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Pediatric Ophthalmology. Irene Anteby Center for Pediatric Ophthalmology Hadassah Medical Center, Jerusalem. Case presentation. 1 week old baby girl Normal pregnancy & delivery, 2700 grams Mom noticed leukocoria. Issues to be discussed. Differential diagnosis?
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Pediatric Ophthalmology Irene Anteby Center for Pediatric Ophthalmology Hadassah Medical Center, Jerusalem
Case presentation • 1 week old baby girl • Normal pregnancy & delivery, 2700 grams • Mom noticed leukocoria
Issues to be discussed • Differential diagnosis? • More info needed from current exam? • Work-up?
PHPV vs. Congenital Cataract • How do we differentiate (clinically) between PHPV (or PFV) and “uncomplicated” congenital cataract? • What types of PFV do you know? • How does the clinical diagnosis affect: • Surgical approach/technique? • Complication rate? • Prognosis?
Timing of surgery • When should surgery be attempted? • If it unilateral? • If it is bilateral? • How does timing affect visual prognosis? • How does timing affect complication rates?
Aphakia Management • How is aphakia treated if unilateral? Bilateral? • State pros and cons regarding: • Aphakia • Contact lens (types? Pros and cons?) • Aphakic spectacles • IOL (how do we calculate IOL power in children? target refraction?)
Case presentation (cont.) • Underwent limbal approach lensectomy + anterior vitrectomy at age 12 days! • Two weeks post-op: • Clinical findings? Diagnosis?
Case presentation (cont.) • Continued corneal haze…
Issues to be discussed • How do we monitor for (secondary) glaucoma? • How do we manage the glaucoma?
Case presentation (cont.) • Second surgery: trabeculectomy at age 2 months
Issues to be discussed • How do we manage the aphakia?