Parent complains: my child squints- what is the first question?
Are they squinting or screwing the eyes- know the difference
When child squint eye?
Uncorrected myopia
What arethe 4 causes headache in children?
Uncorrected hypermetropia, decompensating phoria, accommodative insufficiency, convergence insufficiency
How to check for decompensating phoria?
Cover test
How to check for accommodative insufficiency?
Checked using convergence
How to check for convergence insufficiency?
Dynamic ret
4 reasons- child moves at a very close working distance to the tv?
1 reason that doesn’t relate to vision?
- Myopia - under or uncorrected.
- Accommodative problem
- General blur vision
- General visual impairment - cataract
- children just generally immerse themselves into the tv and they have no visual problem?
Accommodative lead is over or under accommodating?
Over
4 reasons of why children might rub eyes a lot?
- Dry eye
- Something in Anterior eye
- Allergy
- Refractive error
Causes of: “My child closes one eye a lot”
- Diplopia – caused due to poor convergence.
- Over accommodation leading to a turn or a recent onset of phoria- could be due to a phoria/ break down of a phoria/ poor convergence/ over accommodation.
- Anisometropia
- Accommodative leak
- Assess motility since the child might be getting diplopia in only 1 position of gaze.
- One pupil larger
- Photophobia
- Intermittent exotropia
What causes : “My child turns her head when reading”- AHP
3 reasons
- Strabismus
- Any Comitant deviation – turning head to get any binocular vision, because deviation present in straight ahead position.
- Nystagmus
How to check incomitant deviations?
CT at different points of gaze. OR motility.
What causes: “My child tilts her head to look at me”
Cyclodeviation – oblique palsy OR nystagmus.
What causes: “My child bumps into things a lot”
- Lack of stereopsis
- Diplopia caused by strabismus
- Neurological issue—eye movement coordination, VF defect
- Retinitis pigmentosa – peripheral field deteriorates.
- Uncorrected refractive error (>7D)
What causes : “My child is falling behind in school” “The teacher says my child does not pay attention in class”
- Uncorrected refractive error, not wearing RX at school.
- Cerebral visual impairment
- Severe colour vision defect- colour used a lot in nursery school. They are not hence very confident
- Headaches
- Poor contrast
- Accommodation lag
- Convergence insufficiency
- Visual field defect
Reasons for: “I took a photo of my child and one eye looked white”
- Retinoblastoma – life threating
- Cataracts
- Corneal scaring
- Opacities – e.g. scar, ulcer.
- Coloboma – the retina doesn’t cover whole of the sclera in this condition, seen with large coloboma.
- Total retinal detachment caused by prematurity – usually more grey in appearance.
- Could be nothing at all- caused by reflection for instance.
How are visual fields measured in a child?
Confrontation with a toy.
Give examples of communication support available?
BSL interpreter, Communication aid, Support with key word signing (e.g. Makaton), Large print, Braille, Easy to read information.
5 difficulties people have in receiving information?
- Problems hearing
- Problems seeing- lip movement, gestures
- Difficulties understanding- vocabulary.
- Difficulties remembering information
- Difficulties using past experiences
5 communication difficulties in providing information?
- Problems speaking
- Problems formulating speech
- Problems with vocabulary
- Difficulties in making appropriate gestures and signs
5, Difficulties with theory of mind.
What is the False- Belief problem?
A type of task used in theory of mind studies in which children must infer that another person does not possess knowledge that they possess.
What is the Sally- Ann demonstration?
Task used to demonstrate a child’s ‘theory of mind’
Refers to their ability to understand how other people think, feel and behave.
Do children with DS vs autism pass the sally and ann test?
Majority of the children with DS pass the Sally- and ann test but not children with autism
How to px’s with difficulties expressing opinions affect eye exams?
The child doesn’t give the right answer, they try to say something to please the optom.
