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Pediatric Ophthalmology

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

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  1. Pediatric Ophthalmology Irene Anteby Center for Pediatric Ophthalmology Hadassah Medical Center, Jerusalem

  2. Case presentation • 1 week old baby girl • Normal pregnancy & delivery, 2700 grams • Mom noticed leukocoria

  3. Issues to be discussed • Differential diagnosis? • More info needed from current exam? • Work-up?

  4. 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?

  5. 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?

  6. 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?)

  7. Case presentation (cont.) • Underwent limbal approach lensectomy with PMMA IOL in sulcus at age 12 days! • Two weeks post-op: • Clinical findings? Diagnosis?

  8. Case presentation (cont.) • Second surgery: IOL removal • Continued corneal haze…

  9. Issues to be discussed • How do we monitor for (secondary) glaucoma? • How do we manage the glaucoma?

  10. Case presentation (cont.) • Third surgery: trabeculectomy at age 2 months

  11. Issues to be discussed • How do we manage the aphakia?

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