A 4-year-old girl is evaluated for a persistent left head turn that her parents say has been present for years. The physical examination reveals limited abduction of the left eye. When the child is asked to look to the right, you note a retraction of the globe into the orbit and a narrowing of the palpebral fissure. What is the underlying pathophysiology of this condition?
A newborn is diagnosed with bilateral cataracts on initial examination. The pediatrician considers metabolic causes. Which of the following disorders is a primary consideration, as early dietary intervention may lead to the reversal of lens changes?
A newborn is noted to have a bilateral central corneal opacity (leukoma). Examination reveals iridocorneal adhesions extending from the iris collarette to the border of the opacity. The infant also has a cleft palate and short stature. What is the most likely underlying diagnosis?
A 4-month-old infant presents with the classic triad of epiphora, photophobia, and blepharospasm. The examination is significant for corneal edema and enlargement of the globes (buphthalmos). Unlike adult glaucoma, what is the primary treatment for infantile glaucoma?
A 2-day-old infant presents with a bluish, tense, subcutaneous mass just below the medial canthal tendon of the left eye. The parents report the infant has been having some difficulty breathing, especially during feeding. What is the most appropriate next step in management for this infant?
An 8-year-old boy presents with a 2-day history of fever to 39°C (102.2°F), proptosis, painful ophthalmoplegia, and decreased visual acuity in his left eye. A CT scan is ordered to confirm the suspected diagnosis of orbital cellulitis. What is the most common source of infection leading to this condition in children?
A 6-month-old infant is diagnosed with sporadic, bilateral aniridia. The examination also reveals sensory nystagmus and macular hypoplasia. In addition to regular ophthalmologic follow-up for glaucoma, what is the most critical long-term screening protocol required for this child due to the genetic implications of sporadic aniridia?
A 2-year-old is brought to the pediatrician because his parents noticed his left eye occasionally turns inward. On examination, a white pupillary reflex (leukocoria) is also noted in that eye. After leukocoria, what is the second most frequent initial sign of retinoblastoma?
A 16-year-old female presents with anisocoria that is more pronounced in dim light. The left pupil is smaller than the right but reacts briskly to light. A swinging flashlight test is normal. To confirm the diagnosis, you instill one drop of 4% cocaine solution in both eyes. After 30 minutes, the right pupil dilates significantly, but the left pupil shows poor dilation. What is the most likely diagnosis?
A premature infant born at 30 weeks gestation is noted to have a cluster of tiny vacuoles in the distribution of the Y-sutures of both lenses during a routine check-up. The parents are worried about long-term vision problems. What is the most likely outcome of the mosy likely diagnosis?
