Infants Flashcards
What are the main parental concerns of their infant?
- Eye turn
- Squinting
- Eye rubbing
- Photoqphobia
- Family Hx
- Eyes look funny
What are the main ophthalmic concerns of an infant?
- Congenital malformations
- Neurological disorder
- Ocular pathology
- RE
- Strabismus
- Amblyopia
What do babies like to look at?
- Mirrors
- Lights
- Faces
What do we want to know for an exam for a birth-2 yo?
- Infancy behavior
- General health
- Dev. Hx
- Educational Info
- Parent Q’s
- Goals for exam
The Denver Developmental screening test looks at what?
- Personal social
- Language
- Fine Motor
- Gross Motor
What is the best type of occlusion for a child from birth to 2?
Adhesive patch applied correctly on the eye
What are we looking for when doing Visual acuity assessments?
- reduced VA
- Unequal acuity
- Amblyopia detection
What’s the gold standard for VA?
Recognition acuity
- not used below 3 yrs
What test of choice for VAs are used for babies and children below the cognitive age of 3 yrs?
Resolution acuity
What is the most common resolution acuity ?
Teller Acuity - detemines 20/20 to 20/2000
What are the 4 types of FPL cards?
- Cardiff Cards
- LEA acuity paddles
- Teller Acuity Cards
What is the basis for decision in FPL?
- first fixation
- duration of fixation
- number of fixations
- behavior response of child
What calculation can be used to determine the VA in FPL?
600/age of child = VA
Ex. 6 mo old = 20/100
TAC are most sensitive to what ocular findings?
- cortical visual impairment
- ON loss
- Delayed vision maturation
- Develop.Abnormalities
- Amblyopia
TAC are less sensitive to what?
- Myopia
- Moderate astigmatism
- Macular loss
- Screening VA (26% false positives)
What are the 2 types of detection acuity tests?
- Stycar
2. Candy beads
This method is used to assess the presence of pattern vision; used to detect high amblyopia
Fix and follow
Fix and follow has a 60-80% false negative rate. What does this mean?
60-80 children out of 100 will be missed when testing if they have amblyopia
Fix and follow has a 31-68% false positve rate. What does this mean?
31-68 children out of 100 will be deemed as amblyopic when they’re not
This is used when there is no response to objects.
Light and form perception
What is an example of an involuntary visual response?
OKN drum
What test can be used to confirm amblyopia?
- Alternate Fixation
2. 10 pd vertical prism
Name the type of supplemental tests to confirm amblyopia?
Bruckner Test
At what age does stereopsis emerge?
3-4 months
At what age are eyes aligned?
6 months
How do we test motor function in children?
- Cover test
- NPC
- Versions
What supplemental tests can be used to determine motor function?
- Hirschberg/Krimsky
- hirsch - confirms presence of strab
- krims - estim. dev. w/ prism - Bruckner Test
The motor function is what the ____ sees. The sensory function is what the ____ sees.
- parent
- baby
What is the normal NPC in a child?
2-3 inches
- emerges at 3-4 months
A lack of stereopsis detects what problems?
- intermittant/small angle strab
- anisometropia
- amblyopia
- ocular pathology
What are the exam techniques used to measure RE?
- Near retinoscopy (Mohindra)
2. Cycloplegic refraction
What are the supplemental techniques to measure RE?
- AutoRefrac
2. Distance retinoscopy
Abnormal motilities indicate what?
- decreased VA
- Nystagmus
- Neurological
Pursuits should be smooth by what age?
6-8 weeks
Saccades should be accurate by what age?
6-8 wks
How do you test VF in infants?
confrontation puppet/monster fields
