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Pediatric Optometry > Pediatric Optometry: L4: Infant and Toddler Eye Exams > Flashcards

Pediatric Optometry: L4: Infant and Toddler Eye Exams Flashcards

1
Q

Case History

  1. Always taken from who’s point of view?
  2. Questions to ask?
  3. What kind of History?
A
  1. from Child and Parents
  2. Ask Non-Threatening Questions first (Age, DOB), ask questions about siblings, sports, etc.
  3. Pregnancy and Birth Hx, Developmental Hx, and Academic Hx
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2
Q

Academic Hx

  1. What should you get?
A
  1. Grade placement, GRADE LEVEL FUNCTIONING, etc.
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3
Q

Prenatal Hx

  1. What should we find out?
A
  1. Maternal Health and Nutrition
    a. Illness/Infection during pregnancy…

b. Maternal Nutrition before and during pregnancy can put kids at risk for developmental handicaps
c. Maternal exposure to toxins, drugs, alcohol, cigarette smoking and meds

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4
Q

Developmental Hx: Devlopmental delays can correlate w/Academic difficulties

  1. Gross motor delay
  2. Delay in Fine Motor
  3. Best predictor of ultimate function in school?
A
  1. Determine preference in sports and games (may avoid stuff that requires motor activity and tend to play w/younger kids)
  2. Shy away from handwritten work
  3. Early Language Development
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5
Q

VAs: Types

  1. Recognition/Identification
  2. Resolution
  3. Detection
A
  1. Objects/Symbols
  2. Minimum Resolvable
  3. Minimum Visible
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6
Q

VA Types

  1. Detection (2)
  2. Resolution (4)
  3. Recognition (6)
A
  1. a. Candy Beads/Sprinkle
    b. Fix and Follow
  2. a. Teller Acuity Cards
    b. LEA Grating Paddles
    c. Patti
    d. OKN
  3. a. Snellen
    b. HOTV
    c. Lea Symbols
    d. Cardiff Cards
    e. Broken Wheel
    f. Allen Pictures
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7
Q

Assessing VA

  1. Infant (3 y/o) (4)
A
  1. a. OKN
    b. Fix and Follow
    c. Teller Acuity Cards
  2. a. Allen Symbols
    b. Broken Wheel
    c. Cardiff Cards
  3. a. HOTV
    b. Lea Symbols
    c. Snellen/ETDRS
    d. Tumbling E
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8
Q

VA Testing

  1. Infants/Toddlers: Type of testing?
  2. Preschoolers?
  3. Always do what?
A
  1. Resolution and Detection
  2. Recognition
  3. Patch; Observe Response to Occlusion
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9
Q

Occlusion

  1. If Pt has Resistance to occlusion, this is our first indication about what for the Pt?
A
  1. That they DO NOT SEEL WELL!
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10
Q

OKN

  1. Complicated or basic assessment?
  2. # of rotations per minute?a. Why?
  3. Observe for what?
A
  1. Basic
  2. 5-10 per minute
    a. Spin too fast = may not pick up nystagmus
  3. Horizontal and Vertical OKN Nystagmus
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11
Q

OKN

  1. Visually normal infants have what kind of response?
    a. Easier which way?
    b. Poor pursuit which way?
    c. Becomes Symmetric by what age?
    d. Persistent asymmetry may indicate what?
  2. Asymmetry of slow phase may be seen with what?
  3. Early saccade impairment may be seen with what?
A
  1. Asymmetric OKN response
    a. T-N
    b. N-T
    c. 3-6 months
    d. Problem w/Visual Development
  2. w/Parietal Lesions
  3. in Dz States
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12
Q

Detection: Candy Beads

  1. Does not give what?
  2. What do u do?
A
  1. Doesn’t give quantifiable VA

2. Increase test distance 6, 10, 12, 14, 16 inches, until response is absent

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13
Q

Fix Follow and Maintain

  1. Age?
  2. Mono/Bino?
  3. What do u do?
A
  1. <1
  2. Monocular
  3. Put character on top, see if they can fixate the target and follow it. Flash transilluminator w/finger to get attention
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14
Q

Teller Acuity Cards

  1. Number of Cards?
  2. Spatial frequency not directly comparable to what?
  3. Test Distance
    a. Infant (birth to 6 months)
    b. Infants (7 months -3 years)
    c. Patients (>3 yrs)
  4. Threshold = ?
A
  1. 17 (1 blank, 1 demonstration, 15 sine wave grating cards) 4 mm peephole in center so tester can observe where child is looking
  2. to Optotype
  3. a. 38 cm
    b. 55 cm
    c. 84 cm
  4. Cant distinguish b/w gray background and contrast bars
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15
Q

Patti Stripes

  1. Works like what test?
  2. What do u do?
A
  1. Like Teller Cards

2. Show infant 2 different paddles, and they should look at more interesting paddle

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16
Q

Cardiff Cards

  1. Age?
  2. What type of VA?
  3. Problem?
A
  1. > 1 yr
  2. Preferential Looking
    * 3 cards per acuity level. Threshold: 2/3 correct
  3. OVERESTIMATES VA!
17
Q

Broken Wheel

  1. Age?
  2. What is it?
  3. How do u do it?
A
  1. 2-3 yrs
  2. Forced choice test
  3. Show both cards at the same time, ask which car has the broken wheel. Present again to determine comprehension and reliability. Do at near. then do at 10 FT w/one eye OCCLUDED!
18
Q

Lea Symbols

  1. Age?
  2. Created of what?
  3. What do they do?
  4. Calibrated for what distance?
  5. Goal?
  6. Threshold = ?
A
  1. 2-3 years
  2. Created of logMAR
  3. Matching/ID
  4. for 10 ft
  5. Reach threshold as fast as they can
  6. Line that 4 symbols are correctly identified out of 5 at that level.

Pediatric Optometry (6 decks)

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