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Contact Lenses > paediatric CL fitting > Flashcards

paediatric CL fitting Flashcards

1
Q

refractive indications for paediatric CL fitting

A
  • aphakia
  • high myopia
  • anisometropia
  • frequent chnages in rx
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2
Q

pathology/therapeutic indications for paediatric CL fitting

A
  • aniridia
  • myopia management
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3
Q

lifestyle indications for paediatric CL fitting

A
  • cosmetic
  • sports
  • regular spectacle breakage
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4
Q

what is aniridia?

A

congenital or traumatic defect where the iris or part of the iris is missing

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5
Q

how would you use a CL to help with aniridia?

A

therapeutic - use a coloured CL to mimic the iris

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6
Q

what are some common concerns from a parent?

A
  • child’s ability to manage CLs
  • potential harm to child’s eye
  • are they old enough?
  • financial consideration
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7
Q

is there an age limit for the use of CLs?

A

no !!

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8
Q

GOS3 and cls?

A

gos3 can be put towards cls but better used for specs as it will ocver the full cost of specs

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9
Q

what are some common concerns for the child?

A
  • painful
  • difficult to handle
  • disappointing others
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10
Q

if a child has no motivation for wearing CLs, what do you do?

A

defer fitting to a later date or when the child is older and has appropriate conversations with their parents

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11
Q

what are some concerns for the optom?

A
  • financial impact of chair time
  • how to take measurements and conduct clinical tests e.g lid eversion
  • maturity
  • consent from parent/guardian
  • child’s hygiene
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12
Q

in the world, where are paediatric CL fittings the highest? (top 3)

A

israel
colombia
spain

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13
Q

which 2 studies investigates CL fitting and wear for children and teens?

A

CLIP and PREP

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14
Q

what does CLIP stand for?

A

CL in Paediatrics

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15
Q

what does PREP stand for?

A

Paediatric Refractive Error Profile

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16
Q

what did the CLIP and PREP survey find?

A
  • CL improved how children feel about their appearance and participation
  • improvement in quality of life within 1 week (23-24%)
17
Q

what did the CLIP study find out about chair time?

A

chair time is greater for children by 15 mins compared to teens
- chair time is similar between children and teens
- insertion/removal took slight longer with children than it did with teens

18
Q

how do you adapt your approach?

A
  • book a longer appointment
  • book in school holidays so less tired
  • some practitioners will use an anaesthetic to reduce chair time
  • let the child touch lens
  • MAKE IT FUN
  • USE LAY TERMS
19
Q

do you use anaesthetic when fitting CL in kids?

A

no - will give the impression the lenses will hurt

20
Q

2 important qs to ask in h&S

A
  • is anyone at home a CL wearer? : any pre-conceived ideas? adopted bad CL care habits
  • who wants the contact lenses? ; is the child motivated enough to trial CL?
21
Q

what are some considerations for when you are doing slit lamp?

A
  • darkness
  • touching eyelids
  • lid eversion
  • instilling NaFl
22
Q

how would you explain keratometry to a child?

A

this machine checks how round your eye is

23
Q

how do you explain slit lamp to a child?

A

this is a giant torch/microscope to check how healthy your eye is

24
Q

what are some fitting considerations for RGPs?

A

BOZR same Ks as adult by 10 yrs old
TDs available in smaller values e.g. 9mm

25
Q

what are some fitting considerations for soft lenses?

A
  • SiHy if available in power range - less change of hypoxia
  • daily disposable best option
  • steep BOZR and mini TDs available
26
Q

considerations when fitting babies with CLs

A
  • usually in hospital
  • have smaller inter-palpebral apertures
  • infants normally have steeper corneas
27
Q

aphakia in babies/infants - what power do you give from 0-12 months?

A

+29-32D

28
Q

aphakia in babies/infants - what power do you give from 12-24 months?

A

+20-26D

29
Q

aphakia in babies/infants - what power do you give from >2 years?

A

+12-20D

30
Q

what happens to the power of the CL, as axial length increases?

A

decrease (emmetropise)

31
Q

if a baby has aphakia, what feature of a CL is a significant consideration?

A

DK

32
Q

how to explain the sensation of CLs to a child?

A
  • explain procedure
  • explain lens may tickle when first inserted
  • explain its important they feel the lens
  • DONT USE THE WORD PAIN
  • if child is struggling rebook for another day
33
Q

how do you teach a child to put a lens in and out?

A
  • be encouraging/be positive
  • make the procedure fun!
  • ensure child can complete insertion and removal
  • ensure child and parent have read instructions
34
Q

how do you ensure compliance in a child?

A
  • explain procedures to parents AND child
  • written info for parent and child
  • written info for child should be age appropriate
  • provide emergency contact details
  • children tend to be more compliant than teenagers
  • at every AC ask child to demonstrate care regime
35
Q

why do infant aphakes need a more positive powered lens?

A

shorter axial length

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