Midterm 1 Flashcards
What makes up the APGAR score and what is a normal score
Appearance, Reflex, Respiratory, Pulse, Muscle Tone
7+ is normal
0-2 in each category
What is the recommended eye exam frequency?
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
What is the age of infant
birth to 1 year
what is the age of toddler
1-3 years old
What is the age of preschooler
3-6
what is school age
6-18 years old
What are the components of a case history
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
What are the FDA pregnancy categories
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
What are the new FDA categories (2015)
Pregnancy Category
Lactation Category
Female and Male Reproductive Potential
What are the types of acuity?
Resolution Acuity (spatial frequencies) Detection Acuity (something is there) Vernier Acuity (misalignment) Recognition Acuity (SNELLEN)
What are the immaturies in visual system?
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)
How do you interpret CSM results
Central
Steady – if not, nystagmus
Maintained – if not, poor acuity
What are the different types of FPL tests?
Forced Preferential Looking (must choose 1)
Resolution VA (spatial frequencies) TAC, Lea Paddles -- not snellen equivalent
What are the expected results of OKN and limits?
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
What happens if there is no OKN response in a non-blind child
lesion in cortex, cerebellum or brainstem
cortical dysplasia or blindness
what can OKN be used for
determine if child has abnormal binocularity based on asymmetric responses
Why do you use cycloplegia for infants
infants have small pupils and high accommodative response
What is the avg RE of a full term newborn
+2D avg with a standard deviation of 2.75D
Range: -0.75 - 4.75
What is emmetropization
tendency for eyes to go to plano
+0.50D to 1.00D with SD of 1D
What is the active evidence for emmetropization
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
What is the passive evidence for emmetropization
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
What was significant about the BIBS study
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
What is the streak for
neutrality and finding cyl axis
what is the spot for
looking at more than 1 axis, brighter, better color, better for peds
How do you measure accommodation ability
NRA/PRA and Facility
How do you measure accommodation amplitude
Push up, Push away, minus lens method
how do you measure accommodation response
FCC + MEM (objective)
What are the reasons for a high lag?
normal, accommodative dysfunction (infacility, insufficiency), uncorrected M/H, overminused, eso with poor ranges or malingering
what are the reasons for low lag?
normal, accommodative dysfunction (spasm), overplussed, exo with poor ranges
What is the timeline for color vision development
infant: red from white
1 mos: blue and green from gray
3 mos: yellow, blue, green from gray
What are the anesthetics used for peds
Proparacaine, Tetracaine, or Benoxinate
AE: irregular HR, SOB, nausea, swelling (SUPER RARE)
