12. PD III - The Paediatric Exam and Communication Flashcards
How do we measure VA in children?
Measuring VA is unlikely in kids under ... due to ..., ..., and .... Should be using ..., ... or ... and presented as a .... The symbols are ... and ... and the first tests are done ... to promote .... It’s important to ... the letters because the kids will ... the letters and ... to impress you.
How do we measure VA in children?
Measuring VA is unlikely in kids under 3 years due to cognitive difficulties, shyness, and unwillingness. Should be using Lea Symbols, Patti Pics or HOTV and presented as a matching game. The symbols are single and large and the first tests are done binocularly to promote confidence. It’s important to randomise the letters because the kids will memorise the letters and lie to impress you.
What are considerations to take into account when measuring a child’s VA?
HTOV may be intimidating as .... There are ... present to help separate out the letters/shapes. When kids know letters, can ... chart, but only if you’re sure because children will ... or ... when not confident. We expect 6/6 when the child is 6years old.
What are considerations to take into account when measuring a child’s VA?
HTOV may be intimidating as it has letters. There are isobars present to help separate out the letters/shapes. When kids know letters, can use the LogMAR chart, but only if you’re sure because children will freeze or withdraw when not confident. We expect 6/6 when the child is 6years old.
What tests are useful for stereopsis in kids?
(4 points)
Titmus Fly, Random Dot, Lang, and Frisbee.
What tests are useful for colour vision in kids?
Test A -> works well when kid knows ..., but could try ... if not.Test B -> ... and ... equivalent of Test A, correlates well
What tests are useful for colour vision in kids?
Ishihara -> works well when kid knows numbers, but could try ray-tracing if not.Waggoner's -> shape and picture equivalent of Ishihara, correlates well
What are considerations for measuring NPC in kids?
Watch ... and make note of ... and what happens when they try to .... Note the child’s ...; is the child ... or has .... Can the child ... at a near target without ...? NPC is not just a measure of ....
What are considerations for measuring NPC in kids?
Watch both eyes and make note of any breaks and what happens when they try to recover. Note the child’s body language; is the child uncomfortable or has watery eyes. Can the child look away and then look back at a near target without breaking? NPC is not just a measure of distance when eyes break.
What are considerations for measuring excursions/ocular motility in kids?
Watch for ..., ..., ability to ..., ... or ... movements, ... of excursions. Note any ... and make sure they are .... Look for ....
What are considerations for measuring excursions/ocular motility in kids?
Watch for head reliance, motor overflow, ability to cross the midline, smooth or jerky movements, fullness of excursions. Note any deviations and make sure they are repeatable. Look for limitations of gaze.
What are considerations for measuring cover test in kids
Make sure it’s ... and keep the child ... and .... Give the child ... to ensure they are .... You need to be ... as children can ... and ... quickly.
What are considerations for measuring cover test in kids
Make sure it’s repeatable and keep the child focused and engaged. Give the child feedback to ensure they are switched on. You need to be quick as children can tire and bore quickly.
What is the main consideration when assessing children’s eye movements?
If the kid’s head moves, ask to repeat the test using just their eyes.
Why is retinoscopy so useful in kids?
It’s ... and could be the only reliable measure of ... in children. Preferable to subjective refraction in kids younger than ..., kids with .... Before doing a ..., attempt a ... with .... Always cycloplege a child with ..., ..., ... or when you’re .... Make sure to do all ... prior to cyclopleging.
Why is retinoscopy so useful in kids?
It’s objective and could be the only reliable measure of refractive error in children. Preferable to subjective refraction in kids younger than primary age, kids with cognitive or motor impairments. Before doing a wet refraction, attempt a dry ret with one WD lens in place. Always cycloplege a child with reduced vision, strabismus, amblyopia or when you’re simply in doubt. Make sure to do all near tests prior to cyclopleging.
Why is near retinoscopy so useful in kids?
It is ... and might be the only measure of ... in kids. Best to ... amount of lead/lag without adding lenses as .... Asymmetry can ... as ....
Why is near retinoscopy so useful in kids?
It is objective and might be the only measure of accommodation-vergence function in kids. Best to estimate amount of lead/lag without adding lenses as they can interfere with the response. Asymmetry can indicate amblyopia as that eye would have greater lag than the fellow eye.
What is Mohindra Retinoscopy?
When retinoscopy is completed at ...cm, ... and ... and without a .... Adjust findings by ... in infants and ... when older than ... years old.
What is Mohindra Retinoscopy?
When retinoscopy is completed at 50cm, monocularly and in the dark and without a working distance lens. Adjust findings by -0.75 in infants and -1.25 when older than 2 years old.
How are topography, keratometry, and auto-refraction useful for refraction in kids?
Astigmatism in kids is ... in nature. Keratometry/topography can be useful for .... Autorefraction is best with done with ... and can confirm ..., but it can ... at the same time.
How are topography, keratometry, and auto-refraction useful for refraction in kids?
Astigmatism in kids is usually corneal in nature. Keratometry/topography can be useful for confirming cyl finding on ret. Autorefraction is best with done with cycloplegia and can confirm cyl found on ret, but it can overestimate cyl at the same time.
Why do we evaluate maximum plus when doing a blur function?
Children have ... that are ..., so ... should be avoided. A ... needs to be used as children are ... than adults.
Why do we evaluate maximum plus when doing a blur function?
Children have very active accommodative systems that are still developing, so overminusing should be avoided. A trial frame needs to be used as children are more dependent on their proximal cues than adults.
How does one do a blur function?
After ret, add ... or .... Warn the child that their vision ... and we will .... Slowly reduce the plus when the child makes mistakes reading out letters. Keep going until the child ..., ..., or ....
If a child has ..., do the process ....
How does one do a blur function?
After ret, add +1.00 or +1.50. Warn the child that their vision will be blurry and we will slowly improve it. Slowly reduce the plus when the child makes mistakes reading out letters. Keep going until the child plateaus, get maximum plus at 6/6, or best VA.
If a child has asymmetric vision, do the process monocularly.
How do we measure binocularity in children?
Suppression: ..., ....
Alignment: ..., ..., ...
Sensory function: ...
How do we measure binocularity in children?
Suppression: worth 4 dot, prism doubling.
Alignment: Hirschberg, HH, Cover test
Sensory function: Stereo tests
