Star slides

Question 1

What percent of all neurological disabilities occur as a result/are related to PREMATURE (

Answer 1

50%

Question 2

The earlier the delivery, the ___ chance of health problems

Answer 2

greater

Question 3

Specific numbers of LBW/how many weeks premature a child w/ ROP is at greater risk of:

Answer 3

LBW:

Question 4

At what stage in ROP is PLUS disease observed? What is PLUS dz?

Answer 4

stage 3

PLUS - THICKENING/TORTUOSITY of the new neo/retinal vasculature - HALLMARK finding that ROP is progressing, quickly. Initiate tx.

Question 5

Treatment of choice in ROP? Especially in what zone?

-What zone is ROP most LIKELY to develop?

Answer 5

Laser photocoagulation - esp if in zone 1 (PP/ONH/Mac)

-develops in zone 3 - temporal retina-ora.

Question 6

Fundamental ocular structures are present by the end of what period? How many weeks gestation is this?

Answer 6

Embryonic; birth-8 wks (specifically, 3 wks-8 wks, as ocular structures aren’t present until 3 weeks)

Question 7

Abnormal development during the FETAL period is more likely to result in (structural/functional) deficits? Name three

Answer 7

FUNCTIONAL [CPR]- Congenital Glc, PHPV, ROP

Question 8

At what age can you expect 20/20 vision from a child in performing forced choice preferential looking (Teller)?

–How about 20/20 doing a Snellen-type test (includes HOTV, Lea, etc.)

Answer 8

Teller - 20/20 by ~4Y/O (3-5)

Snellen - 20/20 by 5-6Y/O

Question 9

Full visual fields can be expected around what age? Is this thought to be a retinal development issue?

Answer 9

10Y/O - NO. Retina is good to go; it’s a COGNITIVE issue/inability to perform test until ~10Y/O.

Question 10

What type of document will a parent/childcare provider fill out as a measure of developmental screening in a child?

What’s the most common test administered by the pediatrician to assess the same thing (developmental screening test)?

Answer 10

parent/provider: “Ages & stages” questionnaire
-also: parent’s evaluation of developmental status, child development inventories

pediatrician: Denver Developmental Screening Test (0-6)

Question 11

Three conditions prompting when ROP screening is appropriate?

Answer 11

1)

Question 12

Order of shapes that child is able to copy (youngest –> oldest)

Answer 12

vertical line (2ish), circle (3ish), cross then square (4ish), triangle (5ish), diamond (8ish)

Question 13

What is the name of the written document that defines a child’s disabilities, states current levels of academic performance, describes educational needs, and specifies goals and objectives? What age group (specific range) is this document created for?

Answer 13

IEP - individual educational plan - 3-21.

IFSPs also exist - birth to 3

Question 14

“Learning to read” occurs in which grades?

KEY elements NOT required at this stage? ***

Answer 14

Grades 1-3

ACCOMMODATION, BV NOT REQUIRED.

Focus is on VOCABULARY DEVELOPMENT; characters are large enough/few enough that accomm/bv not required.

Question 15

Two main OCULAR S/Es of ADHD meds: (Methylphenidate, dextroamphetamine)

Answer 15

1) Reduced accommodation
2) Blur

Recall (boards) - these are dopamine agonists - behave as sympathetic agonists - so would also increase dry eye, potentially elicit AACG, etc.

Question 16

Children with learning-related vision problems have similar complaints to children with what other issue/diagnosis?

Answer 16

similar complaints to those w/ LEARNING DISABILITIES.

-complaints include: not performing to potential, frequent reversal errors, poor reading performance, not completing work on time, losing place while reading, difficulty copying from board, distraction/poor comprehension

Question 17

Most emmetropization is done by what age?

Answer 17

1 year (actually closer to 18 months)….but mostly by 1 year.

**MOST EMMETROPIZATION OCCURS IN THE FIRST YEAR OF LIFE

Question 18

AR astig ____ w/ age. If stable, it’s associated w/ amblyopia.

Obl astig ___ or ___ w/ age. Result: high risk of amblopia

Answer 18

AR DECREASES, OBL STABLE, or increases w/ age.

Question 19

Hyperopic anisometropia >_____D at 1 yr of age is likely to persist into childhood and cause amblyo.

2/3 of children w/ strab or amblyo have >____D of aniso.

MAJORITY of children w/ aniso >_____D have SOME level of amblyo

Answer 19

> 3.00

> 1.00

> 2.00

Question 20

What to Rx for aniso?

Answer 20

FULL CYL, FULL ANISO.

Question 21

Note that although vision, OM, BV, accommodation, and entrance testing findings may all be normal, but always be conscientious that the effects of ____ & ____ may have a HUGE effect on a child’s visual efficiency, causing their classroom issues to be much worse than the lack of issues you’re not finding when they’re in your chair.

Answer 21

TIME & STRESS

Question 22

Most important thing to do when Rx’ing orals to a child?

Answer 22

COMMUNICATE W/ THEIR PEDIATRICIAN…honestly, you should let them Rx it anyway.

Question 23

Most common misdiagnosis of SBS (shaken baby syndrome)?

Answer 23

viral gastroenteritis

-infant gets sent home; sx get worse.

Question 24

Most common ophthalmic finding in SBS?

Answer 24

retinal hemorrhages - usually multiple, in multiple layers

-usually BIlateral (uni is possible), found extensively throughout retina

Question 25

more than 50% of people with WHAT kind of nystagmus have ocular albinism? (dr moore)

Answer 25

SENSORY nystagmus (d/t vision loss of ANY cause)

-check for TIDs!

Question 26

MOST important aspect a pediatric pt who wants CLs must possess?

Answer 26

MOTIVATION. They’ll be much more responsible if they WANT CLs.

Question 27

**Accommodative and convergence demands, specifically for MYOPES, (increase/decrease) with CLs as opposed to spectacles.

Which types of prescriptions is this MOST significant for?

Answer 27

INCREASED accomm/convergence for myopes (less for hyperopes)

-HIGHER RX = MORE SIGNIFICANT effects

Question 28

**Cause of a crying child during lens insertion?

Answer 28

feeling of restraint, NOT d/t feeling/sensation of CL