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III. Vision of Children > Anterior Segment (F) > Flashcards

Anterior Segment (F) Flashcards

1
Q

What are the possible causes of preseptal cellulitis in children?

A 
o Spread of infection
o Hordeolum
o Conjunctivitis
o Ethmoid sinus infection
o Trauma, laceration to skin
o Insect bite
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2
Q

What is the pediatric dosing for augmentin in children?

A
  1. under 12 wks old: 30 mg/kg/day q12h with 125mg/5mL suspension
  2. over or equal to 12 wks old: 25 to 45 mg/kg/day q12h with 200/5 or 400/5 mg/mL suspension
  3. 40kg use adult dose: 875mg PO BID x 10 days
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3
Q

What are the signs of preseptal cellulitis in children?

A 
o Unilateral
o Erythema
o Edema
o Tender/painful
o WARM to the touch
o Ptosis
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4
Q

What are the solutions involved in treatment of bacterial conjunctivitis?

A
  1. polytrim
  2. Gentamycin (>1 mo)
  3. Tobramycin (> 2 mo)
  4. Moxeza (> 4 mo)
  5. Azasite (>1 yr)
  6. Ciloxan, Ocuflox, Quixin, Zymaxid, Vigamox, Besivance (> 1 yr)
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5
Q

What is the type of Juvenile Idiopathic Arthritis with 5 or more joints involved called? 1. What is the percentage of JIA cases? 2. What is the likelihood of uveitis? 3

A
  1. polyarticular
  2. 40%
  3. 5%
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6
Q

Why is screening for JIA involvement so important related to uveitis?

A
  1. 75% of children with severe uveitis experience vision loss (from complications) (Band keratopathy, cataract and secondary glaucoma)
  2. 12% will develop permanent and profound vision loss
  3. This is preventable through early diagnosis and treatment!!
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7
Q

What is the cause of phlyctenulosis? 1. What are the signs and symptoms? 2

A
  1. delayed hypersensitivity rxn to bacterial, fungal, or parasitic antigens or TB
  2. red, watery, painful, photophobic eye, Raised white/yellow nodule, Pannus
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8
Q

What are the corneal signs of Reis-Bucklers’ Dystrophy?

A 
o Fine, reticular formation at Bowman’s
o Most dense centrally
o Irregular epithelium
o Loss of corneal sensation
o Corneal erosions (RCE)
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9
Q

What is the management of dacryocystitis?

A
  1. Oral antibiotics, same as with preseptal cellulitis (Augmentin)
  2. If causing concurrent conjunctivitis: Polytrim
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10
Q

What are benign tumors of endothelium and anastomosing, blood-filled channels? 1. What is the epidemiology? 2. When do they reach maximum size? 3

A
  1. hemangioma
  2. females, caucasians
  3. 12 to 18 months
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11
Q

What is the type of hemangioma that is red and superficial? 1. Type that is purple and deeper? 2

A
  1. capillary

2. cavernous

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12
Q

What are the ointments involved in treatment of bacterial conjunctivitis?

A
  1. Erythromycin (birth)
  2. Gentamycin (> 1 mo)
  3. Tobramycin (> 2 mo)
  4. Ciloxan (>1 yr)
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13
Q

What is the treatment for preseptal cellulitis in children?

A
  1. augmentin
  2. cefuroxime
  3. azithromycin if PCN allergy
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14
Q

What are the signs and symptoms of bacterial conjunctivitis in children?

A
  1. Redness
  2. Crusting of eyelids
  3. Goopy discharge
  4. Swollen eyelids*
  5. Begins unilateral and turns bilateral in 24-48 hours
  6. Conj injection
  7. Mucopurulent or purulent discharge
  8. Papillary reaction
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15
Q

What are the signs and symptoms of congenital glaucoma?

A 
o Epiphora
o Photophobia
o Blepharospasm
o Irritability
o Buphthalmos (K diam > 12)
o Corneal edema
o Haab’s striae
o Elevated IOP (>25-30mmHg)
o Glaucomatous ON atrophy
o Increased axial length
o Myopia (often aniso)
o Reduced acuity
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16
Q

When does Reis-Bucklers’ Dystrophy present? 1. What is the prognosis? 2

A
  1. 1st decade

2. visually devastating

17
Q

What is the ocular management of a congenital cataract?

