OPHTHALMOLOGY |
Retinopathy of Prematurity:
All infants <30 weeks gestation or <1300 grams birth weight and any infant < 35 weeks gestation or
<1800 grams who received supplemental oxygen, should have a retinal examination at 6-8 weeks postnatal age, if stable. Supplemental oxygen does not include blow-by oxygen in the delivery room, but does include brief oxygen(1-2 hours) in the NICU. Infants discharged prior to this age should be examined as outpatients and should have an examination scheduled at discharge. Follow-up will be arranged by the consulting ophthalmologist.
Conjunctivitis:
A conjunctival specimen for chlamydia (MicroTrak) should be obtained prior to starting therapy, usually Sulamyd Ophthalmic Drops. If MicroTrak is negative and conjunctival discharge persists, a specimen for gram stain and culture should be obtained before changing therapy. Positive chlamydia specimens require two weeks therapy with oral erythromycin ethylsuccinate, 40-50 mg/kg/day q.i.d. (topical therapy is not necessary), or erythromycin estolate, 30-40 mg/kg/day q.i.d. Optimally, parents of infants with chlamydial conjunctivitis should be treated with oral tetracycline hydrochloride or erythromycin stearate, 500 mg q.i.d., for two weeks.
Remember: Conjunctival discharge may be due to serious pathogens such as penicillin resistant gonococcus, Herpes Simplex virus, or Pseudomonas which can cause corneal ulcers. Also, congenital glaucoma can cause an inflamed conjunctiva.
CLEFT LIP AND/OR CLEFT PALATE |
Orders need to be written for the following specialists: Genetics, Speech Therapy, Plastic Surgery (Dr. Pilney), and the Cleft Palate Clinic.
MYELOMENINGOCELE |
All myelomeningocele patients need to be placed on "Latex Precautions", to limit exposure and decrease the incidence of latex allergy. Orders need to be written for consults from Neurosurgery (usually Dr. Tynan or someone from his group) and Urology (Dr. Wolpert). Most children go to the Myelodysplasia Clinic at Gillette Children's Hospital where they can also be evaluated by Neurology and Orthopedics; Dr. Tynan and Dr. Wolpert will follow-up there also. Other options for follow-up are at Shriners Hospital or U. of M.