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Peadiatric ophthalmology in 10 minutesDavid Kinshuck, Good Hope Hospital• Retinopathy of Prematurity• Leukocoria………• Examining neonates • Amblyopia• Squint=Strabismus• (not covered here in detail…links)
• 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
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