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Med 2 - Week 41 > Pediatric Ophthalmology > Flashcards

Flashcards in Pediatric Ophthalmology Deck (35)
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When should the red-reflex be checked?

- within the first week of life
- at 2 weeks
- every eye exam following that: 1, 2, 3, 6... months


When should the corneal reflex be added to the eye exam?

At 1 month


When should the cover/uncover test be added to the eye exam?

6 months


When should visual acuity testing be done in children

starting at around 2-3 years


What can an abnormal red reflex be a sign of?

can indicate a pre-cancerous lesion on the retina
- can lead to retinoblastoma if not treated


What can the cover/uncover test tell you?

if there is a tropia = aka a manifested strabismus

covering the "good" eye will cause the "bad" eye to redirect itself


What is the difference between a tropia and a phoria?

tropia = manifested strabismus or misalignment of the eye

phoria = latent deviation of the eye that is manifested when the "good" eye is covered and binocular vision is broken


What are the main "types" of tropias and phorias?

either eso = inverted or exo = everted with regards to the midline vision

or hyper = up, and hypo = down with regards to horizontal plane of vision


Besides the cover/uncover test, what 3 tests can be used to identify strabismus?

Hirshberg = looking for the corneal light reflex

Bruckner = looking for asymmetry in the red reflex

Krimsky = essentially the Hirschberg test, but with prisms employed to quantitate deviation of ocular misalignment by determining how much prism is required to centre the reflex


What is normal for a child's vision at 1 month?

Appreciating light


What is normal for a child's vision at 1-2 months?

- making eye contact
- following a slow target


What is normal for a child's vision at 3 months ?

demonstrates binocular coordination


What is normal for a child's vision at 6 months?

reaches accurately for toys


What is normal for a child's vision at 2 years?

Can match pictures


What is normal for a child's vision at 3 years?

Can match letters


What is normal for a child's vision at 5 years?

Determined by the Snellen chart


What are the 3 types of refractive errors?

myopia: "near sightedness"

Hyperopia = "far sightedness"

Astigmatism = uneven focussing of light on the retina


What are 2 ways to slow myopia progression in children?

- outdoor play
- atropine drops


What are the 4 types of esotrophic strabismus?

1. pseudoesotrophia
2. infantile esotrophia
3. accommodative
4. non-accommodative/acquired


What are the 3 types of exotrophic strabismus?

1. pseudo
2. intermittent
3. convergence insufficiency


What are 4 features of infantile esotropia? when does it present?

Presents before 6 months
- cross fixation
- nystagmus
- larger deviation
- can alternate


What is the treatment for infantile esotropia?

early surgery


When does accommodative esotropia present? What are 2 features?

Presents between 6 months to 7 years. average is 2.5 years
- intermittent at initial presentation
- have hyperopic refraction sometimes due to cycloplegia = paralysis of the ciliary muscle of the eye


What are 2 treatment options for accommodative esotropia?

1. glasses
2. surgery for residual deviation


When does intermittent exotropia present? Wheat are some features on history and exam?

Presents before 5 years old
- worse with fatigue, distance vision
- will close eyes in the sun


What are 3 treatment options of intermittent exotropia?

1. glasses
2. surgery
3. patching


What are 4 possible causes of vertical strabismus ?

1. 4th nerve paresis
2. Monocular elevation deficiency
3. Brown syndrome
4. "Trapdoor" fracture in the floor of the orbit


What is the most common cause of monocular visual impairment from childhood to middle age?

Amblyopia = aka lazy eyes


What % of the population are affected by amblyopia?



What are 3 causes of amblyopia?

1. strabismus
2. anisometropia, ametropia
3. visual deprivation