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38 Cards in this Set
- Front
- Back
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When should a corneal exam be done? |
When eye trauma or suspicion of TORCH |
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When should you first check a preterm baby's eyes? |
31-34 weeks corrected age |
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For normal term nbn, when should first retinal exam be done? |
6-8 weeks; retinal exam by pediatric ophthalmologist or retinal specialist |
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When are babies visually aware / when do they begin to show visual interest & acuity |
40-44 weeks / several months |
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If you think a baby is cross eyed, what should you look for? |
Look for LIGHT REFLEX to be sure it's in same spot on each eye |
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What is a nevus simplex vs nevus flammeus |
"angel kiss" ; it BLANCHES and eventually goes away. "port wine stain" ; does NOT blanch |
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When do tears form / when are they fully patent |
Tears form at 2-4 months Tear ducts NOT fully patent until 5-7 months |
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What do you see with a clogged lacrimal duct |
Sticky drainage with NO edema or erythema or injected conjuctiva If you culture, you'll get a lot of random junk |
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Dacrostenosis |
non patent tear duct |
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Injected eye |
inflammed conjunctiva |
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Dacrocystoceles |
Needs an ENT consult & to be drained |
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What is a conjunctival hemorrhage / when does it resolve |
Rupture of capillaries of mucous membranes that line eyelids Resolves in 7-10 days |
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What does a normal sclera look like? |
White to blueish (more blue d/t veins with preemies) yellow - jaundice blue - OI *No sclera should be seen over iris (sun setting eyes) |
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Normal newborn eye color / when do they have final pigmentation |
Dark gray, blue, or brown 6 months for final pigmentation |
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Brushfield spots |
white specks scattered around circumference of iris down syndrome |
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When is pupillary reflex 1st seen |
28-30 weeks (CN II, III) --> check with ophthalmoscope ~ 6 in away; also check equality of pupil size |
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Normal red reflex color / what causes obstruction? |
Clear red-orange color (reflected from retina) Dark skin? Reflex is slightly pale (peach/gray) opacity of lens or cornea causes obstruction of reflex - congenital cataracts (rubella), retinoblastoma, glaucoma |
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Coloboma |
keyhole shaped pupil (CHARGE association) |
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Anterior vascular capsule of lens changes with GA (27-34 weeks) - exam must be done _____ |
within 24-48 hrs before vessels begin to atrophy |
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Nystagmus |
rapid searching a little is normal should disappear by 3-4 months if persists --> CNS abnormalities, blindness CN III, IV, VI |
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Strabismus |
crossed eyes thickness of epicanthal folds may make eyes appear crossed check by comparing corneal light reflexes |
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Dysconjugate eye movements |
OK when awake & trying to focus, bad when they're asleep |
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exophthalmos |
protrusion of eyeball (hyperthyroid / congenital glaucoma) |
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What do you see with glaucoma |
ENTIRE corneal area is cloudy |
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What do you see with neisseria gonorrhea & what are the risks |
large amount of copious discharge great risk of corneal perforation & permanent eye damage 1/200 live births incubation period of 2-5 days --> give erythromycin to help avoid ophthalmia neonatorum |
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Does erythromycin ointment prevent chlamydial conjunctivitis or chlamydial pneumonia? |
NO!!!! |
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Treatment for gonorrhea |
Immediate penicillin IV & topical antibiotics If resistant to PCN, 3rd generation cephalosporin |
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ROP - what is it / factors / when do vessels being to grow |
disease of retinal vessels factors: prematurity, O2, growth factors. Takes several weeks to develop retinal vessels begin to grow @ 16 weeks & reach periphery of retina by 40 weeks |
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What are you looking for at the ears? |
-Examine & compare each auricle for size, shape, configuration, & position -Look for pits, sinuses, & accessory tragi -Check for normally directed ear canal -Palpate pinna for firmness -Check recoil of pinna -Assess hearing (CN VIII) |
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Do you need to get a renal US with an isolated ear pit? |
RUS is actually NOT recommended Kidneys/ears/genitalia develop @ same time |
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Accessory tragus |
-often misnamed "preauricular skin tag" (skin tags don't show up until later) -autosomal dominant -may be singular or multiple -will see cartilage, hair follicles -From 1st brachial arch (along with jaw) - rest of ear forms from 2nd arch -Often unilateral -Vary in size, up to 2 cm -Associated with cleft lip, cleft palate, hypoplasia of jaw - No hearing loss unless other anomalies |
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Cup ear |
-Concave cocha resulting in small ear size with pinna that stands out -Ear forms cup shape -Sporadic -May have middle ear malformations or atresia of canal > 2 cm from side of head |
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Microtia |
Small/malformed ear. Disorganized. 4 grades 1 - smaller than normal, mostly normal anatomy 2 - Part of ear looks normal, usually lower 1/2. Canal may be normal/ small/closed 3 - Just a small remnant of "peanut shaped" skin & cartilage; no canal (aural atresia) 4 - absence of external and internal ear "anotia" --> get a hearing screen early -MAY be associated with other anomalies & hearing can be affected -Prosthetic / surgical correction |
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Otitis media |
MC ailment for children Bacteria travels up eustacian tube and lodges in middle ear |
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Size of disposable speculums for otoscopy |
2.5 mm for < 12 months 4 mm for > 12 months |
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Pathway of sound |
Sound waves enter ear --> strike tympanic membrane --> vibration of ossicles --> cause movement of cochlear fluid --> stimulates cilia --> cilia send electrical impulses along 8th auditory nerve to brain for interpretation |
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How do you move pinna to look in ears? |
"Dear baby" Down and Back for babies (up and out for kids) |
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Tympanostomy tubes |
drain fluid for otitis media with effusion or repeated otitis media |
