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Visual acuity in newborns - what is preferential looking

A

Cards with different sized grating patterns on one side and plain on other side
Child will look at grating side of card if normal vision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Visual acuity in newborns - what is visual evoked potentials

A

Electrodes places on child’s head

Record signals when child sees pattern on screen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Visual acuity in infants (0-3) - what type of visual acuity test is used?

A

Cardiff Cards
Cards with line drawings of familiar objects, on upper or lower half of card and with different line thicknesses
Show cards quickly at 1m + observe vertical eye movements

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Visual acuity in toddlers (1.5-4) - what type of visual acuity test is used?

A

Kay picture tests
Book of cards with line drawings
Child can name or match using matching cards
Single - one drawing on each card
Crowded - four drawings; better sensitivity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Visual acuity in children (4-5) - what type of visual acuity test is used?

A

Keeler crowded LogMAR test
Book with each page containing four letters
Child names letters or uses matching card

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Strabismus - what is strabismus?

A

Malalignment of the two eyes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is heterophoria

A

Latent strabismus
Malalignment only present on dissociation with cover-uncover test
Both eyes look straight but deviate on dissociation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is heterotropia

A

Manifest strabismus
Malalignment constantly present
One eye not directed towards fixation point

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is concomitant strabismus

A

Deviation remains same in all directions of gaze

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is incomitant strabismus

A

Deviation changes with direction of gaze

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is amblyopia

A

‘Lazy eye’
Vision developmental disorder where one eye fails to achieve normal visual acuity
Due to insufficient use of eye during visual development so the brain suppresses image from the eye, disrupting visual development in that eye

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is pathophysiology of concomitant strabismus

A

Failure for binocular single vision to develop
Due to disruption in vision in one eye

Risk factors: hypermetropia, developmental abnormalities, family hx of trabismus or refractive error

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is binocular single vision

A

Use of both eyes together to achieve binocular depth perception

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are causes of concomitant strabisums

A

Reduced vision in one eye:
Retinoblastoma
Cataracts
Anisometropia (different refraction in two eyes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are causes of incomitant strabismus

A

Congenital: CN palsies
Acquired: secondary CN palsies, thyroid eye disease, orbital floor fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is pathophysiology of incomitant strabismus

A

Angle of deviation changes with direction of gaze
Acquired incomitant strabismus causes diplopia
Child may have compensatory head tilt to minimise diplopia
Young child may suppress second image and develop amblyopia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the role of orthoptists in management of strabismus

A 
Assess visual acuity
Measure strabismus
Assess eye movements
Assess binocular vision (inc stereopsis)
Monitor amblyopia therapy with patching
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the tests for strabismus

A

Cover-uncover test: detects presence of strabismus, cover fixating eye and see if other eye moves to take up fixation
Alternate cover test: detect latent strabismus, rapidly cover each eye and observe movement of eye to take up fixation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the management of strabismus in children

A

Correct refraction - glasses
Amblyopia therapy - patch
Surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How do you correct refractive error in strabismus

A

In esotropia with high hypermetropia

Glasses - correct strabismus and improve visual acuity, surgery may not be needed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

How do you treat amlyopia

A

Patch on good eye worn for several hours a day
Encourages amblyopic eye to develop vision
Unsuccessful after 7yo

26
Q

What is surgical management of strabismus

A

In esotropia:
recess medial rectus
resect lateral rectus

27
Q

How do you manage strabismus in adults

A

Treat underlying cause
Prism incorprated into glasses - joins diplopia
Strabismus surgery - if BSV not restored once EOM recover

28
Q

Neonates - what is leukocoria

A

White pupillary reflex on opthalmoscopy

Indicates severe ocular pathology and is amblyogenic

29
Q

What are the causes of leukocoria

A 
Retinoblastoma
Coloboma
Congenital
Retinopathy of prematurity
Non-accidental injury
30
Q

What is retinoblastoma

A

Malignant tumour of retina - most common intraocular tumour of childhood
Most sinister cause of leukocoria

31
Q

What are features of congenital cataracts

A 
Leukocoria
Concomitant Strabismus
Amblyopia 
Nystagmus
Can be bilateral - visually inattentive
32
Q

What are causes of congenital cataracts

A

Idiopathic
Familial autosomal dominant
Galactosaemia
Rubella infection

33
Q

How do you manage congenital cataracts

A

Urgent referral
Cataract surgery
Amblyopia therapy

34
Q

What is coloboma

A

Hole in any structure of the eye, due to failure for choroidal fissure to fuse during embryological development

