8.1.5 - Child at Risk of BV Anomaly

Question 1

Risks for BV issues in children

Answer 1

• FH
• premature birth
• birth problems
• GH conditions

Question 2

Appropriate examinations

Answer 2

• Stereopsis
  
  • Reduced early on puts child at risk
• VAs
  
  • If assymetrical or they don’t like one eye compared to the other to be covered then indicates start of amblyopia
• Squint
  
  • If early onset, then automatically at risk of amblyopia
• 20 base out
  
  • Looks for any suppression
• CT
  
  • Looking for a squint generally speaking
  • Sometimes an esophoria or exophoria can start decompensating early on depending on extent of fusional reserves and cause a tropia. If within critical period then suppression can build to prevent diplopia
• Pull up amplitude test
  
  • Accommodative insufficiency will affect Down syndrome patients!
  • It can also affect normal children so it must be measured to allow the correct Rx to be given for close up tasks, otherwise their education will be affected
  • Dynamic - a lag greater than 1 D suggests a degree of hypermetropia that the child cannot manage. An unequal lag between the two eyes suggests a degree of anisometropia that is poorly compensated for
• Motility
• Shadow test - to check AC angle
• Ret - Cyclo normally