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Binocular Vision > Peads - External eye - Alistair > Flashcards

Peads - External eye - Alistair Flashcards

(52 cards)

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1
Q

What does the external Eye cover?

A
  1. Eyelids
  2. Conjunctiva
  3. Cornea
  4. Orbit
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2
Q

What age is a child?

A

0-16

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3
Q

How do we know is the px has Microphthalmia or exophthalmos?

A

Measure the cornea size. The normal size is around 11.5mm

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4
Q

what should we do when working with children?

A
  1. Talk to the child! do no ignore them
  2. Do not touch children (pedo)
  3. Attitude
  4. Be on the same level as them.
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5
Q

when does the baby have their first eye exam?

A

24-48 hours! This is a general exam and looking for abnormalities

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6
Q

When is the next check?

A

6-8 weeks.

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7
Q

When does the orthoptist check visions?

A

4.5-5 years for a full work up

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8
Q

What happens during the neonatal eye exam? (25-48 hours after birth)

A

1.Look for Redness
2. Size and symmetry of the globe, cornea and pupil
3. Clarity of the cornea and lens
4. Family queries

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9
Q

what does a coloboma of the iris look like?

A
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10
Q

What is ptosis?

A

Dropping of the eyelid

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11
Q

What is epicanthus?

A

Vertical fold of the skin over the innner canthus

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12
Q

What is telecanthus?

A

This is increased distance between the inner canthi

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13
Q

what is hypertelorism?

A

Increase inner and outer canthal distances ; the orbits set wider apart.

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14
Q

How can we classify ptosis?

A
  1. Congenital
  2. Neurological
  3. Myogenic
  4. Mechanical
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15
Q

What to consider with congential ptosis?

A

Is it isolated or due to another problem

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16
Q

What neurological problems causes ptosis?

A
  1. 3rd nerve
  2. Marcus Gunns
  3. Horners
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17
Q

What myogenic problems causes ptosis?

A
  1. Myasthenia G
  2. Progressive external opthalmoplegia
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18
Q

NOTE : what is progressive external opthalmoplegia?

A

slow Loss of function to the EOM/ eye lids

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19
Q

What are the consequences of Ptosis?

A
  1. Vision
  2. Refractive status - can induce astig
  3. Amblyopia
  4. CHP
  5. Cosmesis
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20
Q

What causes congential ptosis?

A

Dystrophy/ dysgenesis of levator palpebrae superioris

Image shows the abnormal lavtaor muscle:

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21
Q

What are some features of congential ptosis?

Study These Flashcards
A
  1. uni or bilateral
  2. Absence skin crease
  3. Lid lag on downgaze
  4. SR weakness often
22
Q

What does absent eyelid crease indicate?

Study These Flashcards
A

Congential Ptosis. Due to abnormal insertion of the levator tendon

23
Q

Reminder :What is marcus gunn ptosis classified as?

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A

Neurological probelm

24
Q

What happens during marcus gunn ptosis?

Study These Flashcards
A

If the child moves their jaw in a particular direction, the eye lid will shoot up. (can be seen by asking the px eat something)
Watch this : 10 second vid:
https://www.youtube.com/shorts/HJiTim6WhLM

25
Why does marcus gun ptosis occour?
Abnormal connection with the 3rd and 5th (trigeminal) cranial nerve
26
what does MG cause?
This will casue bilateral ptosis.
27
What are some features of horners syndrome?
1. Ptosis : less then 2mm (sutble) 2. Heterochromia - only congential 3. Enophthalmos 4. Anhidrosis 5. Lower IOP (subtle)
28
What does ptosis in one eye in 3rd nerve palsy mean?
One muscle is affected in the nucleus or the orbit
29
How can we manage the ptosis?
1. Refer for medical condition 2. Manage RX and amblyopia 3. Manage CHP 4. Surgery : the urgency is governed by the impact on the child
30
what age is the best for ptosis surgery if, not affecting their vision?
4-5 years old for cosmosis, as you get a better long term result with this age
31
What eyelid lumps may present?
1. Inflammatory 2. Stasis 3. Tumour 4. Hamartoma 5. Haemangioma
32
What can cause inflammatory lumps?
1. Meibomian cyst 2. Hordoleum 3. Molluscum contagisum
33
NOTE: what is Molluscum contagisum?
lump casued by virus. Eyelid lesions Self limiting
34
what is Haemangioma?
This is a collection of small blood vessels. Known as a vascular birthmark. Tends to resolve 5-7 years. (However, parents may not be happy with hearing it is self limiting so we can limit the amount of blood going thorugh them using ----> Propanolol)
35
what does a coloboma of the eyelid look like?
36
What is a dermoid?
Associated with coloboma : The tissue that was meant to go on the eyelid, was misplaced and inserted on the eye
37
Why may infants get epiphoria?
Due to blocked nasolacrimal systems.
38
what are the features of blocked nasolacrimal systesms?
1. Epiphoria 2. Discharge 3. But they are not red eyes!
39
How to treat blocked nasolacrimal glands?
1. self limiting 2. Massage the lacimal sac (parents) 3. Consider a syringe / probe under genral anestetics if it does not resolve.
40
What is opthalmia neonatorum?
This is conjunctivitis within the first 4 weeks of birth
41
What causes Ophthalmia neonatorum?
1. Chlamydia Trachomatis : both eyes and starts in 2 weeks time 2. Neisseria gonorrhoea: 4-7 days and corneal penetration 3. Herpes simplex
42
Why can Neisseria gonorrhoea cause blindess?
Corneal penetration microbes
43
what are the symptoms of conjunctivitis?
1. Bilateral 2. redness and discharge 3. itchiness (Not severe pain) 4. vision is not affected
44
What causes conjunctivitis?
1. bacterial or viral 2. Allergic 3. Trauma We treat based upon these
45
what are some tips with red eye in infants?
1. Blocked nasolacrimal ducts do not cause red eye 2. Conjunctivitis is Bilateral 3. Do not forget about congential glaucoma 4. Any lumps ect, think of Tumour of eyelids
46
What is phlyctenular conjunctivtis?
This is an immunological mechanism. Due to staphlycococal lid disease.
47
What is vernal disease?
1.This is an allergic response. 2. Cobble stone appearance : large papillae 3. IgE and IgG found in tears 4. We give steroids
48
Is herpes simplex in babies bilateral or unilateral?
Mostly bilateral.
49
What does herpes simplex cause?
Affects skin and eyes. Dendricit ulcers are uncommon in children
50
What is band shaped keratopathy?
This is when the eye has gone through a shit ton of stuff... recurrent uveitis, glaucoma ect ... and it will cause calcium deposits to form on the cornea
51
What does red eyelid indicate?
It can be a cellulitis, under the eyelid. We should refer as it can casue meningitis
52
NOTE : *he said the details on the slide for cellulits is not important*
he said alot of the things on each slide were not important tbf- Aliya :)

Binocular Vision (30 decks)

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