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Peadiatric ophthalmology in 10 minutes David Kinshuck, Good Hope Hospital

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

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Peadiatric ophthalmology in 10 minutes David Kinshuck, Good Hope Hospital

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  1. 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

  2. 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

  3. www.nyee.edu/images/ar038.jpg Retinopathy of prematurity (2) • vascularisation • Scarring • Laser peripheral retina • Without laser,retinal detachment/blindness; have to check (screen) all appropriate neonates www.nei.nih.gov

  4. Retinopathy of prematurity (3) www.aafp.org/afp/990901ap/907.html

  5. www.occhioallaretina.it/Immagini/leucocoria.JPG 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

  6. Leukocoria (2) http://oftalmologo.bravepages.com/Leucocoria%201.jpg

  7. 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

  8. 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

  9. Examination of neonates (3):ophthalmic neonatorum

  10. arapaho.nsuok.edu/~fulk/ Images/Img0055.JPG Examination of neonates (4) buphthalmos

  11. 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

  12. 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

  13. www.aafp.org/afp/990901ap/907.html 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 Esotropia: convergent Exotropia: divergent

  14. www.aafp.org/afp/990901ap/907.html Squints (2) • Exotropia • See video if online http://www.mrcophth.com/vidoes.html

  15. …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

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