risks_examination_detailed_flashcards
Why is family history a significant risk factor for tropia?
If parents have tropia, it is very likely that the child will also develop it. Tropia can be hereditary, making it important to assess family history for squints, lazy eye, and other related conditions like diabetes that could contribute to eye health risks.
What should you ask regarding family history when assessing for tropia or lazy eye?
Ask ‘Any family history of squints or lazy eye?’ and ask about any hereditary health conditions such as diabetes, as systemic conditions could also influence visual health.
What developmental factors increase the risk of developing eye-related problems such as squints?
Premature birth, emergency c-section, forceps delivery, low birth weight (less than 5.5 pounds), the need for oxygen therapy, and hospitalisation for more than 3 days after birth all contribute to increased risk for developmental issues including visual problems like squints.
How would you inquire about birth-related problems when assessing a child’s risk for eye problems?
You might say, ‘This might sound a little strange, but were there any complications during the birth, such as prematurity, emergency c-section, or forceps delivery? I ask because these are risk factors for developing eye-related problems like squints, which may require further investigation.’
What specific birth-related risk factors are associated with developmental eye issues?
Unplanned/emergency c-section, breech delivery (which can lead to developmental problems such as cerebral palsy), forceps delivery (risk of damage to lateral recti or nerve supply), significantly pre-term birth (risk of retinopathy of prematurity), and low birth weight.
What are the neo-natal and infancy-related risk factors for eye development?
Hyperactivity, hypoactivity, epilepsy, accidental or non-accidental head trauma, systemic illnesses, and the use of medication during infancy can all contribute to visual development issues, including squints.
Which conditions are associated with difficulties in visual processing, and why?
Conditions like Down syndrome, cerebral palsy, and autism can impair visual processing. These patients may have difficulty coordinating eye movements, processing visual information, and may experience related developmental delays that affect vision.
Why is reduced stereopsis early in development a concern?
Reduced stereopsis (depth perception) puts a child at higher risk for amblyopia (lazy eye) because the brain may begin to favor one eye over the other, leading to suppression of the weaker eye.
What does asymmetry in visual acuity indicate in young children?
If one eye has significantly different visual acuity compared to the other, or if a child resists having one eye covered, it may indicate the onset of amblyopia. Early detection is critical to prevent permanent vision impairment.
What is the significance of early-onset squint in children?
Early-onset squint (strabismus) puts the child at risk of developing amblyopia. The brain may suppress the input from the misaligned eye to avoid double vision, leading to poor visual development in that eye.
What does the 20 base out test assess, and why is it important?
The 20 base out test assesses for suppression in binocular vision. If the patient fails to respond to the test, it suggests that one eye is being suppressed, which can indicate strabismus or amblyopia.
What does the cover test (CT) look for, and what conditions can it detect?
The cover test is used to detect strabismus by observing the movement of the eyes when one is covered. It can also detect latent phorias, which may decompensate into a tropia if the fusional reserves are insufficient.
How can esophoria or exophoria develop into tropia in children?
Esophoria or exophoria can decompensate into tropia if the child’s fusional reserves are inadequate. During the critical period of visual development, the brain may suppress one eye to avoid double vision, leading to long-term suppression and amblyopia.
What is the importance of the pull-up amplitude test in children, especially those with Down syndrome?
The pull-up amplitude test helps detect accommodative insufficiency. This is especially common in children with Down syndrome, but normal children may also experience it, affecting their ability to focus on near objects, which can impact their education.
What does a dynamic lag greater than 1D suggest in children?
A lag greater than 1D suggests hypermetropia (farsightedness) that the child is unable to manage on their own. This could lead to visual fatigue, headaches, or difficulties with close-up tasks.
