3. Communication Flashcards

1
Q

Parent complains: my child squints- what is the first question?

A

Are they squinting or screwing the eyes- know the difference

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2
Q

When child squint eye?

A

Uncorrected myopia

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3
Q

What arethe 4 causes headache in children?

A

Uncorrected hypermetropia, decompensating phoria, accommodative insufficiency, convergence insufficiency

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4
Q

How to check for decompensating phoria?

A

Cover test

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5
Q

How to check for accommodative insufficiency?

A

Checked using convergence

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6
Q

How to check for convergence insufficiency?

A

Dynamic ret

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7
Q

4 reasons- child moves at a very close working distance to the tv?
1 reason that doesn’t relate to vision?

A
  1. Myopia - under or uncorrected.
  2. Accommodative problem
  3. General blur vision
  4. General visual impairment - cataract
  • children just generally immerse themselves into the tv and they have no visual problem?
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8
Q

Accommodative lead is over or under accommodating?

A

Over

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9
Q

4 reasons of why children might rub eyes a lot?

A
  1. Dry eye
  2. Something in Anterior eye
  3. Allergy
  4. Refractive error
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10
Q

Causes of: “My child closes one eye a lot”

A
  • 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
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11
Q

What causes : “My child turns her head when reading”- AHP
3 reasons

A
  • Strabismus
  • Any Comitant deviation – turning head to get any binocular vision, because deviation present in straight ahead position.
  • Nystagmus
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12
Q

How to check incomitant deviations?

A

CT at different points of gaze. OR motility.

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13
Q

What causes: “My child tilts her head to look at me”

A

Cyclodeviation – oblique palsy OR nystagmus.

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14
Q

What causes: “My child bumps into things a lot”

A
  • Lack of stereopsis
  • Diplopia caused by strabismus
  • Neurological issue—eye movement coordination, VF defect
  • Retinitis pigmentosa – peripheral field deteriorates.
  • Uncorrected refractive error (>7D)
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15
Q

What causes : “My child is falling behind in school” “The teacher says my child does not pay attention in class”

A
  • 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
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16
Q

Reasons for: “I took a photo of my child and one eye looked white”

A
  • 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.
17
Q

 How are visual fields measured in a child?

A

Confrontation with a toy.

18
Q

Give examples of communication support available?

A

BSL interpreter, Communication aid, Support with key word signing (e.g. Makaton), Large print, Braille, Easy to read information.

19
Q

5 difficulties people have in receiving information?

A
  1. Problems hearing
  2. Problems seeing- lip movement, gestures
  3. Difficulties understanding- vocabulary.
  4. Difficulties remembering information
  5. Difficulties using past experiences
20
Q

5 communication difficulties in providing information?

A
  1. Problems speaking
  2. Problems formulating speech
  3. Problems with vocabulary
  4. Difficulties in making appropriate gestures and signs
    5, Difficulties with theory of mind.
21
Q

What is the False- Belief problem?

A

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.

22
Q

What is the Sally- Ann demonstration?

A

Task used to demonstrate a child’s ‘theory of mind’
Refers to their ability to understand how other people think, feel and behave.

23
Q

Do children with DS vs autism pass the sally and ann test?

A

Majority of the children with DS pass the Sally- and ann test but not children with autism

24
Q

How to px’s with difficulties expressing opinions affect eye exams?

A

The child doesn’t give the right answer, they try to say something to please the optom.

25
Impact of the optom completing sentences for patient with learning diabilities?
The patient feels less confident
26
Simplify this: Hold this occluder over your right eye and read the top line of the chart for me please:
“I’ll cover your eye”
27
Read the letter on the letter chart?
Read the big letters please
28
What is the 5 second rule?
When giving instructions to patients with learning disabilities give them 5 seconds before you repeat the question- to process what you have said. After the 5 seconds- the question can be repeated.
29
7 non-verbal ways of communicating?
* Facial expression * Body posture * Proximity * Physical touch * Gesture * Mime * Intonation
30
How to use gestures with speech for example in cover test and when measuring VA?
- Cover your own eye first. - Point to the letters.
31
Advantages of non-verbal methods of communication
* Removes pressure to speak * Avoids problems of auditory processing and memory * Limits vocabulary * Simplifies language used * Adjusts presentation to comprehension * Easier to direct attention * Can be more consistent * Multi-modal helps comprehension * Adjustable duration
32
What is object of reference?
Means using real objects to signify actions, times etc.
33
What is PECS?
Picture exchange communication system. Using pictures to communicate what the child wants.
34
What tools can be used to aid communication?
* Sequence strips and visual timetable * Talking Mats * Communication books and boards * Technology - Pictures are put together to make more complex information.
35
What are sequence strips ? 2 advantages? How can it be used in eye examinations?
Explain the progression of an action or Visualising temporal concepts which are otherwise abstract. - Reducing anxiety - Enabling completion of activity / task --Can have this to show stages of an eye exam. It also helps them identify when the test has really ended.
36
Communication board is most useful in?
Particularly useful for those with cerebral palsy where they can be attacked to the wheelchair – may be a pre-cursor for technology – Voice Output communication aids.
37
What is a communication passport?
* A useful introduction to the individual and the ways they communicate. - Always ask patients if they have one. It allows you to tailor exams to particular individuals.
38
Books in the waiting room- with how eye examinations work is helpful, because?
Books in the waiting room or recommend to carriers or patients to have to help them and the patient prepare better for an eye exam.