Lecture 3

Question 1

1 mm growth in axial length can cause a refractive change of how many diopters?

Answer 1

3 D
(1/3mm = 1 D)

Question 2

What is the gold standard for retinoscopy of infants/toddlers/preschoolers?

Answer 2

Cycloplegic Ret

Question 3

What is the problem with the Molinder technique of retinoscopy?

Answer 3

Underestimates hyperopia even with correction factor of 1.25D

Question 4

Distant (Static) Retinoscopy is most reliable in older children, but it also underestimates the true amount of hyperopia. T/F?

Answer 4

True

Question 5

Which type of Retinoscopy does not measure refractive error?

Answer 5

Dynamic Ret (aka MEM)

Question 6

When should you occlude the non-tested eye while performing retinoscopy and why is this done?

Answer 6

To perform an on-axis retinoscopy on a patient with strabismus. Occluding the non-tested eye, will straighten out the turned eye for ret.
(prisms an also be used to neutralize the devotion in the of the non-tested eye).

Question 7

Autorefraction is generally only useful in children over what age?

Answer 7

3 years +

Question 8

When doing the Bruckner test the eye with the dimmer reflex is the problematic eye. T/F?

Answer 8

False. (The brighter reflex indicates problem)

Question 9

Subjective refraction is usually not used until the child reaches what ages?

Answer 9

At least 7

Question 10

When calculating trial frame over refractions what is one step that if overlooked can result in inaccurate calculations?

Answer 10

Axis of initial cycle ret and axis of ret over trial frame must be the same before you add the two together to see if you have the wanted plano over refraction. (cannot add +2.00 x 180 to +1.00 x090… must transform to same axis, then add)

Question 11

Why are 2 downfalls of the Atomizer Spray Administration of anesthetic drops?

Answer 11

Spray may not give full cycle effect.

You don’t know how much of the spray actually went into the eye

Question 12

When are contact lenses consider in pediatric patients?

Answer 12

1) if very high refractive error (10D+)
2) significant anise
3) Nystagmus
4) Cosmesis
5) When compliance will not be an issue

Question 13

How much astigmatic, hyperopic, and myopic anisometropia is considered to be amblyogenic?

Answer 13

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

Question 14

How much astigmatic, hyperopic, and myopic isometropia is considered to be amblyogenic?

Answer 14

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

Question 15

Infants with a refractive error > +3.50D are at a ___ times higher risk for developing ________ by the age of 4.

Answer 15

13X

strabismus

Question 16

What are the benefits of partially correcting hyperopia?

Answer 16

Reduce risk of strabismus and amblyopia without altering emmetropization process

Question 17

What 3 pieces of information should be obtained during the exam of a child with hyperopia?

Answer 17

1) manifest hyperopia (distance ret without cyclo)
2) is there enough accommodation to overcome the manifest hyperopia? (MEM and Amp of Accom)
3) latent hyperopia (cyclo ret)