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Peadiatric ophthalmology in 10 minutes David Kinshuck, Good Hope Hospital

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Peadiatric ophthalmology in 10 minutes David Kinshuck, Good Hope Hospital

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    1. Peadiatric ophthalmology in 10 minutes David Kinshuck, Good Hope Hospital Retinopathy of Prematurity Leukocoria……… Examining neonates Amblyopia Squint=Strabismus (not covered here in detail…links) Cataracts Nystagmus Anisocoria Nasolacrimal Duct Obstruction Ptosis Cloudy Cornea/many other conditions Infections: conjunctivitis, cellulitis, etc

    2. Retinopathy of prematurity (1) in premature babies peripheral retina is not vascularised at birth Under certain conditions instead of the vascularisation proceeding normally, there is a growth of new vessels and scarring 100% oxygen, crucial period 28-36weeks, especially low birth weight

    3. Retinopathy of prematurity (2) vascularisation

    4. Retinopathy of prematurity (3)

    5. Leukocoria (1) = white pupil Have to check red reflex of all neonates & children Retinoblastoma congenital cataract PHPV (persistent hyperplasia of primary vitreous) Retina detachment (trauma/ retinopathy of prematurity) Toxocariasis (nematode infection) from exposure to puppies Uveitis, infections, other conditions

    6. Leukocoria (2)

    7. Examination of neonates Gross abnormality Red reflex (eg cataract) Discharge (gonococcal/chlamydial conjunctivitis) Large eye..buphthalmos

    8. Examination of neonates (2): ophthalmic neonatorum Discharge in first week of life will be gonococcal or chlamydial conjunctivitis. Gonococcal infection can cause serious corneal damage

    9. Examination of neonates (3): ophthalmic neonatorum

    10. Examination of neonates (4) buphthalmos

    11. Amblyopia (1) Early childhood is essential for visual maturation….visual cortex has to receive good quality images to develop Critical period 6 weeks…….(5y) Early period most important If no clear image is received, even if the problem (eg cataract, squint) is corrected, eye will never see

    12. Amblyopia (2) A structurally normal eye that cannot see as well as it should Common causes are Squints Refractive errors with/without a squint cataract

    13. Squints (1) Esotropia Exotropia (vertical) Correct refractive error & patch good eye to treat amblyopia online (section 12, double vision and pupil, 3rd ‘?’ left) Folder similar

    14. Squints (2) Exotropia See video if online http://www.mrcophth.com/vidoes.html

    15. …briefly (not omitted here)………………. Cataracts (danger of amblyopia) online Nystagmus online (section 12, double vision and pupil) folder Anisocoria online (section 12, double vision and pupil) folder Nasolacrimal Duct Obstruction online Ptosis online (section 12, double vision and pupil) folder Cloudy Cornea/many other conditions Infections: conjunctivitis, cellulitis, etc

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