A
  1. surgically removed (6wks old if unilateral, 10 if bilateral)
  2. Contact lenses
  3. Glasses with bifocal!!
  4. Amblyopia treatment
18
Q

What is the management for a hemangioma?

A
  1. Monitor for involution (90% involute by age 9)
  2. Steroid injection
  3. Laser
  4. Surgical excision
19
Q

When does Posterior Polymorphous Dystrophy present? 1. What is the prognosis? 2

A
  1. early childhood

2. does not affect vision

20
Q

What is the extra fold of horizontal skin that stretches across the anterior lid margin and the lashes become vertically misdirected called? 1. What is the treatment? 2

A
  1. epiblepharon

2. Monitoring for spontaneous resolution with age and maybe surgery

21
Q

What are the possible causes of red eye in children?

A
  • Conjunctivitis
  • Bacterial
  • Viral
  • Vernal
  • Allergic
  • Abrasion
  • Erosion
  • Phylctenulosis
22
Q

What are the ocular sequelae of a congenital cataract?

A

o Aphakic glaucoma
o Amblyopia
o Nystagmus
o Strabismus

23
Q

What is the cause of nasolacimal duct obstruction?

A

failure to complete nasolacrimal duct patency

24
Q

What is the type of Juvenile Idiopathic Arthritis with 4 or less joints involved called? 1. What is the percentage of JIA cases? 2. What is the likelihood of uveitis? 3

A
  1. Pauciarticular
  2. 50%
  3. 20%
25
Q

What are the signs of viral conjunctivitis?

A 
o Pink, hyperemic conj
o Watery discharge
o Follicular reaction
o (+) PAN
o Edematous lids
26
Q

What is the epidemiology and timing of congenital glaucoma? 1. What is the treatment? 2

A
  1. more male than female and 80% diagnosed by age 1

2. refer for surgery

27
Q

What is the type of Juvenile Idiopathic Arthritis with systemic involvement called? 1. What is the percentage of JIA cases? 2. What is the likelihood of uveitis? 3

A
  1. systemic onset
  2. 10%
  3. no uveitis
28
Q

What is the treatment for viral conjunctivitis? 1. When can the child go back to school? 2

A
  1. warm/cool compresses

2. after eye stops watering (3 to 7 days)

29
Q

How long are children contagious following bacterial conjunctivitis?

A

for 24 after taking medication

30
Q

What are the signs of dacryocystitis?

A

o Erythema
o Edema of lower lid over lacrimal sac and canalicula
o Tearing
o Regurgitation of purulent material on palpation of lacrimal sac

31
Q

What is an eye infection transmitted during vaginal birth called? 1. What is the prophylactic treatment given? 2

A
  1. ophthalmia neonatorum

2. erythromycin and silver nitrate

32
Q

What is the critical sign of viral conjunctivitis? 1. Allergic? 2. Vernal? 3 Microbial? 4

A
  1. follicles
  2. itch and watery discharge
  3. itch and ropy discharge
  4. purulent discharge
33
Q

What is the management of phlyctenulosis?

A
  1. Treat the staph bleph with lid scrubs, topical/oral Ab

2. Treat the phlyctenule with steroids (pred forte or tobradex)

34
Q

What is the management for nasolacrimal duct obstruction?

A
  1. nasolacrimal massage (5 reps QID) usually takes care of it
  2. antibiotics drops if infection
  3. OMD probing at 6 to 10 months old
35
Q

What are the signs of Posterior Polymorphous Dystrophy?

A

gray haze at the level of Descemet’s

36
Q

What are the things to look for to rule out orbital cellulitis when thinking it is preseptal?

A

proptosis, EOM restrictions, reduced acuity, fever

37
Q

What is an acute infection of the diffuse lid tissue anterior to the orbital septum called?

A

preseptal cellulitis

38
Q

What are the most common organisms involved in bacterial conjunctivitis in children?

A
  1. Haemophilus influenza (gram neg)

2. Streptococcus pneumoniae (gram pos)

III. Vision of Children (19 decks)

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