ommon Eye Problems in Childre

and Strabismus

Blepharoptosis
-

congenital
acquired

When to Treat
- Amblyopia due to
- Cover pupil
- Astigmatism
- Abnormal head position
- Cosmetic concern

Congenital Nasolacrimal Duct

Obstruction

Congenital Nasolacrimal Duct

Obstruction
- Incidence 2-6% of normal lived birth
Etiology : innermost cells of passage
lumen at nasal opening not atrophy
-

Symptoms and signs : Signs and

symptoms : epiphora, crusting,
mucopurulent discharge
-

Congenital Nasolacrimal Duct Ob

How to diagnose
- Hx
- Symptoms & Signs
- Fluorescein dye disappeara

Congenital Nasolacrimal Duct Ob

- Suitable time to treat

- How to treat simple massage + antibio

2
Criglers method

Congenital Nasolacrimal Duct Ob

Probing if massage can not help

Epiblepharon

Epiblepharon

- Etiology : horizontal fold of skin

and orbicularis muscle at both
upper and lower lid make eyelash
irritated corneal
- Signs and symptoms : eye
irritation, epiphora and conjunctival
injection

When to Treat
-

Severe eye irritation, epiphora

Conjunctival injection off and on

Method

Eliptical
excision

Leukocoria (white Pupil)

Important diseases that you

have to seek for
- Cataract

- Retinoblastoma

- Retinopathy of prematurity

Congenital Cataract

- Incidence 3:10000 live births

- How to diagnose
- Suitable time to treat depend o

If cataract is visually significant : before

- How to treat lens aspiration wi

intraocular lens

Red Reflex

Direct ophthalmo

Retinoblastoma

- Incidence 1:18,000 live births

- How to diagnose
- Suitable time to treat
- How to treat

Retinopathy of Prematurity

Amblyopia

..............

best-corrected
visual acuity

posterior visual
pathway


- Strabismic amblyopia
- Anisometropic amblyopia

- Isoametropic amblyopia
- Deprivation amblyopia



VA < 20/40 VA 2
2 Snellen chart

-
significant
cataract
- VA

-
(occlusion therapy)

-
- 6
VA < 20/100
- 2
VA > 20/100

Strabismus

Strabismus


binocular vision

neuromuscular control

fusion
- phoria
- intermittent tropia
- tropia
2.
- congenital
- acquired
3.
- horizontal
- vertical
- torsional
- combined
1.

1. Unknown etiology
2.
Structural anomalies
extraocular muscles
3. Accommodation refraction
4. Innervational factors
5. Brain damage

1.
2.
3.

VA

alignment

 VA

Ages (yr)
normal0-2

20/30 (1 yr)

20/30 (2 yr)

vision test

visual evoked potential (VEP)

Preferential looking

- Binocular fixation preference testing

2-5
- Allen pictures ()
20/40 - 20/20
HOTV
20/40 - 20/20
- E - game
20/40
20/20

 VA
0-2

Preferential looking

 VA

HOTV
Snellen

E game
Allen
ETDRS
picture
VA should be 20/20 in children > 5 yrs


alignment
position gaze, cardinal position
diagnosis
positions of gaze
-
alignment
- corneal light reflex test
- Hirchbergs method
- Krimskys method
- cover test
- cover-uncover test
-

Corneal Light Reflex

Hirschbergs Method

Krimskys Method

Cover-Uncover Test

Alternate Cover Test



strabismus

- organic cause

-
-
-

- Functional improvement
- Cosmetic improvement