II. Exam: Normal or common eye findings
- Following delivery
- Subconjunctival Hemorrhages (common)
- Lid edema and lid eversion
- Dysconjugate gaze
- Normal as a newborn due to Decreased Visual Acuity at birth (20/400)
-
Dacryostenosis (blocked tear ducts)
- Very common in newborns, presenting with sticky yellow, non-purulent secretions from the nasolacrimal duct
- Responds to medial canthus massage with a warm, moist cloth
-
Neonatal Conjunctivitis
- Distinguish Conjunctivitis from Dacryostenosis
- Distinguish chemical Conjunctivitis from Gonococcal Conjunctivitis, Chlamydia Conjunctivitis and HSV Conjunctivitis
III. Exam: Abnormal funduscopic findings
- Lens opacity (Congenital Cataract)
- Associated with TORCH Virus infection
- White reflex (Leukokoria) on Pupillary Light Reflex
- Suggests lens, vitreous or fundus abnormality
- Evaluate for Retinoblastoma
IV. Exam: Congenital defect related eye findings
-
Coloboma
- Ocular tissue defect
- Associated with Treacher Collins Syndrome and CHARGE Syndrome
- May be associated with poor Vision (especially if iris is absent)
-
Inner Epicanthal Fold
- Medial eye covered by small folds of skin
- Normal variant in asian and native american patients
- Associated with many congenital syndromes (e.g. Down Syndrome, Noonan Syndrome, Rubinstein-Taybi syndrome)
- Structural eye findings associated with congenital disorders
- Orbital Orientation
- Downslanting Palpebral Fissure (eyes form a "^" shape, e.g. Marfan Syndrome)
- Upslanting Palpebral Fissure (eyes form a "V" shape, e.g. Down Syndrome)
- Orbital Size
- Orbital Separation
- Hypertelorism (widely spaced eyes, e.g. Trisomy 18)
- Hypotelorism (narrowly spaced eyes, e.g. Fetal Alcohol Syndrome)
- Orbital Orientation