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Pediatric Optometry > Midterm 1 > Flashcards

Midterm 1 Flashcards

1
Q

What makes up the APGAR score and what is a normal score

A

Appearance, Reflex, Respiratory, Pulse, Muscle Tone

7+ is normal

0-2 in each category

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2
Q

What is the recommended eye exam frequency?

A

Birth to 2 years: at 6 months

2-6: at 3 years old

6-18: Before 1st grade and then every 2 years if no risks

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3
Q

What is the age of infant

A

birth to 1 year

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4
Q

what is the age of toddler

A

1-3 years old

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5
Q

What is the age of preschooler

A

3-6

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6
Q

what is school age

A

6-18 years old

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7
Q

What are the components of a case history

A 
Chief Complaint with at least 4 HPI (FLORIA) 
- routine, first eye exam, or annual 
Ocular History 
Family History 
Medical History -- ADHD, Asthma, Allergies
Allergies 
Medications
Academic History 
Developmental History
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8
Q

What are the FDA pregnancy categories

A

A: well controlled studies failed to demonstrate risk to fetus
B: Animal studies only
C: no animal or human studies show effect on fetus
D: evidence of human fetal risk
X: human or animal study have demonstrated risk to fetus

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9
Q

What are the new FDA categories (2015)

A

Pregnancy Category
Lactation Category
Female and Male Reproductive Potential

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10
Q

What are the types of acuity?

A 
Resolution Acuity (spatial frequencies) 
Detection Acuity (something is there) 
Vernier Acuity (misalignment) 
Recognition Acuity (SNELLEN)
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11
Q

What are the immaturies in visual system?

A

cortical immaturity: incomplete myelination throughout visual pathway and foveal cone immaturities (adult by 4 years old) and foveal pit morphologies (varies by adult like by 17 months)

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12
Q

How do you interpret CSM results

A

Central
Steady – if not, nystagmus
Maintained – if not, poor acuity

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13
Q

What are the different types of FPL tests?

A

Forced Preferential Looking (must choose 1)

Resolution VA (spatial frequencies) 
TAC, Lea Paddles -- not snellen equivalent
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14
Q

What are the expected results of OKN and limits?

A

OKN: involuntary eye movement induced by the speed of motion of visual field

Holds images stable on retina

Start T to N first and then N to T and record if response

Not truly foveal; not affected by RE

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15
Q

What happens if there is no OKN response in a non-blind child

A

lesion in cortex, cerebellum or brainstem

cortical dysplasia or blindness

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16
Q

what can OKN be used for

A

determine if child has abnormal binocularity based on asymmetric responses

17
Q

Why do you use cycloplegia for infants

A

infants have small pupils and high accommodative response

18
Q

What is the avg RE of a full term newborn

A

+2D avg with a standard deviation of 2.75D

Range: -0.75 - 4.75

19
Q

What is emmetropization

A

tendency for eyes to go to plano

+0.50D to 1.00D with SD of 1D

20
Q

What is the active evidence for emmetropization

A

The eye is regulated by retinal blurs and adjusts accordingly

Increase axial length of eye = eye is growing

Lots of reading = increase myopia

Media opacities and retinopathy prematurity leads to more myopic patients

21
Q

What is the passive evidence for emmetropization

A

occurs as a result of physical or genetic changes

change in corneal lens power

parents who are myopic increases the chance of child being myopic

22
Q

What was significant about the BIBS study

A

Berk Infant Biometric Study
(2009)
262 infants defined emmetropization around less than 2D by 9 months

  • bidirectional: both M and H did it (the more magnitude of RE, the less likely to become emmetropic)

cycloplegic refraction was best predictor

23
Q

What is the streak for

A

neutrality and finding cyl axis

24
Q

what is the spot for

A

looking at more than 1 axis, brighter, better color, better for peds

25
Q

How do you measure accommodation ability

A

NRA/PRA and Facility

26
Q

How do you measure accommodation amplitude

A

Push up, Push away, minus lens method

27
Q

how do you measure accommodation response

A

FCC + MEM (objective)

28
Q

What are the reasons for a high lag?

A

normal, accommodative dysfunction (infacility, insufficiency), uncorrected M/H, overminused, eso with poor ranges or malingering

29
Q

what are the reasons for low lag?

A

normal, accommodative dysfunction (spasm), overplussed, exo with poor ranges

30
Q

What is the timeline for color vision development

A

infant: red from white
1 mos: blue and green from gray
3 mos: yellow, blue, green from gray

31
Q

What are the anesthetics used for peds

A

Proparacaine, Tetracaine, or Benoxinate

AE: irregular HR, SOB, nausea, swelling (SUPER RARE)

Pediatric Optometry (14 decks)

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