Pediatric ophthalmology - Semmelweis Egyetem

Pediatric ophthalmology

Dr. Szamosi Anna

When we should ask for

ophthalmological examination?

Strange blinking,conjunctivitis, inflamm. of the lids

Alteration in the red reflex (RB, cataracta, toxocara,

refractive error)

Pupil differencies (anisocoria)

Any indirect sign of lowered vision

Strabismus

Difference between the size of the eyes, or the lids

Tearing (DCN, refractive errors, foreign

body,buphthalmus)

congenitalis ptosis

hemangioma

cryptophthalmus

ankyloblepharon

dermoid cyst

coloboma in the lids

distichiasisNeisseria gonorrhoea-ophthalmia neonatorum

dacryocistocele

Gyermekszemészet és Strabismus. A Magyar Gyermekszemészek és Strabológusok Társaságának 2005-ös kiadványa. Felelős szerkesztő: Soproni Anna. Az

eredeti kiadvány címe: Pediatric Ophthalmology and Strabismus. Section 6. Basic and Clinical Science Course of Academy of Ophthalmology, 2002—2003.

dacryocystitis neonatorum

coloboma iridis

aniridia

membrana pupillaris persistens

Red reflex

Congenital cataract

retinoblastoma

Examination

Visus near-far(different optotypes, pictures)

Objective measurements of the refr. error

Eyemovements

Examination of the binocularity

Examination of the strabismus

1. Visus

•

One eye in time!

Sényi Katalin: Útmutató gyermekorvosok számára. 2004.

1. Visus

Optotyp:

Snellen, Ammon, Landolt gyűrű

From the age of 4 months

Brown syndroma

Congenital abducens paresis

Neil R. Miller et al.: Walsh and Hoyt's clinical neuro-ophthalmology, Lippincott Williams & Wilkins, 2004

Eyemovements

Examination of the binocularity

1. Simultan perception

2. Fusion (Worth test)

3. Stereo vision (Lang test)

Types of strabismus

Ortophoria (no alteration)

Heterophoria (hidden strabismus)

Heterotropia (manifest strabismus)

1. strabismus convergens= esotropia

divergens=exotropia

sursumvergens=hypertropia

deorsumvergens=hypotropia

2. unilateral=monocular ↔ alternal

3. intermittant ↔ constans

4. -concomitant (permanent angle)

-incomitant(the angle depend on gaze)=paralitic strabismus

Cover test

epicanthus

The treatment of strabismus

Total correction (glasses, cycloplegy)

Facial occlusion (therapy against lazy eye)

Operation

Correction with prismatic lens

In paralitic strabismus we should wait about a

year before the operation