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Flashcards in Peds CLs Deck (22):
1

T/F: though many benefits of CL wear in peds exist, ~25% of pediatric ER visits are related to medical devices

true - CLs fall under this umbrella. So, use with caution.

2

What factors are MORE important in a peds CL than an adult CL?

-higher Dk (kids will sleep in), excellent fit (kids active/lenses will pop out), durability/easy handling

3

a toddler/infant cornea is (flatter/steeper), and (smaller/larger) than an adult cornea

steeper, smaller --> need to fit accordingly

4

Most appropriate age group to start fitting CLs?

12-13Y/O; younger if appropriate (8-11 can be independent and able to adapt if motivated/sports needs)

5

**MOST important aspect a pediatric pt who wants CLs must possess?

MOTIVATION. They'll be much more responsible if they WANT CLs.

-must feel sense of responsibility; should have appropriate lifestyle, ability to handle lenses

6

T/F: According to the CL in Peds Study and Achieve study, 8-12 Y/O peds CL pts had improved confidence in school performance (if they didn't like glasses), and no effect on global self-worth, but overall, 75% PREFERRED CLs over glasses.

True. all of it.

-appearance, acceptance by peers, and athletic competence also all improved.

7

Most highly recommended lens in the peds pop?

soft, daily disposable

-most convenient, lowest risk of infx

8

**Accommodative and convergence demands, specifically for MYOPES, (increase/decrease) with CLs as opposed to spectacles.

Which types of prescriptions is this MOST significant for?

INCREASED accomm/convergence for myopes (less for hyperopes)

-HIGHER RX = MORE SIGNIFICANT effects

9

In the event of congenital cataracts, prognosis is best if they're removed within the first __-__ weeks of life.

-usually, you'll fit a CL __-__ wks after surgery

-what may result if cataract not removed by 6 months?

4-6 wks - best prog

1-3 wks post-surg - optimal

-deprivation amblyopia likely (will also result if correction not used appropriately/consistently

10

Of the three options available post-op congenital cataract removal (aphakic patient), WHICH tx is the safest/least invasive?

-precise refractive correction w/ less invasiveness than surgical procedures, but potentially expensive?

-constant optical correction, but risk of IOL displacement/post-surgical inflammation, uveitis, medication S/Es

-spectacle correction

-contact lenses (expensive if lenses keep getting lost - common)

-IOL implantation (only recommended if OVER 1Y/O d/t growth rate of ocular components in first year)

11

The "Infant Aphakia Treatment Study" concluded what?

caution should be used when considering implanting pediatric IOLs less than 6 months old - no difference in VA/stereo or ocular problems, with increased infx risk

12

Most common CL used in pediatric aphakia?

-key characteristics?

Silsoft

-100% hydroPHOBIC (100% silicone)

(+)Dk 340; approved for 30d EW; replacement q 3-6 months

(-)limited power/astigmatic correction/expensive

13

Silsoft trial lens of choice (BC and powers) for:

0-6mo:
6-18mo:
18-28mo:
>28mo:

0-6: BC 7.5, +29 (steep/high power)

6-18: BC 7.7, +26

18-28: BC 7.7-7.9, +23

>28mo: BC 7.9, +18

14

**Cause of a crying child during lens insertion?

feeling of restraint, NOT d/t feeling/sensation of CL

-stabilize child
-hold cl b/w thumb/forefinger, pinch inf third
-place on sup bulbar conj
-allow child to blink/center lens

15

If you're doing an OR in a pediatric aphake, what do you need to make sure the lens possesses, refractively-speaking?

ADD POWER. will be HIGHER if kid is younger (shorter working dist)

0-1Y/O: overcorrect by +2-3DS
walking: " by +1-2DS
>2: consider bifocal if near add too great, OR overcorrect CLs by +1-2DS

16

T/F: a Silsoft lens can be observed using Fluorescein

TRUE! Just like a GP. Ideal pattern:

-minimal AC, minimal intermed bearing, 1-2mm mvmt

17

Regardless of the lens type, how should you REMOVE a pediatric contact lens?

thumbs/pointer finger @ lid margins, widen just outside lens perimeter, pop out/have kid blink

18

Are hard or soft lenses more commonly prescribed in children w/ nystagmus?

-advantages of CLs (general) in kids w/ nystagmus?

soft more common

(+) move w/ eyes (always looking thru OC), peripheral VA improved, minimize distortions and improved cosmesis

-chance that GPs may provide proprioreceptive fdbk that diminish nystagmus

19

T/F: you should Rx a CL in the non-amblyopic eye in unilateral amblyopes

FALSE. increased risk of trauma if (-)poly lens in front, and increased risk of infx in the good eye.

20

Two syndromes manifesting w/ craniofacial abnormalities for whom CLs may be a viable alternative for refractive correction?

Crouzon's syndrome
Apert's syndrome

other ideal situations: KC, post-surg/post-trauma, prosthetic tints for disfigured or photophobic eyes, or for intractable diplopia

21

A child can be fit w/ a pediatric contact lens using normal adult-parameters around ___ years of age.

-How often should you F/U?

5 yrs - can use adult parameters

1wk after dispensing, then 3 months, then q6 months

22

F/U for a infant/toddler CL fitting?

__-__ days, then __weeks, then every __ months once established

3-5 days
2 weeks
every 3 months once estab