Nr 602 Exam Study Guide Solutions
Strabismus - ANSWER✔✔-crossed eyes; a defect in In ocular alignment, or
the position of the eyes in relation to each other; It is commonly called lazy
eye. And strabismus, the visual axes are not parallel because the muscles of
the eyes are not coordinated; When one eye is directed straight ahead, the
other deviates
Retinoblastoma - ANSWER✔✔-tumor arising from a developing retinal
cell; intraocular tumor that develops in the retina. Although it is rare, this
malignant retinal tumor is the most common tumor in childhood (some 4%
of cancers in children younger than 15 years of age)
Retinoblastoma clinical findings - ANSWER✔✔-strabismus is the most
common finding
there is a decreased visual acuity uni- or bilateral white pupil (leukocoria),
described often as an intermittent "glow, glint, gleam, or glare" by parents,
is usually seen in low light settings or noted in photographs taken with a
flash i.e. (cat's eye reflex); other symptoms include an abnormal red reflex,
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,nystagmus, glaucoma, orbital Cellulitis and photophobia, hyphema,
hypopyon (plus an anterior Chamber of eye); Signs of global rupture or
also possible
leukocoria - ANSWER✔✔-condition of white pupil
Bulbar or palpebral conjunctival infection - ANSWER✔✔-a common
presentation, which can be unilateral or bilateral
conjunctival infection differential diagnosis - ANSWER✔✔-allergy,
conjunctivitis, infection, foreign body, chemical exposure, or systemic
inflammatory disease, irritation of the conjunctiva or cornea, and
congenital glaucoma.
conjunctival infection drainage - ANSWER✔✔-watery discharge;
purulent/mucoid discharge
watery discharge - ANSWER✔✔-can occur with allergies, nasolacrimal
obstruction, foreign bodies, viral infection, and iritis.
Purulent or mucoid discharge - ANSWER✔✔-noted with chronic
dacrocystitis or nasolacrimal obstruction.
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,Dacrocystitis - ANSWER✔✔-inflammation of the tear sac
Advanced allergic conjunctivitis - ANSWER✔✔-have some mucoid
production.
To differentiate, microscopic investigation of discharge may lead to other
clues
photophobia - ANSWER✔✔-sensitivity to light; symptom common of
trauma and in infants with glaucoma or retinal disease. Other non-eye
related causes of this include migraines and meningitis.
leukocoria - ANSWER✔✔-serious finding and demands immediate referral
to the pediatric ophthalmologist. white pupil
causes of leukocoria - ANSWER✔✔-retinal detachment, cataract, retinal
dysplasia, retinopathy of prematurity, and in newborns retinoblastoma All
newborns should have a fundoscopic examination within 24 hours of birth
and yearly on physical examinations.
ophthalmia neonatorum - ANSWER✔✔-conjunctivitis of the newborn.
Etiology: chlamydia, staphylococcus aureus, gonorrhea, HSV (silver nitrate
reaction occurs on 10% of neontes). Clinical findings: erythema, chemosis,
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, purulent exudate with gonorrhea. Clear to mucoid exudate with
chlamydia. Diagnosis through gram stain to rule out gonorrhea and
chlamydia.
ophthalmia neonatorum management - ANSWER✔✔-saline irrigation to
the eyes until exudate is gone; follow with erythromycin ointment. N.
gonorrohea: ceftriaxone IM or IV. Chlamydia:
ceftriaxone IM or IV. Chlamydia: - ANSWER✔✔-ophthalmia neonatorum
management x/t N. gonorrohea:
Erythromycin or possibly azithromycin PO - ANSWER✔✔-ophthalmia
neonatorum management d/t Chlamydia:
Antivirals IV or PO - ANSWER✔✔-Ophthalmia neonatorum management
d/t HSV
Bacterial conjunctivitis - ANSWER✔✔-pinkeye; very contagious
Bacterial conjunctivitis - ANSWER✔✔-in neonates 5-14 days, preschoolers,
sexually active teens: Haemphilus influenza (Most common organism),
streptococcus pneumoniae, S. Aureus, N. gonorrohea. Erythema, chemosis,
itching, burning, mucopurulent exudate, matter in the eyelashes - worse in
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