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Peds eyes

713 wk 1: common opthalmic disorders

QuestionAnswer
Nasolacrimal duct obstruction Nasolacrimal duct obstruction. 20% of all babies in 1st yr. Tx with massage. Refer @ 9mth for stint/ probe insertion to clear. . Often present at birth/ wk 1-2. 90% resolve.
Congenital infant glaucoma no red reflex/ cloudy
Retinoblastoma NO red reflex unilateral. Black on otoscope exm. Immediate referral. CC - sitting to close to TV or vision impairment. No cat's eye on photo
HSV infection associated with hand foot mouth. Immediate referral
Corneal abrasions/structural abnormalities Dx with florsene & woods lamp. Document by face of clock. Patch or not? controversial- may cause more scratching. Tx with drops q 2hr . refer to optho.
Chlamydia infection common in first 6k of life. All babies given profolactic erythromycin ointment at birth, but this does not eradicate nasopharyngeal colonization.
Allergic conjunctivitis cobble stoning appearance to conjunctiva
Differentials for red watery eyes Allergic conjunctivitis (cobble stoning apperance to conjunctiva), Bacterial conjunctivitis, viral conjunctivitis (beefy red conjunctiva)
Blepharitis inflammation of eyelash follicles, secondary to overgrowth of normal bacteria. Can lead to Chalazion & hordeolum.
Chalazion fatty granuloma under eyelid- no tx goes away in 2-3 wk.. meibomian gland lipogranuloma, cyst in the eyelid inflammation of a blocked meibomian gland. Subacute, nontender, and usually painless nodules.
Hordeolum Stye- partially blocked meibomian gland. papule on eyelid margin ; warm compresses
Ptosis droopy eye lid. If not congenital w/u immediately
Coloboma "Cat's eye disorder" The defect may include the iris, retina, choroid, or optic nerve. "Tissue missing from the eye" congenital- some link to renal dx
Created by: JennRN on 2011-02-02




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