Flashcards in Peds CLs Deck (22):
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.
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
a toddler/infant cornea is (flatter/steeper), and (smaller/larger) than an adult cornea
steeper, smaller --> need to fit accordingly
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)
**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
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.
Most highly recommended lens in the peds pop?
soft, daily disposable
-most convenient, lowest risk of infx
**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
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
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
-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)
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
Most common CL used in pediatric aphakia?
-100% hydroPHOBIC (100% silicone)
(+)Dk 340; approved for 30d EW; replacement q 3-6 months
(-)limited power/astigmatic correction/expensive
Silsoft trial lens of choice (BC and powers) for:
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
**Cause of a crying child during lens insertion?
feeling of restraint, NOT d/t feeling/sensation of CL
-hold cl b/w thumb/forefinger, pinch inf third
-place on sup bulbar conj
-allow child to blink/center lens
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
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
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
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
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.
Two syndromes manifesting w/ craniofacial abnormalities for whom CLs may be a viable alternative for refractive correction?
other ideal situations: KC, post-surg/post-trauma, prosthetic tints for disfigured or photophobic eyes, or for intractable diplopia
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