Symposium refraction in children

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Symposium on Refraction in Children :

Symposium on Refraction in Children

Objective :

Objective Develop an appropriate timetable for eye and vision examinations for children • Select appropriate examination procedures for all childern •Minimize or avoid the adverse effects of eye and vision problems in children through early identification, education, treatment, and prevention • Inform and educate patients, parents/caregivers, and other health care providers about the importance and frequency of pediatric eye and vision examinations

Develop an appropriate timetable for eye and vision examinations for children :

Develop an appropriate timetable for eye and vision examinations for children

Development of visual functions:

Development of visual functions Birth- 4/400 1yr – 6/12 2-3 yrs- 6/6 BSV – 4/52- 6/52 full @ 18/12 Color vision – 4/52 ( differentiation 3/12- 4/12) Critical period – 4- 18/12 Plasticity - ? Upto 12 yrs

Select appropriate examination procedures for children :

Select appropriate examination procedures for children

Refraction Techniques :

Refraction Techniques

Dynamic Retinoscopy :

Dynamic Retinoscopy

Bruckner reflex (Red reflex) :

Bruckner reflex (Red reflex)

Minimize or avoid the adverse effects of eye and vision problems in children through early identification, education, treatment, and prevention:

Minimize or avoid the adverse effects of eye and vision problems in children through early identification, education, treatment, and prevention

Slide 14:

Animal studies would suggest that correcting refractive errors at a young age is likely to impede emmetropisation , (in effect ‘fooling the eyes into thinking they are already emmetropic ’) and one study with children supports this.

Slide 15:

CONDITION AGE 0 - 1 1 -2 2 - 3 ISOMETROPIA Myopia > - 4.0 > - 4.0 > - 3.0 Hypermetropia with ESO > + 6.0 > + 5.0 > + 4.5 Hypermetropia without ESO > + 2.0 > + 2.0 > + 1.5 Regular astigmatism > 3.0 > 2.5 > 2.0 Oblique astigmatism > 1.0 > 1.0 > 1.0 ANISOMETROPIA Myopia > - 2.5 > 2.5 > 2.0 Hypermetropia > + 2.5 > + 2.0 > + 1.5 Astigmatism > 2.5 > 2.0 > 2.0

Inform and educate patients, parents/caregivers, and other health care providers about the importance and frequency of pediatric eye and vision examinations:

Inform and educate patients, parents/caregivers, and other health care providers about the importance and frequency of pediatric eye and vision examinations

Slide 17:

The management of strabismus in childhood is multidisciplinary matter and usually involves parents and children, ophthalmologists, orthoptists and optometrists. General practitioners, health visitors, paediatricians and paediatric neurologists may also become involved in the management of children with strabismus . It is desirable that these parties are committed to locally agreed care pathways, covering visual screening , referral, assessment, treatment and the monitoring of progress of children identified with strabismus. The latter is particularly important, as it is common that information will change with development, and multiple follow up visits will be required. The Royal College of Ophthalmologists

Slide 18:

Unfortunately , undue reliance on vision screening by pediatricians or other primary care physicians may result in the late detection of amblyopia and other vision disorders. One study reported that in a sample of 102 private pediatric practices in the United States, vision screening was attempted on only 38 percent of 3-year-old children and 81 percent of 5-year-old children. The study also showed that only 26 percent of children failing the American Academy of Pediatrics vision screening guidelines were referred for a professional eye examination. The American Public Health Association adopted a resolution that recognizes the shortcomings of vision screenings, encourages regular eye examinations at the ages of 6 months, 2 years, and 4 years, and urges pediatricians to recommend that all children receive eye examinations at these intervals - AOA

THANK YOU:

THANK YOU DR. AMILA DE ALWIS SNR. ORTHOPTIST J U SEEKUBADU OPTO. YESHWANT SOAJI OPTO. TUSHIL GUNAWARDANA MR. JAYASEKARA

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