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Common eye disorders in children 2 :closed_umbrella: (:bell:Ambylopia…
Common eye disorders in children 2
:closed_umbrella:
:bell:
Ambylopia
Causes
Occlusion of one eye - deprivation
Misalignment - strabismus (M/C cause before age 3 y/o)
Blurred vision - refractive error (more common cause in age > 3 y/o)
esp if unilateral
Crowding phenomenon
Treatment
if started
early (before age 4-6)
➭ remarkable responsive to Rx
Pre-school detection of RF is thus essential
Poor vision
in
structually normal
eye
advises
careful screening of fall children for eye problems at q visit
:bell:
Strabismus
Detection
Corneal light reflex (useful in all ages)
Cover/Uncover testing (useful for older children)
Photographic & automated methods
Inheritance
Tends to
cluster in families
consider
referring all younger siblings
- maintain high lvl of suspicion
Causes
Visual loss
Trauma
Neurologic ds
Refractive error
Idiopathic
Treatment
Non-Sx
Rx
Eye exercises
occasionally helpful
Vision therapy
rarely helpful
Glasses (refractive esotropia)
Patching - delays Sx in selected exotropia pt
Sx
Rx
Botox :grapes:
Benefits
Preserve binocular vision
Depth perception
Stable long-term alignment
Avoid strabismic amblyopia
Psychosocial benefits
Improve self esteem
Avoid social exile
Reconstructive! to correct deformity caused by disease
Def
:check: Disease that causes defect in Binocular vision system
:bell:
Pseudostrabismus
Clinical
:frame_with_picture:
Flat nasal bridges & prominent epicanthal folds
maybe asymmetric - eye appears esotropic
Differentiate by
Corneal light reflexes
Cover testing
:!:
refer anyway
as some later develop true strabismus
:bell:
Refractive strabismus
Hyperopia (Farsightedness)
Hyperopes must accommodate to see
Eyes converge with accommodation
Typical
onset
around age ~
2 y/o
Develop as child learns to accommodate
Mayb sudden or gradual