Hi all. Came across an interesting baby last night. Seemed okay to me, was doing a lot of that newborn stuff with his eyes, rolling them around, seeming unfocused etc. but mostly sleeping when I saw him. Heavily bruised/petechia on face d/t birth trauma.
So later at the end of my shift, I was helping in the nb nursery and said baby was there. The NB nurse asked me if I noticed anything weird w/ his eyes and I told her what I wrote above. The baby was awake now and he definitely had that unfocused look that you sometimes see with neonates. But he didnt track at all, and I tried to elicit a blink from him by trying to startle him by flicking my fingers near his eyes and nothing at all. Just that blank kind of glassy stare. We turned out the light and tried to assess his pupils w/ the penlight and it was hard to tell, but I know that his pupils stayed relatively the same size and he didn't flinch or turn away from the light. And his eyes didn't widen in the dark like lots of them do. VS wnl, no hx of infection/gbs w/ mom. Only thing was hydronephrosis and prophylactic abx, and of course the bruising.
So we paged the ped but I had to go before she got there and I have two days off and won't find out what happened with him.
Has anyone ever come across an infant with blindness? What kinds of testing can be done to determine if he can see? Do babies flinch? And I know that babies widen their eyes in the dark, is that d/t their pupillary responses bieng slow? I am thinking this little one does not see. He also startled really easy and once he got crying from it, he really kept on going. Very odd, huh?
Last edit by MIA-RN1 on Jul 19, '07
Sep 23, '06
You did a very thorough evaluation of this baby and noticed some interesting things that many nurses and docs would have missed. Good for you!!!
I'd love to hear what the pediatrician's exam revealed. Was s/he able to elicit a red reflex?
Please try to find out what the outcome was and let us know.
Sep 23, '06
yeah I will find out if I can when I go back on Monday. I didn't think to look in the chart for the red reflex but I am not sure if the physical had been done yet.
I am anxious to know myself.