NR602 / NR 602 Primary Care of the

Childbearing and Childrearing Family

Practicum Final Exam Study Guide |

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College

Eye Disorders

Strabismus- a defect in In ocular alignment, or the position of the eyes in relation to each other;

It is commonly called lazy eye. And strabismus, the visual axes are not parallel because the

muscles of the eyes are not coordinated; When one eye is directed straight ahead, the other

deviates.

Retinoblastoma is an intraocular tumor that develops in the retina. Although it is rare, this

malignant retinal tumor is the most common tumor in childhood (some 4% of cancers in children

younger than 15 years of age)

Clinical findings

• strabismus is the most common finding

• there is a decreased visual acuity uni- or bilateral white pupil (leukocoria),

described often as an intermittent “glow, glint, gleam, or glare” by parents, is

usually seen in low light settings or noted in photographs taken with a flash i.e.

(cat's eye reflex)

• other symptoms include an abnormal red reflex, nystagmus, glaucoma, orbital

Cellulitis and photophobia, hyphema, hypopyon (plus an anterior Chamber of

eye); Signs of global rupture or also possible

Bulbar or palpebral conjunctival injection is a common presentation, which can be unilateral or

bilateral.

differential diagnosis should include allergy, conjunctivitis, infection, foreign body, chemical

exposure, or systemic inflammatory disease, irritation of the conjunctiva or cornea, and

congenital glaucoma.

Watery discharge can occur with allergies, nasolacrimal obstruction, foreign bodies, viral

infection, and iritis.

Purulent or mucoid discharge can be noted with chronic dacrocystitis or nasolacrimal

obstruction.

Advanced allergic conjunctivitis can have some mucoid production.

To differentiate, microscopic investigation of discharge may lead to other clues.

Photophobia is a symptom common of trauma and in infants with glaucoma or retinal disease.

Other non-eye related causes of photophobia include migraines and meningitis.

A white pupil, or leukocoria serious finding and demands immediate referral to the pediatric

ophthalmologist.

Causes of leukocoria include retinal detachment, cataract, retinal dysplasia, retinopathy of

prematurity, and in newborns retinoblastoma.

All newborns should have a fundoscopic examination within 24 hours of birth and yearly on

physical examinations.

Conjunctivitis chart

Chalazion vs Stye

CHALAZIONS – Benign, chronic lipogranulomatous inflammation of the eyelid

Causes – blockage of the meibomian cyst

Risk – hordeolum or any condition which may impede flow through the meibomian gland. Also

mite species that reside in lash follicles

Assessment – PAINLESS, NOT INVOLVING LASHES

 Lid edema, or palpable mass

 Red or grey mass on the inner aspect of lid margin

Prevention – good eye hygiene

Treatment – warm, moist compresses 3x per day

 Antibiotics not indicated because chalazion is granulomatous condition, if

secondarily infected consider SULFACETAMIDE, ERYTHROMYCIN

Follow up – 2-4 weeks, if still present after 6 weeks follow up with ophthalmologist

Blepharitis-