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DIAGNOSIS AND MANAGEMENT

OF CHILD WITHOPHTHALMOLOGY DISORDER

Dr. Sunerti, SpM

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ANATOMI

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Equipment for OphthalmologicExamination

Flash light

Loupe

Ophthalmoscopy (Direct, Indirect) Slit lamp

Tonometry (Schiotz Tonometry)

Snellen chart

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Eye Examination

Anterior Segment

Eyelid, Eye brow

Conjunctiva

Sclera

Cornea

Anterior Chamber

Pupil

Posterior Segment

Lens

Vitreus Body

Retina

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Vision Examination

Any ocular examination must includeassessment of vision

Measurement of visual acuity is subjective

recuire respon from the patient Examines with Snellen chart, children can

be tested at about age 3 years

Normal visual Acuity 6/6 (20/20)

Poor vision 3/60, HM, LP

Totally blind NLP

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ILLiterate eye chart

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Slit Lamp Examination

The patient is seated, the head is stabilized byan adjustable chinrest and Fore head strap

We can be visualized the anterior segment

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Direct Ophthalmoscopy

Is a standard partof theophthalmologicexamination

Need dark room toallow evaluation ofthe central fundus

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Normal Fundus

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It is practical device, who might use it to screen patientfor glaucoma.

Patient is placed supine and topical anasthetic is instilledinto each eye

Normal intra ocular pressure 15 20 mmHg

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Congenital Ptosis

Is commonly due todytrophy of thelevator muscle of the

upper lid Other causes are

congenital thirdnerve palsy

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Congenital Palpebra Coloboma

Is a cleft ofussually the upperlid due to

incomplete fusionof fetal maxilaryprocesses

Large defects

require early repairto avoid cornealulceration

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MEGALOCORNEA

Is an enlargedcornea with normalclarity and function

It must bedifferentiated fromcongenital glaucoma

In new born thecorneal diameter is

9.5 to 10.5 mm

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CONGENITAL GLAUCOMA

Early sign : CornealHase/opacity,Increased cornealdiamter, increased

intra ocular pressure

The most strikingsymptom is extremephotophobia

Early Recognation isessential to preventpermanent blindness

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COLOBOMA OF THE IRIS

Indicatesincomplete closureof fetal ocular cleft

Usually occursinferiorly andnasally

It may beassociated withcoloboma of thelens, choroid andoptic nerve

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ANIRIDIA

Absence of the iris

Frequentlyassociated with

secondaryglaucoma andwilms tumor

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STRABISMUS

Any deviation fromperfect ocularalignment

Misalignment my beany direction inward,outward up or down

Treatment should be

started as soon as adiagnosis is made

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CONGENITAL CATARACT

A Cataract is anyopacity in the lens

Congenital cataractare common and often

visually insignificant If cataract are dense,

central and larger than2 mm in diameter,require surgical

management with inthe first 2 months oflife

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RETINOBLASTOMA

Malignant tumor ofchildhood

90 % of cases thediagnosis is madebefore the end of thethird year

Infants and childrenwith presentingsymptom of Strabismusshould be examined

carefully to role outRetinoblastoma

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Gonococcal Conjuntivitis

Inflamation of theconjunctiva cause byNeisseria gonorrhoeal,present between the

second and fifth daysafter birth

Marked by a profusepurulent exsudat

Profusely exsudativedemands immediatelaboratore andimmediate treatment

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