7.1.4- techniques of infant assessment Flashcards
What q’s would you ask a parent for hx of 18 month old?
Do you have any concerns about your child’s vision?
Do they seem to be able to see things OK when you point to objects?
Are they bumping into things?
Do their eyes seem to have a turn one way or the other?
Were there any complications during the birth?
What was their birth weight?
Is there any relevant family history?
Has the child suffered from any illnesses?
What type of tests are good for pre-verbal children and how do they work?
Preferential looking like cardiff acuity test- use child eye movements to check if target seen. Cardiff Acuity Test presents vanishing optotypes which measure resolution acuity (the ability to detect and resolve a target). Cards are presented at 50cm or 1m
What is the disadvantage for preferential looking tests?
Not as sensitive to amblyopic deficits as a picture/letter naming matching test
How do you know the visions/VA for sure on a preferential looking chart?
Should be sure on preferential looking on 3 out of 4 presentations of a card
What are the normative values of binoc and monoc va’s for children doing a preferential looking test like cardiff acuity?
What stereopsis tests would you use for a child under 2
Tests that don’t require the use of dissociating filters (polarizing filters or red/green glasses) such as the Lang and the Frisby
Why does the Lang test not require dissociative filters?
It is a random dot stereotest where dissociation is provided by the vetical cylinders arranged on the front surface of the card (each eye has a different view of the card). Without stereopsis, the card just looks like grey dots; with stereoscopic viewing conditions the px can see shapes. It should be done at 40 cm
Why does the Frisby not require dissociative glasses?
It is a real stereo test as the target is on one side of the perspex plate and the pattern on the other side. A range of stereo disparities can be presented using the same plate at different distances
For a child under 2 in what sense is stereopsis important?
Just check whether they have or don’t have stereopsis, not necessarily stereoacuity. 3-4 month old should have gross stereopsis and at 6 months they should have adult like in lab setting
What are the key points in refracting a chld under 2 and why/how?
Carry out cycloplegic refraction to control accommodation and gain accurate refractive error assessment and provide dilation to allow a better internal ocular examination.
0.5% in under 12months and 1% cyclopentolate HCl for over 12 months. 1 drop is placed in each eye (occlude puncta to maintain as much as possible on the eye) and then 10 mins later check as dark iris px may need another drop. Dilation occurrs before cycloplegia- cyclo should happen 30-40 mins after and ret results will fluctuate if full cyloplegia not achieved
don’t use trial frame- hold lenses
use bracketing technique with lenses and compare reflexes between eyes (make sure similar and check both meridians)
