Week 6 - Fitting Children Flashcards
What are 5 common eye conditions that effect children and are indications for cl wear?
-Aphakia
-Pseudophakia
-High Myopia
-ocular motility (* aniseikonia induced by anisometropia exceeding 6 D
* accommodative esotropia (older children)
* nystagmus
* Occlusion)
-irregular astigmatism
What is aphakia?
having no natural lens in the eye normal due to congenital cataracts
What type of material is used for cls for children with aphakia ?
high-water-content
hydrogel lens based on age, corneal radius and diameter
What is pseudophakia?
having an artificial lens implanted after the natural eye lens has been removed
When fitting a child with cls who has pseudophakia, how do we obtain a satisfactory long - term refractive result?
allowances
must be made for growth of the eye
deliberately left hypermetropic to allow for axial elongation with
the corresponding myopic shift
Why can glasses be a disadvantage for children who are highly myopic? 3
- reduces the retinal image size
-peripheral distortion
-reducing the effective
visual field
If spectacle correction is problematic and normal visual development is threatened Contact lenses correction can be used in children. T/F
TRUE
If a child is young when fitting cls what can be expected of the fit of the cls?
they will need refitting often due to the growing eye
What 4 ocular motility disorders can be corrected/managed by cls?
*aniseikonia induced by anisometropia exceeding 6 D;
*accommodative esotropia (older children);
*nystagmus; and
*occlusion.
How do cls help with aniseikonia?
reduces image sizes
How do cls help with accommodative esotropia?
reduce the accommodative effort
How do cls help with nystagmus?
stabilizes eye movements
How do cls help with Occlusion?
cover the better seeing eye to force the worse eye to work - like patching
What can cause irregular astigmatism?2
-corneal ectasia (rare)
-following corneal infection or laceration
Scleral lenses and rgps can help with what condition?(other than keratoconus etc)
irregular astigmatism
What common cls types are used on children? 3
-Tinted and Prosthetic Lenses
-Therapeutic Lenses
-Elective Contact Lens Wear in Children
What 2 slit lamp techniques can be used on babies (1)
infants+young children (1 )?
baby - flying baby
infant+young children - hand help slit lamp
A handheld keratometer is used of children who can not sit at a conventional keratometer. T/F
TRUE
What 2 ways can we refract a child?
-retinoscopy using hand-held lenses
-a paediatric trial
frame in an older child
When are cycloplegic drugs needed during refracting a child?
in those children with normal accommodative function
What material is commonly used in modern day for children?
silicone hydrogel - readily available in the range of base curves, diameters and powers that are required for fitting complex refractive error in young eyes
When would we choose hydrogel high water content lens for children?
worn for continuous or daily wear
Silicone rubber lenses are often used to correct refractive errors in babies and young children. T/F
TRUE
What are ways we can insert/remove cls from babies? 5
-child lying down on a
firm, flat surface
-Babies can be swaddled
-give parents confidence
-keep a regular routine
-while child is asleep
What are some 5 common aftercare problems?
-red or sticky eye
-neovascularization
-papillary conjunctivitis
-glaucoma
-other coexisting ophthalmic disease
What could cause a red or sticky eye in a child wearing cls? 4
-tight-fitting lens
-infection
-inflammation
-allergic reaction
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.
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
What could be a sign of Papillary conjunctivitis?
eye rubbing
What is giant papillary conjunctivitis (GPC)caused by? 2
-an allergy to care solutions
-protein deposition on
lenses
two thirds of patient will develop glaucoma or become
glaucoma suspects by 10 years after surgery for congenital catarats. T/F
TRUE
How can we measure the introcular pressure of babies/infants? 2
-hand-held non-contact tonometer
-rebound
technology tonometer
When fitting a child with aphakia, which type of lens is typically reccommened?
high water content hydrogel lens
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
What is a common contact lenses for high myopia in children?
soft contact lenses
Marfan syndrome is associated with which condition?
increased risk of retinal detachment
