logging in or signing up Paediatric Visual Acuity Testing optometrist.pal Download Post to : URL : Related Presentations : Share Add to Flag Embed Email Send to Blogs and Networks Add to Channel Uploaded from authorPOINT lite Insert YouTube videos in PowerPont slides with aS Desktop Copy embed code: Embed: Flash iPad Copy Does not support media & animations WordPress Embed Customize Embed URL: Copy Thumbnail: Copy The presentation is successfully added In Your Favorites. Views: 3010 Category: Education License: All Rights Reserved Like it (6) Dislike it (0) Added: August 06, 2010 This Presentation is Public Favorites: 1 Presentation Description No description available. Comments Posting comment... By: abdallahellabban (22 month(s) ago) dear sir , can you please allow me to download for educational purpose Saving..... Post Reply Close Saving..... Edit Comment Close By: evarositadewi (23 month(s) ago) Thanks.... Saving..... Post Reply Close Saving..... 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Stereopsis matures. Accommodation develops. Etc… Visual Problems : Visual Problems Visual disorders leading cause for childhood disabilities. Amblyopia: Most common cause for monocular vision loss in young people. Impact on reading skills and educational development. Early detection means PREVENTION and better TREATMENT. Paediatric Eye Examination : Paediatric Eye Examination Different considerations and important aspects. For any parent, a first eye examination generally arises because: Concerns regarding child’s eyes or vision. Family history of an eye condition. They have been informed that their child may have an eye problem (for eg, by a health care professional, school teachers). History and Observations : History and Observations Very important to get thorough history from the parents. Reason for visit – any concerns? Family h/o – high refractive errors, amblyopia, strabismus? Birth history. Visual behaviour – Clumsy? Visually inattentive? Close viewing distance? Preliminary Tests : Preliminary Tests Begin with general observation of the child. Hirschberg’s Test: Gross check of ocular alignment. Pupils: size, shape, reaction. Ocular motility. Fixation pattern. Visual development : Visual development Adapted from Mayer et al 1995 In visual development, visual acuity improves rapidly during the first year of life and then matures more gradually to adult levels at approximately 5-6 years of age. Classification : Classification Infants: < age 1 yr Toddlers: 1 yr – 4 yrs Children: 5 yrs – 14 yrs Adolescence: 15 yrs – 17 yrs Adults: 18 yrs and above Visual Acuity : Visual Acuity To correctly interpret a child’s visual results one needs to know the normal range of vision for that age. If a difference in acuity is found between eyes, one should relate this to other findings, i.e. refractive error, binocular function, stereopsis, ophthalmoscopy etc. Crowding phenomenon : Crowding phenomenon Single optotype better visualized than crowded letters. Crowding phenomenon is a more sensitive measure. Amblyopia more susceptible to crowding effects. VA measurements (Infants) : VA measurements (Infants) Optokinetic Nystagmus: Nystagmus is elicited by passing a drum with black and white stripes. If normal vision is present, rail-road nystagmus will be seen. VA measurements (Infants) : VA measurements (Infants) Preferential Looking Test: Child is presented with two adjacent stimulus fields, one is striped and the other is a plain background. The child will look at the striped pattern for a longer time. The location of the stripes is shifted randomly from right to left. Fineness of the stripes is reduced till the infant can no longer differentiate the stripes and the background. VA measurements (Infants) : VA measurements (Infants) Visually Evoked Response: Useful in assessing visual function in infants. It is the electroencephalographic recording made from the occipital lobe in response to visual stimuli. Flash VER determines the integrity of macular and visual pathway functions. Pattern VER depends on form sense and gives rough estimate of the VA. VA measurements (Infants) : VA measurements (Infants) Indirect assessment of VA: Blink reflex in response to sound. Menace reflex i.e. closure of eyes on approaching of object if vision is normal. Fixation pattern i.e. Central / Steady / Maintained. Monocular behaviour: resists occlusion on covering good eye. VA measurements (1-2 yrs) : VA measurements (1-2 yrs) Marble game test: Child is asked to place marbles in the holes of the box. Not intended to measure the visual acuity, but the monocular visual functioning. Vision is noted being ‘useful’ or ‘less useful’. Sheridan’s ball test: Series of balls of progressively smaller sizes used. Balls rolled on grey or white background, smallest size which the child picks gives the estimation of vision. VA measurements (2-3 yrs) : VA measurements (2-3 yrs) Dot visual acuity test: Child shown illuminated box with black dots of different sizes. Smallest dot identified determines the vision. Coin test: Child asked to identify two faces of a coin of different sizes at different distances. Miniature toy test: Child shown a miniature toy from a distance of 10 feet and child asked to pick the pair from the assortment. VA measurements (3-5 yrs) : VA measurements (3-5 yrs) Tumbling E test: Consists of different sizes of E with 4 directions. Child asked to identify the correct direction. Sjogren’s hand test: Similar to Tumbling E test. Consists of picture of hand in 4 different directions. Landolt’s C test / Broken wheel test: Pair of cars of progressively smaller sizes, one of it with a broken wheel is shown. Child asked to identify the one with broken wheel. VA measurements (3-5 yrs) : VA measurements (3-5 yrs) Sheridan-Gardiner HOTV test: Child is handed a card of HOTV. Asked to match the letters on the chart. Snellen's equivalent 6/60 – 6/6 can be estimated. Boek candy bead test: Child asked to match beads at 40 cms. Snellen’s VA of 20/200 can be estimated. VA measurements (3-5 yrs) : VA measurements (3-5 yrs) Light home picture cards: Performed at 10 feet distance. Contains apple, house and umbrella arranged in Snellen's equivalent 20/200 – 20/10. Child asked to identify pictures in each line. Kay picture tests / LEA symbols: Child is given set of pictures in hand. Similar pictures shown at 10 feet distance on a log MAR chart. Snellen’s equivalent 20/200 – 20/20 can be measured. Repeatability of Visual Measure : Repeatability of Visual Measure What is a significant difference between eyes or between visits? It depends on how you’ve tested vision... Keeler cards 2 cards Cardiff acuity test 2 cards Kay pictures 2 lines Snellen acuity 3 lines Log MAR acuity test 4 letters (Saunders et al 2002) Conclusions : Conclusions Paediatric eye examination is difficult aspect. Challenging. Requires enthusiasm, skill and speed with accuracy. Potential to benefit the patient. Slide 23: Thank U… You do not have the permission to view this presentation. In order to view it, please contact the author of the presentation.