Flashcards in Star slides Deck (28):
What percent of all neurological disabilities occur as a result/are related to PREMATURE (
The earlier the delivery, the ___ chance of health problems
Specific numbers of LBW/how many weeks premature a child w/ ROP is at greater risk of:
At what stage in ROP is PLUS disease observed? What is PLUS dz?
PLUS - THICKENING/TORTUOSITY of the new neo/retinal vasculature - HALLMARK finding that ROP is progressing, quickly. Initiate tx.
Treatment of choice in ROP? Especially in what zone?
-What zone is ROP most LIKELY to develop?
Laser photocoagulation - esp if in zone 1 (PP/ONH/Mac)
-develops in zone 3 - temporal retina-ora.
Fundamental ocular structures are present by the end of what period? How many weeks gestation is this?
Embryonic; birth-8 wks (specifically, 3 wks-8 wks, as ocular structures aren't present until 3 weeks)
Abnormal development during the FETAL period is more likely to result in (structural/functional) deficits? Name three
FUNCTIONAL [CPR]- Congenital Glc, PHPV, ROP
At what age can you expect 20/20 vision from a child in performing forced choice preferential looking (Teller)?
--How about 20/20 doing a Snellen-type test (includes HOTV, Lea, etc.)
Teller - 20/20 by ~4Y/O (3-5)
Snellen - 20/20 by 5-6Y/O
Full visual fields can be expected around what age? Is this thought to be a retinal development issue?
10Y/O - NO. Retina is good to go; it's a COGNITIVE issue/inability to perform test until ~10Y/O.
What type of document will a parent/childcare provider fill out as a measure of developmental screening in a child?
What's the most common test administered by the pediatrician to assess the same thing (developmental screening test)?
parent/provider: "Ages & stages" questionnaire
-also: parent's evaluation of developmental status, child development inventories
pediatrician: Denver Developmental Screening Test (0-6)
Three conditions prompting when ROP screening is appropriate?
Order of shapes that child is able to copy (youngest --> oldest)
vertical line (2ish), circle (3ish), cross then square (4ish), triangle (5ish), diamond (8ish)
What is the name of the written document that defines a child's disabilities, states current levels of academic performance, describes educational needs, and specifies goals and objectives? What age group (specific range) is this document created for?
IEP - individual educational plan - 3-21.
IFSPs also exist - birth to 3
"Learning to read" occurs in which grades?
KEY elements NOT required at this stage? ***
ACCOMMODATION, BV NOT REQUIRED.
Focus is on VOCABULARY DEVELOPMENT; characters are large enough/few enough that accomm/bv not required.
Two main OCULAR S/Es of ADHD meds: (Methylphenidate, dextroamphetamine)
1) Reduced accommodation
Recall (boards) - these are dopamine agonists - behave as sympathetic agonists - so would also increase dry eye, potentially elicit AACG, etc.
Children with learning-related vision problems have similar complaints to children with what other issue/diagnosis?
similar complaints to those w/ LEARNING DISABILITIES.
-complaints include: not performing to potential, frequent reversal errors, poor reading performance, not completing work on time, losing place while reading, difficulty copying from board, distraction/poor comprehension
Most emmetropization is done by what age?
1 year (actually closer to 18 months)....but mostly by 1 year.
**MOST EMMETROPIZATION OCCURS IN THE FIRST YEAR OF LIFE
AR astig ____ w/ age. If stable, it's associated w/ amblyopia.
Obl astig ___ or ___ w/ age. Result: high risk of amblopia
AR DECREASES, OBL STABLE, or increases w/ age.
Hyperopic anisometropia >_____D at 1 yr of age is likely to persist into childhood and cause amblyo.
2/3 of children w/ strab or amblyo have >____D of aniso.
MAJORITY of children w/ aniso >_____D have SOME level of amblyo
What to Rx for aniso?
FULL CYL, FULL ANISO.
Note that although vision, OM, BV, accommodation, and entrance testing findings may all be normal, but always be conscientious that the effects of ____ & ____ may have a HUGE effect on a child's visual efficiency, causing their classroom issues to be much worse than the lack of issues you're not finding when they're in your chair.
TIME & STRESS
Most important thing to do when Rx'ing orals to a child?
COMMUNICATE W/ THEIR PEDIATRICIAN...honestly, you should let them Rx it anyway.
Most common misdiagnosis of SBS (shaken baby syndrome)?
-infant gets sent home; sx get worse.
Most common ophthalmic finding in SBS?
retinal hemorrhages - usually multiple, in multiple layers
-usually BIlateral (uni is possible), found extensively throughout retina
more than 50% of people with WHAT kind of nystagmus have ocular albinism? (dr moore)
SENSORY nystagmus (d/t vision loss of ANY cause)
-check for TIDs!
MOST important aspect a pediatric pt who wants CLs must possess?
MOTIVATION. They'll be much more responsible if they WANT CLs.
**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