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Pediatrics > Lecture 3 - 4 - Refraction and Prescribing for Infants and Young children > Flashcards

Lecture 3 - 4 - Refraction and Prescribing for Infants and Young children Flashcards

1
Q

Axial length increase within the first ___ years of life.

A

5 years

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2
Q

Every ___ of growth can cause 1.00D of refractive change

A

1/3 mm

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3
Q

Majority of infants have what type of refractive error?

A

Hyperopia

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4
Q

What is the percentage of astigmatism in infancy?

A

50%

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5
Q

Mohindra retinoscopy (Near) is a good non cycloplegic technique. But it _________ hyperopia, so it is NOT appropriate to determine true refractive error.

A

Underestimates

Note: Mohindra suggests 1.25D to be subtracted from your findings while Saunders says 0.75 for children under 2

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6
Q

Out of all the retinoscopy techniques, which is the most RELIABLE?

A

Static (Distance)

Note: It still does underestimates

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7
Q

What is the most ACCURATE retinoscopy?

A

Cycloplegic retinoscopy

Note: Gold standard

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8
Q

True or False. MEM measures refractive error?

A

False

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9
Q

What measurement device is excellent in finding astigmatism?

A

Autorefraction

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10
Q

What test gives you the gross estimation of equality of refractive error between the two eyes?

A

Bruckner

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11
Q

True or False. The phoropter will induce astigmatism?

A

True

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12
Q

What spectacle lens material is best suited for infants?

A

Polycarbonate or Trivex

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13
Q

What are the ranges in identifying amblyopia?

A

Anisometropia
Astigmatism = >1.50D
Hyperopia = >1.00D
Myopia = >3.00D

Isometropia
Astigmatism >2.50D
Hyperopia >5.00D
Myopia >8.00D

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14
Q

If a hyperopic pt is uncorrected and excessive amount of accommodation is notice, what is their likely deviation to occur with their eye?

A

ESO deviation

Note: Symptoms are strongest at near

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15
Q

What is the usual birth refractive error?

A

+2.00D

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16
Q

What is the likelyhood of a infant with RE greater than +3.50D will develop strabismus?

A

13x higher

17
Q

What would you do with a Bilateral High Hyperopia (>+5.00D) with no associated esotropia in an Infant, preschooler, and school children?

A

Infant = Partial correction given

Preschool children (3 to 5) = Partial correction

School children (3 to 5) = Partial correction but can tolerate all the way upto 3.00D

18
Q

What would you do with a Bilateral Moderate Hyperopia (+2.00D to +5.00D) with no associated esotropia in an Infant, preschooler, and school children?

A

Infant = Monitor 3 to 6 Months

Preschool = Partial correction

School children = Full Rx., or partial correction if symptomatic

19
Q

True or False. regardless of age you will give the full prescription to achieve ocular alignment when esotropia is associated with hyperopia

A

True

20
Q

At birth what is the most common type of astigmatism, ATR or WTR?

A

ATR

21
Q

True or False. Decreased acuity in the orientation of maximum blur caused by astigmatic refractive error is considered Meridional Amblyopia?

A

True.

Note: This is only present after 2 years of age

22
Q

At what ages should you consider prescribing, when the refractive power is greater than 1.50D?

A

1 to 3 years but should be associated with
•It is stable or increasing in amount over 3 visits

  • It has an oblique axis or associated anisometropia
  • If > 2.50 D and stable, prescribe to prevent amblyopia
23
Q

At what age group do children present with less than 0.50D of cylinder

A

3 to 5 years of age

24
Q

What is a normal amount of Aniso found in infants?

A

> 1.00D

25
Q

What is the percentage of remaining aniso in school age children?

A

3 to 4%

26
Q

When should you be concerned about Aniso when they are 1 years of age?

A

> 3.00D, this will likely presist into childhood

27
Q

What is the management protocol for infants with Aniso?

A

–Monitor at 3 month intervals for stability
–Prescribe if
•> 3.00 D of anisometropia stable over 2-3 visits
•Increasing amounts of anisometropia
•Strabismus/amblyopia is present

28
Q

What is the management of Aniso for children age 3 and over?

A

–Anisometropia of 1.00 D or greater

–If acuity or binocularity is compromised

29
Q

what should you prescribe in the presence of Aniso?

A

Prescribe entire anisometropic difference in spherical refractive error
•Hyperopic -If esotropia is present, prescribe maximum hyperopic correction
•Hyperopic -If no strabismus, can under correct both eyes by the same amount, especially before school-age
•Myopic –prescribe the full minus

30
Q

What type of infants show a common sign of myopia?

A

Myopia

Females tend to develop myopia soon than males.

31
Q

Which of the two drugs, Atropine or Pirenzipine, is considered safer to use to minimize the progression of myopia?

A

Pirenzipine

Pediatrics (6 decks)

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