35
Q

What are features of coloboma

A

Choroido-retinal coloboma, optic disc coloboma: leukocoria, severe amblyopia
Iris coloboma: misshaped pupils, posterior eye normal, normal visual acuity

36
Q

What is retinopathy of prematurity (ROP)

A

Incomplete retinal vascularisation causes hypoxia and stimulates neovascularisation
New vessels leak and cause scarring

37
Q

Why do you get leukocoria in ROP

A

It occurs only in late disease due to tractional retinal detachment

38
Q

What is the management for ROP

A

Ablation of avascular retina

Laser - reduce VEGF production

39
Q

Sight threatening conditions of neonates - What is Ophthalmia neonatorum? What is the management?

A

Purulent conjunctivitis of newborn within few days of birth
It is a notifiable disease
Organisms: Neisseria gonorrhoea (acute), Chlamydia trachomatis (subacute)

Systemic + topical antibiotic treatment
Referral of parents to STD clinic

40
Q

Sight threatening conditions in neonates - What is buphthalmos

A

Congential glaucoma

Can cause defective vision or blindness

41
Q

What are features of buphthalmos

A

Large, watering photophobic eyes
corneal clouding
raised intraocular pressure

42
Q

Sight threatening conditions in neonates - what is anopthalmos? what is micropthalmos?

A

Anopthalmos - absence of eye

Microphthalmos - small remnant of eye

43
Q

What is the management for Anophthalmos/microphthalmos?

A

Promote growth of bony orbit
Expand soft tissues of orbit
Ocular prosthesis

44
Q

Sight threatening conditions in neonates - what is a differential for buphthalmos?

A

Congenital Nasolacrimal duct obstruction - watery eyes in neonates but without large eye

45
Q

What is congenital nasolacrimal duct obstruction

A

Common condition where there is a delay in opening of nasolacrimal duct at inferior meatus

46
Q

What is the management for congenital NLDO

A

Reassurance - 90% resolves in 1 yr
Massage over lacrimal sac at medial canthus
If mucocoele at medial canthus - dacryocystorhinostomy
Persistant after 1 yr - syringe and probing under GA

47
Q

Common paediatric conditions - what are common eyelid lumps

A

Capillary haemangioma
Stye
Chalazion
Molluscum contagiosum

48
Q

What is capillary haemangioma

A

Benign swelling of capillaries at superonasal orbit or eyelid
Occurs shortly after birth and grows in size for 6 months
Can lead to mechanical ptosis and amblyopia if ptosis covers visual axis or weight causes astigmatism

49
Q

What is molluscum contagiosum

A

Pearly umbilicated itchy nodules on hands, face, trunk and around eyes
Caused by viral infection
Leads to follicular conjunctivits if at lid margin

50
Q

What is limbal dermoid

A

Benign congenital tumour at limbus

Associated with Goldenhar’s syndrome

51
Q

What is dermoid cyst

A

Smooth round non-tender immobile lump on orbital rim

52
Q

What is dermolipoma

A

Benign congenital conjunctival fatty lesion

Lies close to lacrimal ductile openings - risk of dry eyes from ductile damage, caution in excision

53
Q

What are the causes of ptosis in children

A

Congenital - levator muscle myopathy (often unilateral)
Acquired - third nerve palsy
Inflammatory - vernal keratoconjunctivitis

54
Q

What is the management of ptosis in children

A

Surgery
Poor levator function - frontalis suspension
Good levator function - levator resection (anterior or posterior LR)
Lid covers visual axis - urgent frontalis suspension
Slight ptosis - wait surgery until >4yo

55
Q

What are the types of cellulitis that can occur in the orbit

A

Preseptal cellulitis: limited and less severe

Orbital/post-septal cellulitis: medical emergency

56
Q

What is preseptal cellulitis

A

Inflammation of eyelids only

57
Q

What are features of preseptal cellulitis

A

Inflamed lids: swollen, red, tender, warm

White eye, No proptosis, normal eye movements, normal optic nerve function

58
Q

How do you treat pre-septal cellulitis

A

IV antibiotics - in children similar to orbital cellulitis bc high risk of progression due to orbital septum not fully developed

59
Q

What are features of orbital cellulitis

A

Inflamed lids
Proptosis
Reduced eye movements
Optic nerve dysfunction: RAPD, VA, colour vision

60
Q

What is the management for orbital cellulitis

A

Blood culture - Strep pneumoniae, Staph aureus, H influenzae
CT - exclude sinusitis and subperiosteal abscess
IV antibiotics

Ophthalmology (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions