Pediatric Ophthalmology Flashcards
(35 cards)
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?
- pseudoesotrophia
- infantile esotrophia
- accommodative
- non-accommodative/acquired
What are the 3 types of exotrophic strabismus?
- pseudo
- intermittent
- 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?
- glasses
2. surgery for residual deviation
