Vision and Ophthalmology Pediatric Ophthalmology 2 — Questions and Answers
Question 1: Leukocoria (white pupillary reflex) in a child is most classically associated with which condition?
- Accommodative esotropia
- Retinoblastoma (Correct answer)
- Congenital ptosis
- Nasolacrimal duct obstruction
Correct answer: Retinoblastoma
Leukocoria is a classic presenting sign of retinoblastoma, though it can also indicate cataract, Coats disease, or other conditions.
Question 2: To minimize the risk of deprivation amblyopia, congenital visually significant cataracts should ideally be removed within:
- The first 6 weeks of life (Correct answer)
- The first 6 months of life
- By age 2 years
- By age 5 years
Correct answer: The first 6 weeks of life
Visually significant unilateral congenital cataracts should be removed by 6–8 weeks of age to allow normal visual development and prevent severe deprivation amblyopia.
Question 3: What is the most common form of childhood glaucoma?
- Traumatic glaucoma
- Primary congenital (infantile) glaucoma (Correct answer)
- Pigmentary glaucoma
- Pseudoexfoliation glaucoma
Correct answer: Primary congenital (infantile) glaucoma
Primary congenital glaucoma, caused by developmental abnormality of the trabecular meshwork, is the most common form of glaucoma in children.
Question 4: Which clinical sign is characteristic of primary congenital glaucoma in infants?
- Leukocoria
- Buphthalmos (enlarged globe) (Correct answer)
- Ptosis
- Ectopia lentis
Correct answer: Buphthalmos (enlarged globe)
Buphthalmos (ox-eye) is enlargement of the infant globe due to elevated IOP stretching the compliant sclera, a hallmark of congenital glaucoma.
Question 5: What is nystagmus?
- Sudden loss of peripheral vision
- Involuntary rhythmic oscillating eye movements (Correct answer)
- Inability to abduct one eye
- Drooping of the upper eyelid
Correct answer: Involuntary rhythmic oscillating eye movements
Nystagmus is characterized by involuntary, rhythmic, repetitive eye movements that can be horizontal, vertical, torsional, or mixed.
Question 6: Retinopathy of prematurity (ROP) primarily develops in which population?
- Full-term infants with macrosomia
- Premature infants with low birth weight receiving supplemental oxygen (Correct answer)
- Children with Type 1 diabetes
- Adolescents with hypertension
Correct answer: Premature infants with low birth weight receiving supplemental oxygen
ROP occurs in premature, low-birth-weight infants whose retinal vascularization is incomplete; supplemental oxygen further increases risk of abnormal vessel proliferation.
Question 7: Congenital nasolacrimal duct obstruction (CNLDO) most commonly resolves spontaneously by what age?
- 3 months
- 6 months
- 12 months (Correct answer)
- 2 years
Correct answer: 12 months
Approximately 90% of CNLDO cases resolve spontaneously by 12 months of age as the membranous obstruction at the valve of Hasner opens.
