713 wk 1: common opthalmic disorders
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| Nasolacrimal duct obstruction | Nasolacrimal duct obstruction. 20% of all babies in 1st yr. Tx with massage. Refer @ 9mth for stint/ probe insertion to clear. . Often present at birth/ wk 1-2. 90% resolve.
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| Congenital infant glaucoma | no red reflex/ cloudy
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| Retinoblastoma | NO red reflex unilateral. Black on otoscope exm. Immediate referral. CC - sitting to close to TV or vision impairment. No cat's eye on photo
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| HSV infection | associated with hand foot mouth. Immediate referral
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| Corneal abrasions/structural abnormalities | Dx with florsene & woods lamp. Document by face of clock. Patch or not? controversial- may cause more scratching. Tx with drops q 2hr . refer to optho.
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| Chlamydia infection | common in first 6k of life. All babies given profolactic erythromycin ointment at birth, but this does not eradicate nasopharyngeal colonization.
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| Allergic conjunctivitis | cobble stoning appearance to conjunctiva
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| Differentials for red watery eyes | Allergic conjunctivitis (cobble stoning apperance to conjunctiva), Bacterial conjunctivitis, viral conjunctivitis (beefy red conjunctiva)
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| Blepharitis | inflammation of eyelash follicles, secondary to overgrowth of normal bacteria. Can lead to Chalazion & hordeolum.
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| Chalazion | fatty granuloma under eyelid- no tx goes away in 2-3 wk..
meibomian gland lipogranuloma, cyst in the eyelid inflammation of a blocked meibomian gland. Subacute, nontender, and usually painless nodules.
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| Hordeolum | Stye- partially blocked meibomian gland. papule on eyelid margin ; warm compresses
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| Ptosis | droopy eye lid. If not congenital w/u immediately
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| Coloboma | "Cat's eye disorder" The defect may include the iris, retina, choroid, or optic nerve. "Tissue missing from the eye" congenital- some link to renal dx
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