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Binocular Vision > Peads - Anterior Segment - Alistair > Flashcards

Peads - Anterior Segment - Alistair Flashcards

(53 cards)

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1
Q

what is a coloboma?

A

failure of fetal fissure to close (at around 4-5 weeks)

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2
Q

What anterior segment developmental anomalies are there?

A
  1. Coloboma
  2. Albinism
  3. Aniridia
  4. Glaucoma
  5. Anterior seg dysgenesis

Many of these are associated with glaucoma.

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3
Q

What are examples of anterior dysgenesis?

A
  1. Posterior embryotoxon
  2. Axenfeld-rieger syndrome
  3. Sclerocornea
  4. Peters anomaly : corneal opacity and sticks to the iris
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4
Q

What defect causes Rieger’s anomaly?

A

Defect of the neural crest

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5
Q

a child with Reiger’s is at a high risk of what disease?

A

glaucoma

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6
Q

What are the signs of Rieger’s anomaly?

A
  1. Facial formation problems
  2. Iris abnormalities - strand of iris stuck to cornea + posterior embryotoxon, iris stroma hypoplasia (multiple pupils)
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7
Q

What are signs of peters anomaly?

A

Strands of the iris which will stick to corneal opacity (cataract)

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8
Q

How do we measure IOP in children?

A

iCare.

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9
Q

What is a albinism neuroectodermal defect?

A

disorder of the neuroectoderm
The two layers behind the iris.

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10
Q

what is the colour of the iris in albinism?

A

any colour- translucent

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11
Q

Where does the colour of the iris come from?

A

iris stroma
This is why in Horner’s syndrome you get heterochromia as the pigment cells have been effected.

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12
Q

What other signs do albinism px have?

A
  1. Fovea hypoplasia
  2. Strabismus
  3. complete crossing of fibres at the chiasm (decussation)
  4. Nystagmus
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13
Q

What is aniridia and how does it come about?

A

complete or partial loss of iris
Non genetic : Signs of kidney tumour !!
Genetic : dominant gene

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14
Q

What are px with aniridia risk of? (3)

A
  1. Glaucoma (50%)
  2. Ectopia lentis (lens is displaced downwards)
  3. Keratopathy : superficial neovas (progressive)
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15
Q

What are the consequences of anterior segment development anomalies?

A
  1. Vision
  2. Glaucoma
  3. Cataract
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16
Q

What are the non specific consequences of reduced vision?

A

strab and nystagmus

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17
Q

Why may the cornea or the eyeball be a small size?

A
  1. Due to maldevelopment
  2. Shrinkage following an infection or trauma
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18
Q

What might the cornea or the eyeball be big size?

A
  1. Maldevelopment
  2. Glaucoma (primary or secondary type)
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19
Q

what is the normal cornea diameter??

A

11.5 (+ or - 0.5mm)

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20
Q

What cause light sensitivity?

A
  • Pigmentation : being blonde / albinism
  • Anterior segment disorders
  • Retinal conditions (achromatopsia and retinitis pigmentosa)
  • CNS : meningitis and migraine
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21
Q

why do anterior segment disorders cause photosensitivity in a child?

A

light scatter

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22
Q

What is photosensitivity a first sign for?

23
Q

What is buphthalmos?

Study These Flashcards
A

This is when the eyeball is bigger than normal, can be caused by glaucoma

24
Q

What are the two classifications of glaucoma?

Study These Flashcards
A

Primary
Secondary

25
What causes primary glaucoma?
1. Infantile / congenital 2. Juvenile
26
What causes secondary glaucoma?
1. Anterior segment dysgenesis 2. Ocular disease and its treatment 3. Inflammatory causes such as uveitis 4. Chromosomal disorders such as downs syndrome 5. Other : there is loads
27
What are the signs of infantile / congenital glaucoma?
There are breaks in the descement's membrane due to forceps injury's
28
Is infantile glaucoma bilateral or unilateral?
It can be both
29
What are the symptoms for infantile glaucoma?
photophobia
30
signs of infantile primary glaucoma?
1. Red eye 2. Enlarged cornea 3. Corneal clouding CAN BE V DIFFICULT TO SPOT
31
How do we treat infantile primary glaucoma?
* Surgically for the glaucoma * treat refractive error * Amblyopia therapy
32
ocular associations of cataract? (specific)
anterior segment dysgenesis
33
ocular associations of cataract? (non-specific)
microphthalmos nystagmus/strabismus --> due to low vision
34
What causes cataract in paeds?
sporadic or inherited
35
What are systemic associations on cataract?
1. Intrauterine infections ; toxoplasmosis / RUBELLA 2. Metabolic : DIABETES and galactosemia 3. Dermatological : atopy. SKIN PROBLEMS 4. Drugs / treatment : steroids 5. Chromosomal : downs 6. Renal 7. Musculoskeletal 8. CNS and hearing 9. Birthweight
36
Why do you get cataract with atopy(dermatological diseases)?
The intraocular lens is ectodermal (LIKE the skin)
37
What is amblyopia caused by?
Obstacle to the visual development. Especially one eye
38
Does cyls causes amblyopia in babies? why/why not?
NO - they are going through emmetropisation
39
How do we manage unilateral cataract?
1. Operate before 9-10 weeks for function 2. Patching post operative 3. Optical correction post operative
40
why are IOLs in infancy a controversial opinion?
risk of glaucoma is v high
41
How do we manage bilateral cat?
1. Do surgery when opacity is interfering with vision 2. post op refractive error correction (CLs, glasses)
42
What complications can occur due to bilateral surgery?
* Amblyopia * Glaucoma * Capsular opacification * Infections
43
What is ectopia lentis?
This is a lens that is not the correct place
44
What are the ocular associations for ectopia lentis?
* Anterior segment dysgensis * glaucoma * surgical trauma
45
What are the systemic assiocations for ectopia lentis?
1. MARFANS syndrome - connective tissue disorder 2. Homocystinuria - cardiac abnormalities 3. Weill-marchesani - short stubby fingers
46
How can we diagnose ectopia lens?
1. unstable refraction 2. Iridodensis (wobbly iris) 3. Stretched zonules (Direction can indicate th aetiology)
47
What is anterior uveitis in childhood associated with?
1. Juvenile arthritis ; px is normally asymptomatic, so they need to be screened 2. Idiopathic 3. Sarcoidosis - inflammatory disease 4. TB 5. Behcet's disease - Blood Vessels inflammatory disease
48
is anterior uveitis in childhood common?
no
49
Why does the pupil margins become irregular?
It is stuck to the lens (posterior synechiae)
50
What is white pupils?
leukocoria
51
leukocoria is indicative of....
Retinoblastoma
52
why do anterior segment disorders cause photosensitivity in a child?
light scatter
53
causes of leukocoria
retinoblastoma coats ROP toxocara + toxoplasmosis AND MORE

Binocular Vision (30 decks)

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