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Pediatrics Ch23
Eye Anatomy, Visual Acuity Tests, Dyslexia, Ambylopia, Strabismus,Conjunctivitis
| Question | Answer |
|---|---|
| What is the organ of vision | The eye |
| When do the eyes begin to develop | 4 weeks gestation |
| How do the eyes develop | As an outgrowth of the forebrain |
| What size is the eye at birth | 65% of an adult size |
| What is visual acuity estimated to be at birth | 20/400 |
| What may visual acuity be by age 2 or 3 | 20/30 to 20/20 |
| How does the newborn’s eye shape compare to the adult’s | less spherical |
| When are alignment and coordination of the eyes achieved by | 3 – 6 months |
| When are tears present | 3 – 6 months |
| When does depth perception begin to develop | 9 months |
| When does the American Academy of Pediatrics recommend that children first undergo visual screening | 2 – 3 years |
| What does a nurse observe for when visually examining the eye | Symmetry and Distance from the nose, Pupil size, shape, movement, and reaction to light |
| What are epicanthal folds | Folds of skin that extend on either side of the bridge of the nose and cover the inner eye canthus |
| What can cause an appearance of crossed eyes | Large, Broad epicanthal folds that cover a large portion of the inner eye |
| What can cause epicanthal folds | Some chromosomal abnormalities |
| What does the healthy pupil do as light approaches | Constrict/get smaller |
| What does the healthy pupil do as light disappears | Dilates/gets larger |
| How will an infant respond to visual stimuli at birth | Cessation of movement |
| What is noted during feeding of a newborn | Responsiveness to the mother during feeding |
| When is an infant able to fixate and focus on an object | 6 weeks |
| When can visual acuity be tested | 2 ½ - 3 years |
| What eye chart is used for preschoolers who have no learned the alphabet | Snellen alphabet chart and the Snellen E version |
| What kind of test is often used for school age children | Titmus machine |
| What is dyslexia | Reading disability that involves a defect in the cortex of the brain that processes graphic symbols |
| What is amblyopia | Lazy eye – reduction in or loss of vision that usually occurs in children who strongly favor one eye |
| What is bilateral amblyopia | Both retinas not receiving a clear image |
| What does the prognosis for abnormal binocular vision depend on | How long the eye has been affected and at what age treatment is begun |
| What is a commonly accepted diagnostic sign of amblyopia | 2 Snellen E chart lines are better in one eye than the other |
| What is strabismus | Most common form of amblyopia with dissimilar refractory errors |
| What causes amblyopia | Sensory deprivation of the affected eye |
| When are children at risk for developing amblyopia | Birth to 9 years |
| What is treatment for amblyopia | Eyeglasses for significant refractive errors, Occlusion of the good eye to force use of the affected eye |
| What is strabismus | Cross eye/Squint – when a child is unable to direct both eyes toward the same object |
| What will the body do when the eyes can not coordinate sight together | Disable one eye to provide a clear image |
| What can the disabled eye with strabismus develop | Amblyopia |
| Concomitant Strabismus | Nonparalytic - Constant deviation in gauge related to faulty insertion of the eye muscle – one eye always looks crossed – extraocular muscles are normal |
| Nonconcomitant Strabismus | Paralytic - Paralysis or weakness in the extraocular muscle – double vision – gaze deviation with movement – head tilting and squinting to avoid double vision |
| What type of strabismus can occur after head trauma or neurological disease | Nonconcomitant |
| What can give a false impression of strabismus | Epicanthal folds |
| What are the symptoms of strabismus | Squinting or frowning to focus, Missing objects that are reached for, Covering one eye to see, Tilting the head to see, Dizziness or headache |
| What usually corrects nonparalytic strabismus | Glasses |
| What may correct paralytic strabismus | Occluding the unaffected eye, Eye exercises, Glasses |
| When is surgery for strabismus typically performed | 3 – 4 years |
| Untreated strabismus can result in | blindness because the brain tends to obliterate confusing double images by disabling the eye |
| What kind of books do children with strabismus need | Large type with letters spaced far apart |
| What are the symptoms of eyestrain | Inflammation, aching, burning, squinting, short attention span, headaches, difficulty with schoolwork, inability to see the board |
| What is conjunctivitis | Inflammation of the conjunctiva, a mucus membrane that lines the eyelids |
| What causes conjunctivitis | Bacterial and Viral agents, Allergies, Irritants, Toxins, Obstruction of the lacrimal duct, and Systemic diseases |
| Which kind of conjunctivitis is usually self-limiting | Those that occur with viral exanthems such as measles |
| What are the forms of conjunctivitis | Infectious, Noninfectious |
| What is infectious conjunctivitis called | Pink eye |
| What does the common treatment for conjunctivitis | Warm compresses and topical antibiotic eye drops or ointments |
| What is ophthalmia neonatorum | Acute conjunctivitis in the newborn |
| What is allergic conjunctivitis associated with | Allergic rhinitis in children with hay fever |
| Hyphemia | Blood in the anterior chamber of the eye – most common ocular injury – caused by injury, coughing, sneezing – appears as bright or dark red spot in front of the lower portion of the iris |
| What is the treatment of hyphemia | Bed rest, Topical medication, HOB at 30 – 45 degrees to decrease intraocular and intracranial pressure if there is an associated head injury |
| What is retinoblastoma | Malignant tumor of the retina of the eye |
| What are the forms of retinoblastoma | Hereditary, Spontaneous |
| What are the average ages of diagnosis | 12 months for bilateral, 21 months for unilateral |
| Which chromosome is thought to form retinoblastoma | 13 |
| How does retinoblastoma manifest | Yellowish white reflex in the pupil because of a tumor behind the lens – may be accompanied by loss of vision, strabismus, hyphemia, pain |
| What is examined in suspected cases of retinoblastoma | Fundus of the eye |
| How is retinoblastoma treated if there is no possibility of saving the vision | Enuclieation (removal) of the eye |
| How are small retinoblastomas treated | Laser photocoagulation |
| How are large retinoblastomas treated | Chemotherapy or External beam irradiation |
| When is an eye prosthesis for a retinoblastoma fitted | When the socket has healed |
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