Visual acuity facts: - ANSWERNewborns can only focus 8-12 inches
Poor control of eye muscles - crossed eye looks
20/20 vision may not be until 6 years old
Fundoscopic exam within 24 hrs of birth
First Vision Screening - ANSWERBetween age 3-5 yo
Refer if: less than 4 out of 6 correct of 20/20 l...
Visual acuity facts: - ANSWERNewborns can only focus 8-12 inches
Poor control of eye muscles - crossed eye looks
20/20 vision may not be until 6 years old
Fundoscopic exam within 24 hrs of birth
First Vision Screening - ANSWERBetween age 3-5 yo
Refer if: less than 4 out of 6 correct of 20/20 line
two-line difference between eyes
Any eye mov't, asymmetry of pupil color, size or brightness
any dark or white spots, absent reflex>=6yo
Eye Symptoms - ANSWERBulbar or palpebral conjunctival injection - uni or bilateral
To differentiate bet watery and mucoid discharge diagnosis - perform microscopic investigation.
Photophobia - ANSWERCommon with trauma or infants with glaucoma or retinal disease.
May also be from migraine or meningitis.
White Pupil (Leukocoria) - ANSWERRefer to Pediatric Optha
Causes: - retinal detachment, cataract, retinal dysplasia, retinopathy of prematurity, and newborns
retinoblastoma
Common pediatric condition need glasses - ANSWERDown syndrome
Marfan syndrome
Ehlers syndrome
Eye Trauma is a Medical Emergency - ANSWERScratch or laceration to the cornea, blunt trauma to
the orbit, hyphema (blood collection), chemical or heat-related burns
Goal: preservation of vision and minimization of pain
Severe pain with restricted eye movement - RED FLAG!
What is a chalazion? - ANSWERBenign, chronic lipogranulomatous inflammation of the eyelid
Firm painless lump on upper eyelid
Blockage of the meibomian gland (oil gland)
What puts a person at risk for a chalazion? - ANSWERHordeolum or any condition which may impede
flow through the meibomian gland.
,Mite species that reside in lash follicles.
What are physical exam findings for a chalazion? - ANSWERPainless
Does NOT involve lashes (Above lashes)
Lid edema or palpable mass
Red or grey mass on the inner aspect of the lid margin
Prevention : Good eye hygiene
What is treatment for chalazion? - ANSWERWarm, moist compresses 3x a day
Antibiotic eyedrops if secondarily infected: sulfacetamide or erythromycin
Surgery
Follow-up : In 2-4 weeks
If still present after 6wks, follow up w/ophthalmologist
Hordeolum (Stye) - ANSWER- Cause: infection
- Symptoms: tender, painful, swelling
- Location: found at or near an eyelash follicle
- Treatment: warm compress, spontaneous drainage
What is blepharitis? - ANSWERInflammation/infection of the lid margins (chronic problem)
What are the two types of blepharitis? - ANSWERSeborrheic (non-ulcerative)- due to irritants
Ulcerative - infection of staph or strep
What can cause seborrheic blepharitis? - ANSWERIrritants (smoke, makeup, chemicals)
What are s/s of seborrheic blepharitis? - ANSWERChronic inflammation of eyelid
Erythema
Greasy scaling of anterior eyelid
Loss of eyelashes
Seborrheic dermatitis of eyebrows/scalp
What are s/s of ulcerative blepharitis? - ANSWERItching
Tearing
Recurrent styes
Chalazia
Photophobia
Small ulceration at eyelid margin
Broken/absent eyelashes
, Most frequent complaint: ongoing eye irritation, conjunctiva redness
What is the treatment for blepharitis? - ANSWERClean w/baby shampoo 2-4 times/day
Warm compresses
Lid massage (right after warm massage)
How are infected eyelids with blepharitis treated? - ANSWERAntistaph abx: bacitracin, erythromycin
0.05% x1 wk and quinolone ointments
How is blepharitis infection resistant to topical abx treated? - ANSWERTetracycline 250mg PO x4
Doxy 100mg PO x2
What is conjunctivitis? - ANSWERInflammation or irritation of conjunctiva
What is the most common cause of conjunctivitis in peds? - ANSWERBacteria- 5-7 days (self-limiting)
Symptoms: sensation of foreign body in the eye
Redness, yellow green purulent discharge, crusted and matted eyelids in the morning
Treatments: (eyedrops) polytrim, erythromycin, tobramycin, or cipro
Most common organism cause is H. influenza
What are some common causes of bacterial conjunctivitis? - ANSWERContact lenses
Rubbing eyes
Trauma
What is treatment for viral conjunctivitis? - ANSWERAntihistamine
Decongestant
Viral conjunctivitis last 7-14 days (self-limiting)
Conjunctivitis: when to refer to Ophtha? - ANSWERIf caused by herpes
hemorrhagic conjunctivitis or ulceration is present.
What is the biggest concern with gonococcal conjunctivitis? - ANSWERCan cause blindness
S/S Marked conjunctival edema, Severe itching, Tearing
Sneezing
Tx:Topical antihistamine or topical steroids
Improves in 2-3 days
Conjunctivitis never accompanies _______________ ________________. - ANSWERVision changes
When can a pt return to work/school with conjunctivitis? - ANSWER24h after topical abx
Dacryocystitis - ANSWERo an inflammation of the involved nasolacrimal duct
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