CLM - Non-Surgical Management of Hyperopia - Week 11 Flashcards
During what period does the major post-natal growth of the eye occur?
First three years
What magnitude is most hyperopia in childhood below?
Below +2.00DD
Is the refractive state of a child soon after birth a good indication of the final refractive error of the child? Describe whay may happens with children who are myopic early in infancy as an example.
It is a good indication
Those with myopia early in infancy will eventually regress back to myopia despite emmetropisation in early childhood
In what three ways can neonatal refractive error be measured and which is the gold standard?
Autorefractor
Non-cycloplegic retinoscopy
Cycloplegic retinoscopy - gold standard
Below what age is subjective refraction not reliable?
Younger than 7-8
What eyedrop is the gold standard for refractive assessment in children under four and children with esotropia?
Cyclopentolate
Given the standing of cyclopentolate for refraction, what may some practitioners believe of this method and is it correct? Explain.
Because it is the gold standard, some believe incorrectly that this is the final hyperopia measurement
You wont be able to determine this by the end of the first visit
What level of hyperopia is it generally recommended to prescribe correction for young children (2)?
Moderate to high hyperopia
What are four considerations that should be given when considering whether to prescribe a young child with hyperopic correction?
Will you interrupt the normal emmetropisation process by prescribing for the hyperopia?
Will you improve or disturb the binocular function of the infant or child if you prescribe?
What is the risk of convergent strabismus if you dont prescribe?
What is the risk of amblyopia if the hyperopia is different in the two eyes and you dont prescribe?
What origin does most esotropia have?
Most is refractive in origin
Is there a risk of strabismus with infant hyperopia?
Yes
Does prescribing harm emmetropisation? Explain.
No
In children with corrected and uncorrected hyperopia, the rate of hyperopia reduction with age was a function of the initial level of hyperopia and not correction status.
What can uncorrected hyperopia result in concerning accommodation? What 6 things can occur as a consequence?
Results in the accommodative demand being greater than for an automatic and accurate response. This can result in:
Blur
Abnormal phorias
Possible strabismus
Asthenopic symptoms
Reduced reading efficiency, fluency, accuracy
Avoidance of reading
What 6 tests should be undertaken when prescribing infants and young children hyperopia correction?
Dry retinoscopy
Subjective refraction (if appropriate)
Blur function
Binocular vision and stereopsis
Accommodative function
Cycloplegic retinoscopy
When doing MEM retinoscopy and you prescribe plus lenses, what should be aimed for in terms of MEM results (3)?
Stable, equal, and low lag of accommodation when plus lenses are worn
