Lec 2. Pediatric Eye Exam Techniques for Infants and Young Children

Question 1

What are you most concerning about infants (birth to 18 months)?

Answer 1

• Amblyopia strabismus (congenital ET, Pseudo-ET) and high refractive error
• congenital malformations, neurologic disorders, ocular pathology and developmental delays

Question 2

What are you most concern about in toddlers (18-3 years)?

Answer 2

• Amblyopia, strabismus (accommodative ET), and moderate refractive error
• congenital malforations, ocular pathology and developmental delays.

Question 3

How many days is normal staying at the hospital after birth?

Answer 3

2 to 3 days.
if it’s a week, there might be some small condition to the baby.
if it’s a month, there must be something serious going on with the baby.

Question 4

What is Monocular/Binocular Fixation Pattern? (Fix, Follow, Maintain)

Answer 4

It’s a gross assessment of acuity and relative difference in acuity between eyes. Not quantitative, may show fixation preference without amblyopia when strabismus present.

Question 5

Which test is most objective?

Answer 5

VEP. It does not require perceptual recognition, communication, coordinated motor responses.

Question 6

What are the subjective tests?

Answer 6

Lea Symbols, Patti Pics, HOTV, Tumbling E, Broken Wheel

Question 7

is preferential looking test objective or subjective?

Answer 7

objective

Question 8

Is preferential looking test under or over- estimates acuity loss due to amblyopia, refractive error and macular/foveal pathology?

Answer 8

underestimates

Question 9

in FPL, 1 month will have VA of ____.

Answer 9

20/600

Question 10

in FPL, 3 month will have VA of ____.

Answer 10

20/200

Question 11

in FPL, 6 month will have VA of ____.

Answer 11

20/100

Question 12

in FPL, 12 month will have VA of ____.

Answer 12

20/50

Question 13

in FPL, 3-5 years will have VA of ____.

Answer 13

20/20

Question 14

What type of test isTeller Acuity Card?

Answer 14

Preferential looking for infants

Question 15

What type of test is Keeler Acuity Card?

Answer 15

PL for infants

Question 16

What type of test is Lea Grating Paddle?

Answer 16

PL. it’s more portable than Teller Acuity or the Keeler Acuity Cards but the examiners’ face can be distracting because it’s not covered.

Question 17

Expected VA of Cardiff acuity test of a 12-18 months is ____.

Answer 17

20/50 - 20/120

Question 18

Expected VA of Cardiff acuity test of a 18-24 months (1.5 - 2 yrs) is ____.

Answer 18

20/25 - 20/100

Question 19

Expected VA of Cardiff acuity test of a 24-30 months (2 - 2.5 yrs) is ____.

Answer 19

20/25 - 20/60

Question 20

Expected VA of Cardiff acuity test of a 30- 36 months (2.5 - 3 yrs) is ____.

Answer 20

20/20 - 20/40

Question 21

What are the advantages of Lea symbols, Patti Pics and HOTV?

Answer 21

they are both distance and near, well standardized, available in LogMAR form with crowding bars; multiple chart formats for distance and near.

Question 22

Why don’t we want to use Allen Figures?

Answer 22

It’s not standardized.

Question 23

What is a significant difference between eyes or between visits?

Answer 23

teller/keller acuity cards…2 cards
Cardiff acuity test..2 cards
Snellen acuity… 3 lines
LogMAR acuity test.. 4 letters

Question 24

What tests to check for the kid’s eye alignments?

Answer 24

Hirschberg, Krimsky, Bruckner test, cover test

Question 25

What can Bruckner Test for?

Answer 25

• The presence of strabismus
• The presence of anisometropia
• The presence of media opacities
• The presence of pupil size asymmetries

Question 26

How can you evaluate the sensory of binocular status of infants and toddlers?

Answer 26

use stereo smile

Question 27

How do you evaluate the sensory of binocular status of preschool children?

Answer 27

Worth 4 dot, Random Dot E, Randot Stereofly.

Question 28

At what age should we be concern about kids color vision?

Answer 28

3-4 y/o

Question 29

Ishihara only tests for which color defects?

Answer 29

protan (red) and deutan (blue)

Question 30

T/F Dont have do dilate all the children during first eye exam.

Answer 30

False. DFE using binocular indirect on all children, especially at first eye exam.