Week 6 - Fitting Children

Question 1

What are 5 common eye conditions that effect children and are indications for cl wear?

Answer 1

-Aphakia
-Pseudophakia
-High Myopia
-ocular motility (* aniseikonia induced by anisometropia exceeding 6 D
* accommodative esotropia (older children)
* nystagmus
* Occlusion)
-irregular astigmatism

Question 2

What is aphakia?

Answer 2

having no natural lens in the eye normal due to congenital cataracts

Question 3

What type of material is used for cls for children with aphakia ?

Answer 3

high-water-content
hydrogel lens based on age, corneal radius and diameter

Question 4

What is pseudophakia?

Answer 4

having an artificial lens implanted after the natural eye lens has been removed

Question 5

When fitting a child with cls who has pseudophakia, how do we obtain a satisfactory long - term refractive result?

Answer 5

allowances
must be made for growth of the eye

deliberately left hypermetropic to allow for axial elongation with
the corresponding myopic shift

Question 6

Why can glasses be a disadvantage for children who are highly myopic? 3

Answer 6

• reduces the retinal image size
  -peripheral distortion
  -reducing the effective
  visual field

Question 7

If spectacle correction is problematic and normal visual development is threatened Contact lenses correction can be used in children. T/F

Answer 7

TRUE

Question 8

If a child is young when fitting cls what can be expected of the fit of the cls?

Answer 8

they will need refitting often due to the growing eye

Question 9

What 4 ocular motility disorders can be corrected/managed by cls?

Answer 9

*aniseikonia induced by anisometropia exceeding 6 D;
*accommodative esotropia (older children);
*nystagmus; and
*occlusion.

Question 10

How do cls help with aniseikonia?

Answer 10

reduces image sizes

Question 11

How do cls help with accommodative esotropia?

Answer 11

reduce the accommodative effort

Question 12

How do cls help with nystagmus?

Answer 12

stabilizes eye movements

Question 13

How do cls help with Occlusion?

Answer 13

cover the better seeing eye to force the worse eye to work - like patching

Question 14

What can cause irregular astigmatism?2

Answer 14

-corneal ectasia (rare)
-following corneal infection or laceration

Question 15

Scleral lenses and rgps can help with what condition?(other than keratoconus etc)

Answer 15

irregular astigmatism

Question 16

What common cls types are used on children? 3

Answer 16

-Tinted and Prosthetic Lenses
-Therapeutic Lenses
-Elective Contact Lens Wear in Children

Question 17

What 2 slit lamp techniques can be used on babies (1)
infants+young children (1 )?

Answer 17

baby - flying baby
infant+young children - hand help slit lamp

Question 18

A handheld keratometer is used of children who can not sit at a conventional keratometer. T/F

Answer 18

TRUE

Question 19

What 2 ways can we refract a child?

Answer 19

-retinoscopy using hand-held lenses
-a paediatric trial
frame in an older child

Question 20

When are cycloplegic drugs needed during refracting a child?

Answer 20

in those children with normal accommodative function

Question 21

What material is commonly used in modern day for children?

Answer 21

silicone hydrogel - readily available in the range of base curves, diameters and powers that are required for fitting complex refractive error in young eyes

Question 22

When would we choose hydrogel high water content lens for children?

Answer 22

worn for continuous or daily wear

Question 23

Silicone rubber lenses are often used to correct refractive errors in babies and young children. T/F

Answer 23

TRUE

Question 24

What are ways we can insert/remove cls from babies? 5

Answer 24

-child lying down on a
firm, flat surface
-Babies can be swaddled
-give parents confidence
-keep a regular routine
-while child is asleep

Question 25

What are some 5 common aftercare problems?

Answer 25

-red or sticky eye
-neovascularization
-papillary conjunctivitis
-glaucoma
-other coexisting ophthalmic disease

Question 26

What could cause a red or sticky eye in a child wearing cls? 4

Answer 26

-tight-fitting lens
-infection
-inflammation
-allergic reaction

Question 27

If a child has a red or sticky eye what does the parent/caregiver need to do?2

Answer 27

-remove the lens
immediately
-seek urgent advice from a cls
practitioner or ophthalmologist.

Question 28

What can we do if a child has neovascularization (especially where thick hydrogel lenses have been used for continuous wear)?

Answer 28

Consider refitting with rigid or silicone
hydrogel lenses

Question 29

What could be a sign of Papillary conjunctivitis?

Answer 29

eye rubbing

Question 30

What is giant papillary conjunctivitis (GPC)caused by? 2

Answer 30

-an allergy to care solutions
-protein deposition on
lenses

Question 31

two thirds of patient will develop glaucoma or become
glaucoma suspects by 10 years after surgery for congenital catarats. T/F

Answer 31

TRUE

Question 32

How can we measure the introcular pressure of babies/infants? 2

Answer 32

-hand-held non-contact tonometer
-rebound
technology tonometer

Question 33

When fitting a child with aphakia, which type of lens is typically reccommened?

Answer 33

high water content hydrogel lens

Question 34

What adjustments might be made in contact lens fitting for a child based on age, corneal radius and diameter?

Answer 34

adjust the lens bc and diameter

Question 35

What is a common contact lenses for high myopia in children?

Answer 35

soft contact lenses

Question 36

Marfan syndrome is associated with which condition?

Answer 36

increased risk of retinal detachment