Flashcards in Ophthamology: pediatric ocular disorders Deck (17):
Two biggest culprits in bacterial neonatal conjuncivits.
1. Neisseria g.
2. Chlamydia t.
What is palpebral conjunctiva vs. bulbar conjunctiva?
Palpebral - inner lining of the eyelids and around the eye
Bulbar - layer on top of the sclera and cornea
How can you diagnose and treat chlamydial conjunctivitis?
Geimsa stain of conjunctival scrapings that will show basophilic inclusion bodies within cells.
Treat with Erythromycin drops and sulfa drugs (for systemic coverage b/c chlamydia can spread to multiple sites in the body)
What is a major concern with Neisseria conjuctivits that is not a big concern with Chlamydial conjunctivitis?
Neisseria secretions can melt the cornea and cause endophthalmitis or other inner eye infections.
Describe the two types of orbital cellulitis.
Pre-Septal Cellulitis: infection or inflammation confined to eyelids and periorbital structures anterior to the orbital septum.
Orbital Cellulitis: active infection or inflammation of the orbital soft tissues posterior to the orbital septum.
What are some clinical findings with orbital cellulitis and which two are more severe findings?
-fever, proptosis, decreased ocular motility, pain with eye movement, chemosis (conjunctival swelling)
Really bad signs:
1. Decreased vision
2. Pupil abnormality
What are the two major culprits of orbital cellulitis?
Staph and Strep
What is the cause of congenital ptosis and the two most common clinical presentations?
Caused by fibrous tissue replacing muscle in development.
Kids present with amblyopia and upward head tilt.
Blockage of the nasolacrimal system leading to an inability to drain tears. Can lead to infection.
What is epiphoria?
Excessive tearing, characteristic of dacryostenosis.
What is the treatment for dacryostenosis?
Antibiotics to control infection
Creiger Maneuver: massage the nasolacrimal sac
Probe and irrigate the nasolacrimal system
Name two conditions associated with most nystagmus pathology but not necessarily associated with congenital nystagmus.
1. Optic nerve hypoplasia
What is one neurologic difference between congenital nystagmus and acquired nystagmus?
Pts. with aquired nystagmus feel like the "world is spinning" but pts. with congenital nystagmus don't perceive this.
What is a treatment for congenital nystagmus.
Pts. will often have a head tilt to improve the nystagmus, so muscle surgical correction of the extra-ocular muscles will fix this.
What is the best treatment for retinoblastoma?
Rb is often fatal at the time of diagnosis. To treat: complete removal of the eye and as much of the optic nerve as possible.
What is the leading cause of childhood blindness?
-need to remove as soon as it is diagnosed to prevent amblyopia or blindness