Paediatric prescribing

Question 1

Paediatric considerations

Answer 1

Is rx in normal range 
Will rx emmetropise
Will rx disrupt normal development 
Will specs improve visual function
Will specs interfere with emmetropisation

Question 2

If <1yo has hyperopia outside 95% range

Answer 2

Leave uncorrected just above mean for their age

Question 3

Aged 1-4 >+3.50D

Answer 3

Prescribe 1D less than least hyperopic meridian

Or half cyl >2.50DC

Question 4

4-5yo >+2.50D

Answer 4

1-1.5D less

Question 5

<1yo , less than -5D

Answer 5

Reduce by 2D

Allow for poss emmetropisation

Question 6

1-4yo

Less than -2D

Answer 6

Reduce 0.5-1D

Question 7

4-5yo < -1D

Answer 7

Prescribe less than -1D

If VA improvement / child notices

Question 8

When would you prescribe full rx

Answer 8

School age >+1.50D/accom sot
School age any myopic rx
Any age >1D oblique astigmatism 
School age >0.75D cyl
School age >1.50 anisometropia

Question 9

2-4yo >2D wtr/atr

Answer 9

1D less than least hyperopic meridian

Half cyl if >2.50dc

Question 10

4-5yo >1.50DC

Answer 10

Reduce 1-1.5D

Question 11

Any age anisometropic amblyopic

Answer 11

Leave uncorrected hyperopia above mean

Question 12

2-3.5yo

>1D and < 3D anisometropia

Answer 12

Potentially transient myopia

Question 13

4-5yo >2.5D anisometropia

Answer 13

Reduce by 1-1.5D

Question 14

Glasses in classes

Answer 14

Schools supporting children wearing specs
Control schools - normal visual screening
Intervention schools - visual coordinator - support child/parents - spare pair of specs