How to communicate with children
talk to child instead of parent
praise child
keep smiling 😃
admire tshirt/ shoes
Birth to 6months- facial expressions/baby talk/singing
6 to 18months - talk to child / stranger anxiety
18 to 36 months-does not like to sit still
3 to 6 yrs- can be talktative/sits alone
6 to 12 yrs- avoid babyish terms/involve in discussions ( which eye first)
During H&S, what is the golden rule? What are some questions you can ask to refine classification of strabismus?
mum is always right!
What are some risk factors?
Developmental:
birth hx - full term/premature/weight/problem on delivery
milestones- 6months sit up, 8 months crawl, 10 months touchs objects, knows colours by 3yrs
Fam hx
genetic link for Rx
Childhood strabismus ( 30% chance of manifest dev if parent strabismic)
Amblyopia
For cerebral palsy and Down syndrome - reduce accom, consider bifocals
What are the normal VAS from birth to 6 yrs?
What is preferential looking?
toddlers prefer to look at stimulus. if it can be resolved, they will look at it
*resolution, not recognition
What other cards are used for testing VAs upto 3 yrs?
What are the normal VAs for Cardiff cards?
Why is crowding better than single letter VA?
cowding phenomenon - more difficult to see adjacent letters if objects around it
single letters will overestimate VA
adjacent letters reduce VA esp. in presence of amblyopia
Kay picture test vs LEA symbols vs Patti pics
KAY : “3m uses logMAR
under 4yrs = +0.20 to -0.10logMAR
over 4 yrs= +0.10 to -0.10logMAR
LEA: 4 symbols
PP: 5 symbols- ETDRS format
Choice of VA test by age
What are the near reading charts for children
Peter rabbit- scored in n point
Thomas the tank engine - scored in npoint
Maclure - arranged by size and reading age
What is the Mohindra Technique for ret
When to do subjective
If child is 5-7, rely less on subjective
If child is 8 or more, rely more
Ask “how does it look now“, not clearer
Auto refractor with cyclo
Does not control accomodation
Used as starting point
What to do before instilling drops
Gain explicit from parent and child, esp older child
Give leaflet
Record drug, dose, batch number, expiry date, time of instillation
One drop into lower fornix without touching eye.
With babies, place drop on medial canthus with eyes closed
What to do after instilling drops
Advice about effects of drug
Dilation make take 48 hrs to go - blurred near vision, Glare in sun
Don't dispense glasses
How to adjust motility, NPC, slit lamp and VF for child?
When to prescribe rx to child
Myopic- correct over 1.50DS after 4 yrs
Recall period for testing children
What are the GOS services for children
under 16 and under 19 in full time education = NHS funded eye test + voucher towards specs
Are MAR worth it?
For teens- yes
Not for longer children bz lens get smeary - use wide brimmed hat for sunshade
Last changed8 days ago
