module 18 common disorders with school-aged children

Question 1

amblyopia

Answer 1

unilateral deficit in which there is defective development of the visual pathways needed to attain central vision

• clear focused imaged fail to reach the brain
• reduced or permanent loss of vision

Question 2

deprivational amblyopia

Answer 2

obstruction of vision

• ptosis
• cataract
• nystagmus

Question 3

refractive amblyopia

Answer 3

myopia: near sighted
hyperopia: far sighted
astigmatism: abnormal curvature of eye
anisometropia: refractive power different between eyes

Question 4

amblyopia clinical findings

Answer 4

• squinting, covers/closes one eye when concentrating
• abnormal vision, cover/uncover, and/or fundoscopic exam
• pain in or around eyes, HA
• fatigue, dizzy
• developmental delay
• family hx

Question 5

amblyopia management

Answer 5

refer to ophthalmologist or optometrist for corrective lens

• annual evaluations recommended
• moderate: can respond to 2 hours of daily patching

Question 6

strabisus

Answer 6

defect in ocular alignment, or position of eyes in relation to each other

• lazy eye
• muscles of the eyes are not coordinated, when one eye is directed straight ahead the other deviates
• children older than 7-9 this causes dbl vision

Question 7

phoria

Answer 7

type of strabismus

• intermittent deviation in ocular alignment that is held latent by sensory fusion.
• child can maintain alignment on object
• deviation occurs when binocular fusion is disrupted, most often during the cover/uncover test

Question 8

tropia

Answer 8

type of strabismus

• consistent or intermittent deviation in ocular alignment
• unable to maintain alignment on an object of fixation
• intermittent occurs when the child is tired

Question 9

strabismus clinical findings

Answer 9

• intermittent exotropia
• when only one eye is affected: child focuses with the unaffected eye
• when both eyes are affected: the one that looks straight is the fixating eye
• persistent squinting, head tilting, face turning, over-pointing
• marked dec. visual acuity in one eye
• possible nystagmus

Question 10

strabismus managment

Answer 10

• suspicious after age 4 months and should be referred
• unaffected eye is occluded, forcing the child to use affected eye
• corrective lenses
• surgery

Question 11

bullying

Answer 11

any unwanted aggressive behavior by another youth or group of youths that involves power imbalance and is repeated or likely to be repeated multiple times

• physical
• verbal
• relational/social
• aggression
• cyber

Question 12

bullying behaviors cause

Answer 12

physical injury
social and emotional distress
depression
anxiety
sleep difficulties
lower academic achievement
eating disorders
health issues
academic issues 
mental health disorders later in life

Question 13

youth who bully are at risk for

Answer 13

substance abuse
academic problems
inc. risk for criminal activity
mental health disorders later in life

Question 14

learning challenges

Answer 14

difficulties with

• basic thinking and processing
• specific problems in language, attention, organizational skills
• higher cognitive functions
• • memory and sensory function
• • motor capacities
• • visuospatial analysis
• • neuro-motor function
• • social awareness and behavior

Question 15

Learning challenges history

Answer 15

• vision and hearing abilities
• progress, interest, success in school
• sudden changes in school performance
• changes noted in vocabulary/language, logical reasoning, ability to problem solve
• hyper/hypo sensitivity to sensory stimuli
• req. fidgeting or inability to meet age appropriate expectations for seated activities
• concerns with peer interactions
• identification of learning problems by school

Question 16

learning challenges exam

Answer 16

• general appearance, interaction with caregiver and examiner.
• ability to follow commands
• eye: nystagmus, strabismus
• neuro: sensation, mobility, tone and strength, fine motor skills
• mental status: sensory, cognitive, and language abilities.