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Paediatrics Flashcards

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1
Q

What are the traditional tests used to assess a child’s VA?

A

Snellen/Logmar
Jay’s
Cardiff cards (forced choice)

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2
Q

What VA is considered to be normal?

A

6/9.5

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3
Q

At what astigmatic power is considered to be normal for a child?

A

20% have ~1-2D

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4
Q

What is Amblyopia?

A

Disruption in the visual development

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5
Q

What key feature is found if a px presented with amblyopia?

A

> 2 lines difference b/w 2 eyes

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6
Q

What are the 3 main causes of amblyopia?

A
  1. Refractive
  2. Strabismic
  3. Structural
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7
Q

At what VA would an amblyopic be presenting with?

A

<6/12 AFTER refraction

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8
Q

When is it most appropriate to refer an amblyopia child?

A

<7yrs

>2 lines difference AFTER refraction

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9
Q

What are the possible management options for amblyopia?

A

Occlusion
Optical penalisation
Atropine
(Successful for <7yrs)

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10
Q

When do you NOT prescribe an rx to a child?

A

If Asxs and Vision better than 6/9.5

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11
Q

When is it indicted to prescribe an rx to a child?

A

Symptomatic
Vision
Strabismus

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12
Q

When is a cycloplegic refraction performed?

A

<6yrs
Reduced vision
Squint

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13
Q

What is a strabismus?

A

Misalignment of the 2 eyes

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14
Q

What features are present in an SOT?

A 
Worse looking Near
Hyperopic 
Loss of binocular function 
Cause Ambly
Asxs
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15
Q

What features are present in XOT?

A 
Worse at Far
Mild myopia 
Normal binocular function
Ambly RARE
Sxs: HAs, blinking
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16
Q

When is it essential to refer for SOT and XOT?

A

SOT- Any variable or constant SOT, Patching/surgery maybe required

XOT- Constant, sxs, only sx surgery (most monitored)

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17
Q

Before a squint surgery takes place, what must be done before?

A

Vision sorted 1st!
Full spectacle adaption
Patching…. then surgery!

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18
Q

What is a nystagmus?

A

Wobbly eyes uncontrolled

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19
Q

What are the common causes of nystagmus?

A 
IDIOPATHIC
Albinism 
Achromatopsia
Aniridia 
Lever cong amarausis
Cone dystrophy 
Congenital/idiopathic
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20
Q

What 4 aspects could potentially cause nystagmus?

A

Meds- toxic, alcohol, thiamine
Neurological- MS, tumour CVA
Ocular- sensory, cataracts, trauma
Physiological

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21
Q

What features are assessed in nystagmus?

A 
Amplitude 
Biggest 
Conjugate 
Direction 
AHP
Frequency
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22
Q

Whats features are suspicious in nystagmus?

A 
ACQUIRED 
Vz
Disconjugate 
Oscillopsia 
Hearing loss
Reversal of dev. Milestones 
Ataxia weakness
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23
Q

When is it necessary to refer urgently when presented with a nystagmus?

A

New
Oscillpsia
Vz

If none of these features present- routine referral

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24
Q

What would give rise to Red eyes?

A

Infection
FB
Allergy

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25
What is blepharitis?
Staphylococcal skin flora interferes with oil at lid margin
26
When are the sxs for chronic blepharitis worse?
Worse in the AM
27
What signs maybe present in blepharitis in children?
Chalazion Red eye Crusty lid Dry eye
28
How is blepharitis treated?
Makeup wipes
29
When is blepharitis referred to the HES?
Any corneal changes
30
What conditions are associated with allergy?
Asthma Eczema Ptosis
31
What are the signs and sxs of allergy?
Itchy Lid papillae Sticky AM
32
What advice would you give to reduce an allergy?
Cold compress and OTC antihistamines
33
What are the sxs if the px has a foreign body?
Photophobic Painful Watery
34
What is the difference in viral and bacterial infectious conjunctivitis signs?
Viral- watery, puffy | Bacterial- sticky
35
What are the 3 blinders found in children?
Cataracts Uveaitis HSK
36
What is the cause of cataracts in children?
Idiopathic- congenital
37
What other disease processes occur with cataracts in children?
Chromosomal Infection Metabolic
38
What is the 1st sign of reduced vision?
Uveitis
39
What key aspects do we look out for in uveitis?
Posterior synachiae | Keratitic precipitate
40
What else can uveitis cause?
Cataracts
41
What is uveitis commonly associated with?
JIA- Juvenile idiopathic atheritis
42
How is cataracts managed in children?
Infancy- 6-8/52 old Sxs- surgery indicated Asxs- no surgery indicated
43
What is the criteria for referral to the HES in young children with the blinders?
Causing amblyopia- urgent
44
How is HSK referred?
Urgently HES
45
What are the killer conditions that maybe found in children?
Retinoblastoma Papilloedma Optic disc drusen
46
What conditions maybe normal to see in children?
Bergmeister papilla | Mylinated nerve fibres
47
What is retinoblastoma and what are the potential signs?
``` Rare malignant tumour (fatal) Signs... Leukocoria Strabismus Poor vision ```
48
What is the referral route for a retinoblastoma?
Urgent referral to HES same day
49
What can papilloedema sometimes be confused with?
Drusen
50
What are options dusc drusen made up of?
Buried colloid bodies (lump under disc)
51
What features are included in optic disc drusen?
``` Disc vasc remains visible Elevation confined to OD No exudate Small cupless discs No venous congestion ```
52
What is myelinated nerve fibres?
Fatty content nerve to brain
53
What is ON Coloboma?
A defect in the retina and choroid
54
What aspects would be considered when referring for swollen discs?
Symptoms Associated signs Incidental findings
55
What are the associated signs for swollen discs?
6th NP Color vision loss Disc Haemmorage
56
What sxs would suggest a disc swelling?
HAs Dip Unwell- referred by GP Appointment made by parents for specific reason
57
What should be included in the referral for swollen discs?
``` Dip CV Pupils NV Prev documentation HAs/sickness ```
58
What are the main causes for a child who can't see?
Refractive error Accom problem Undiagnosed ambly No specific cause
59
What is included in an eye exam for children?
Stereoacuity Cyclo refraction Recheck VA after cyclo Tes t @ 3m not 6m
60
What cerebral VI problems would a child be experiencing?
``` Using vision for a long term Copying from board Problems c VF Problems finding way around placs Problems with visual search and noisy places ```
61
Who would need referring in relation to cerebral VI?
Brain injury Probs using vision No tx- solution strategies to help make seeing easier

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