Pediatrics / Strabismus

Published on 10/03/2015 by admin

Filed under Opthalmology

Last modified 10/03/2015

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5 Pediatrics / Strabismus

Pediatrics

Orbital Disorders

Benign Lesions

Capillary Hemangioma

Most common benign tumor of the orbit in children

Often manifests in the first few weeks of life and enlarges over the first 6 to 12 months, with complete regression by age 5–8 years in 80% of cases

Spontaneous involution over the next few years

Predilection for the superior nasal quadrant of the orbit and medial upper eyelid

Female > male (3 : 2)

Diffuse irregular mass of plump endothelial cells and small vascular channels

High-flow lesion

Malignant Neoplasms

Rhabdomyosarcoma

Most common primary orbital malignancy of children

Most common soft tissue malignancy of childhood

Most common mesenchymal tumor of orbit

Malignant spindle cell tumor with loose myxomatous matrix

Average age at diagnosis is 8 years old (90% before age 16)

Cell of origin is an undifferentiated, pluripotent cell of the soft tissue; does not originate from the extraocular muscles

Unilateral; tends to involve superonasal portion of orbit

More common in males (5 : 3)

Aggressive local spread through orbital bones; hematogenous spread to lungs and cervical lymph nodes; most common location for metastasis is chest

Craniofacial Disorders

Structural development of head and face occur during 4th–8th week of gestation

Ocular motility disturbances occur in 75% of patients with craniofacial disorders

Syndromes

Lid Disorders

Conjunctival Disorders

Conjunctivitis

Ophthalmia Neonatorum

Conjunctivitis within first month of life

Papillary conjunctivitis (no follicular reaction in neonate due to immaturity of immune system)

Etiology