Week 6 - Fitting Children Flashcards

1
Q

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

A

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

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2
Q

What is aphakia?

A

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

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3
Q

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

A

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

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4
Q

What is pseudophakia?

A

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

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5
Q

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

A

allowances
must be made for growth of the eye

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

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6
Q

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

A
  • reduces the retinal image size
    -peripheral distortion
    -reducing the effective
    visual field
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7
Q

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

A

TRUE

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8
Q

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

A

they will need refitting often due to the growing eye

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9
Q

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

A

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

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10
Q

How do cls help with aniseikonia?

A

reduces image sizes

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11
Q

How do cls help with accommodative esotropia?

A

reduce the accommodative effort

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12
Q

How do cls help with nystagmus?

A

stabilizes eye movements

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13
Q

How do cls help with Occlusion?

A

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

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14
Q

What can cause irregular astigmatism?2

A

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

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15
Q

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

A

irregular astigmatism

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16
Q

What common cls types are used on children? 3

A

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

17
Q

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

A

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

18
Q

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

19
Q

What 2 ways can we refract a child?

A

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

20
Q

When are cycloplegic drugs needed during refracting a child?

A

in those children with normal accommodative function

21
Q

What material is commonly used in modern day for children?

A

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

22
Q

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

A

worn for continuous or daily wear

23
Q

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

24
Q

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

A

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

25
What are some 5 common aftercare problems?
-red or sticky eye -neovascularization -papillary conjunctivitis -glaucoma -other coexisting ophthalmic disease
26
What could cause a red or sticky eye in a child wearing cls? 4
-tight-fitting lens -infection -inflammation -allergic reaction
27
If a child has a red or sticky eye what does the parent/caregiver need to do?2
-remove the lens immediately -seek urgent advice from a cls practitioner or ophthalmologist.
28
What can we do if a child has neovascularization (especially where thick hydrogel lenses have been used for continuous wear)?
Consider refitting with rigid or silicone hydrogel lenses
29
What could be a sign of Papillary conjunctivitis?
eye rubbing
30
What is giant papillary conjunctivitis (GPC)caused by? 2
-an allergy to care solutions -protein deposition on lenses
31
two thirds of patient will develop glaucoma or become glaucoma suspects by 10 years after surgery for congenital catarats. T/F
TRUE
32
How can we measure the introcular pressure of babies/infants? 2
-hand-held non-contact tonometer -rebound technology tonometer
33
When fitting a child with aphakia, which type of lens is typically reccommened?
high water content hydrogel lens
34
What adjustments might be made in contact lens fitting for a child based on age, corneal radius and diameter?
adjust the lens bc and diameter
35
What is a common contact lenses for high myopia in children?
soft contact lenses
36
Marfan syndrome is associated with which condition?
increased risk of retinal detachment