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34 Cards in this Set
- Front
- Back
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What is the best way to try to examine a crying infant's eyes?
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Having the parent place the infant over their shoulder and you can try to look at the infant's eyes in the moments they open. This allows you to try to evaluate the symmetry and extraocular muscular balance and whether there is a light reflex.
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What can encourage a newborn to open its eyes?
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Examining the newborn's eyes in a dimly lit room.
Also holding the infant upright, suspended under its arms. |
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How does one detect the epicanthal folds?
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By looking for a vertical fold of skin nasally that covers the lacrimal caruncle.
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Which group of people have prominent epicanthal folds?
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Asian infants.
They are also suggestive of down syndrome or other genetic abnormalities in children of other ethnic groups. |
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The medial and lateral canthi are usually horizontal. When are they not?
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If an infant has a slant present (Mongolian). The outer canthi are above the line, upward.
If an infant has a downward slant, it's called antimongolian. The outer canthi is below the horizontal line. |
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How can you quickly detect the sunsetting sign in infants?
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By quickly lower the infant from upright to supine position. You then look at the sclera above the iris. This sign may be an expected variant in newborns, however it is also observed in infants with hydrocephalus and brainstem lesions.
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What is hypertelorism?
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Wide spacing between the eyes.
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In what cases is hypertelorism seen?
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It is associated with craniofacial defects including some with mental retardation.
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What is pseuodostrabismus?
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The false appearance of strabismus caused by a flattened nasal bridge or epicanthal fold.
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When is pseuodostrabismus seen?
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It is an expected variant in Asian and Native American/American Indian infants as well as some whites.
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When does pseuodostrabismus usually disappear by?
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1 year of age.
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How can you distinguish pseuodostrabismus from strabismus?
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By using the corneal light reflex. An asymmetric light reflex can indicate a real strabismus or hypertelorism.
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Enlarged corneas are a sign of what?
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Congenital glaucoma.
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What is an expected find on physical exam of eye of a newborn?
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Swollen or edematous eyelids.
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After birth, if the newborn's eyelids are swollen or edematous, AND accompanied by conjunctival inflammation and drainage what might this suggest?
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Newborn with opthalmia neonatorum.
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Redness, hemorrhages, discharge or granular appearance beyond the newborn period may be due to what?
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Infection, allergies or trauma.
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What is a coloboma and what is it seen with?
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A coloboma is a keyhole looking pupil. It is often associated with other congenital abnormalities.
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If a child is suspected of having Down Syndrome or mental retardation what might a PE of the iris have?
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White specks scattered in a linear pattern around the entire circumference of the iris. These are called Brushfield spots
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How many degrees should you expect an infant to follow through when focusing on and tracking light?
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60 degrees.
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Expected results of optical blink reflex?
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By shining a bright light at the infant's eyes you should elicit a quick closure of the eyes and dorsiflexion of the head.
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Since a fundoscopic exam is difficult to conduct on a newborn or young infant until when should you defer it?
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Until the kid is about 2 to 6 months of age.
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What popular mydriatic is used in infants to dilate their irises to allow for a proper fundoscopic exam?
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Cyclopentolate hydrochloride .5%
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Red reflex present in newborns?
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Yes, should be present bilaterally.
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If their is interruption or opacities of the red reflex, what might this indicate?
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Congenital cataracts or retinoblastoma.
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How soon should you test visual acuity?
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Test with the Snellen E game, usually at about 3 years of age. Like adults, children need to stand 20 feet away from chart.
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Anticipated visual acuity in 3 year olds?
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20/50 or better
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Anticipated visual acuity in 4 year olds?
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20/40 or better
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Anticipated visual acuity in 5 year olds?
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20/30 or better
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Anticipated visual acuity in 6 year olds?
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20/20
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If there is a two line difference between eyes (ie. 20/50 and 20/30), what might this indicate?
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Amblyopia
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What should you screen at birth through 3 months of age?
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Red reflex
Inspect for constant strabismus |
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Screening method used 6 months to 1 year?
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Fix and follow with each eye.
Alternate occlusion. Corneal light reflex. Red reflex. Inspection for strabismus. |
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Screening method for kids around 3 years?
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Visual acuity. (20/50 or worse)(or 2 line difference)
Corneal light reflex/cover-uncover test. Stereoacuity Inspection for structural abnormalities. |
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Screening for kids older than 5 years of age?
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Visual acuity. (20/30 or worse)(or 2 line difference)
Corneal light reflex/cover-uncover Stereoacuity Red reflex Inspection for structural abnormalities. |
