Pediatric Vision Evaluation and Screening - VanderMuelen Flashcards Preview

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Flashcards in Pediatric Vision Evaluation and Screening - VanderMuelen Deck (29)
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1

When does normal vision develop?

During infancy and childhood

2

Focused visual stimuli are critical to:

Normal sight development Early detection and correction of vision problems

3

Visual Development- a) Newborns follow: b) By 2-3 months infants follow: c) By 4-6 months:

a) Faces b) Lights and high contrast objects c) Visual system matures (20/40)

4

Symptoms of Potential Eye Problems

Rubbing the eyes Shutting or covering one eye Tilting or turning head Squinting Inability to see distant objects clearly Bumping into walls or objects Holding objects close to see Crossing of eyes

5

Red Reflex

Screen for posterior segment (RETINA) abnormalities or corneal opacities

6

3 Categories of Visual Impairment

Neurological abnormalities that mimic vision impairment Vision impairment with Nystagmus Vision impairment without Nystagmus

7

Neurological Abnormalities mimicking visual impairments

Developmental delay or autism - poor visual fixation

Poor occulomotor control - cerebral palsy or congenital motor apraxia

8

define Nystagmus:

rhythmic oscillation of the eyes

usually horizontal, but can be vertical or rotatory

9

Visual Impairment with Nystagmus

any disorder of the bilateral anterior visual pathways (cornea to geniculate body) that affects the visual acuity under the age of 2 almost always results in nystagmus

ex: Congeital cataracts, anterior segment anomalies, retinal degenertation/dystrophy, optic nerve anomalies

10

Visual Impairment without Nystagmus is (almost always) caused by-

cortical visual impairment or delayed visual maturation

abnormality of the posterior visual pathways

  • Hypoxia
  • Hemorrhage
  • Cerebral malformations
  • Metabolic disorders
  • Infections

11

define Amblyopia:

lazy eye - loss of one eye's ability to see details 

in the absence of proper visual input from the visual pathway the brain "shuts down" the vision in the affected eye

12

Amblyopia causes

 

prolonged abnormal visual experience

  • distortion of normally clear retinal image (cataracts, refractive difference between eyes)
  • abnormal binouclar interaction (Strabismus)

13

Amblyopia treatment

address refractive errors

visual rehabilitation - patching eyes, fogging the good eye with chemicals or lenses

14

define Strabismus:

misalignment of one eye relative to the other in one or more positions of gaze

15

Manifest Strabismus (Tropia)

occurs spontaneously

may be constant or intermittent

examiner cannot induce it

16

Latent Strabismus (Phoria)

apperent only when single binocular vision is disrupted (Cover Test)

can be induced by examiner

17

Comitant Strabismus

misalignment is the same in all positions of gaze

18

Incomitant Strabismus

misalignment is apperent in only certain positions of gaze

19

Testing for Strabismus

corenal light reflexes

cover test

extraocular rotations

red reflex

20

define: Esotropia

visual axes of the eyes are convergent

21

Congential (Infantile) Esotropia

onset in first year of life

large, obvious deviation

treatment: surgery

22

Accomodative Esotropia

cuased by excessive focusing due to normal accomodation in uncorrected hyperopia

intermittent intially and gradually becomes constant

age of onse ~2 years (6m -7y)

managment: glases, amblyopia treatment, surgery

23

Nonaccomodative (Aquired Esotropia)

caused by unequal refractive errors, cataracts, corneal scarrring

treat underlying condition

24

define: Exotropia

visual axes of the eyes are divergent

25

Exotropia

begin intermittently after age 2

child often closes one eye in bright sunlgiht

more noticeable when fatigued or ill

26

Color Blindness

80% of white-males have some red-green deficiency

familial

tested using Ishihara tests

27

Retinoblastoma

most common childhood occular tumor

can be hereditary (bilateral) or sporadic (unilateral)

28

Occular Tumors: Congenital Cataracts

can be secondary to trauma or inherited

can be unilateral or bilateral

29

Retinopathy of Prematurity

common in infants <28 weeks gestation

incomplete retinal vascularization, can lead to retinal detachment