peadiatric ophthalmology in 10 minutes david kinshuck, good hope hospital
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Peadiatric ophthalmology in 10 minutes David Kinshuck, Good Hope Hospital. Retinopathy of Prematurity Leukocoria……… Examining neonates Amblyopia Squint=Strabismus (not covered here in detail…links) Cataracts Nystagmus Anisocoria Nasolacrimal Duct Obstruction Ptosis - PowerPoint PPT PresentationTRANSCRIPT
Peadiatric ophthalmology in 10 minutesDavid Kinshuck, Good Hope Hospital• Retinopathy of Prematurity• Leukocoria………• Examining neonates • Amblyopia• Squint=Strabismus• (not covered here in detail…links)
– Cataracts– Nystagmus– Anisocoria– Nasolacrimal Duct Obstruction– Ptosis– Cloudy Cornea/many other conditions– Infections: conjunctivitis, cellulitis, etc
Retinopathy of prematurity (1)
• in premature babies peripheral retina is not vascularised at birth• Under certain conditions instead of the vascularisation proceeding
normally, there is a growth of new vessels and scarring • 100% oxygen, crucial period 28-36weeks, especially low birth
weight
www.nyee.edu/images/ar038.jpg
Retinopathy of prematurity (2)
• vascularisation
www.nyee.edu/images/ar038.jpg
• Scarring
• Laser peripheral retina
• Without laser,retinal detachment/blindness; have to check (screen) all appropriate neonates
www.nei.nih.gov
Retinopathy of prematurity (3)
www.aafp.org/afp/990901ap/907.html
Leukocoria (1)=white pupil
Have to check red reflex of all neonates & children• Retinoblastoma• congenital cataract • PHPV (persistent hyperplasia of primary vitreous)• Retina detachment (trauma/ retinopathy of
prematurity)• Toxocariasis (nematode infection) from exposure
to puppies• Uveitis, infections, other conditions
www.occhioallaretina.it/Immagini/leucocoria.JPG
http://oftalmologo.bravepages.com/Leucocoria%201.jpg
Leukocoria (2)
Examination of neonates
• Gross abnormality• Red reflex (eg cataract)
• Discharge (gonococcal/chlamydial conjunctivitis)
• Large eye..buphthalmos
http://oftalmologo.bravepages.com/Leucocoria%201.jpg
www.kfunigraz.ac.at
Examination of neonates (2):ophthalmic neonatorum
Discharge in first week of life will be gonococcal or chlamydial conjunctivitis. Gonococcal infection can cause serious corneal damage www.kfunigraz.ac.at
Examination of neonates (3):ophthalmic neonatorum
arapaho.nsuok.edu/~fulk/ Images/Img0055.JPG
Examination of neonates (4) buphthalmos
Amblyopia (1)
• Early childhood is essential for visual maturation….visual cortex has to receive good quality images to develop
• Critical period 6 weeks…….(5y)• Early period most important• If no clear image is received, even if
the problem (eg cataract, squint) is corrected, eye will never see
Amblyopia (2)
• A structurally normal eye that cannot see as well as it should
• Common causes are– Squints– Refractive errors with/without a
squint– cataract
Squints (1)
• Esotropia
• Exotropia
• (vertical)
• Correct refractive error & patch good eye to treat amblyopia
• online (section 12, double vision and pupil, 3rd ‘?’ left)
• Folder similar
www.aafp.org/afp/990901ap/907.html
Exotropia: divergent
Esotropia: convergent
Squints (2)
• Exotropia
• See video if online http://www.mrcophth.com/vidoes.html
www.aafp.org/afp/990901ap/907.html
…briefly (not omitted here)……………….
• Cataracts (danger of amblyopia) online• Nystagmus online (section 12, double vision and pupil)
folder
• Anisocoria online (section 12, double vision and pupil) folder
• Nasolacrimal Duct Obstruction online • Ptosis online (section 12, double vision and pupil) folder
• Cloudy Cornea/many other conditions• Infections: conjunctivitis, cellulitis, etc