Emergency Eye Exam in Children is Modified
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Visual acuity – either with fix and follow for preverbal children or Snellen chart for verbal children
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Extraocular movements
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Lids/lashes, Conjunctiva/Sclera, Cornea
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Symmetry with the Hirschberg test
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Confrontation (cover/uncover test)
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Red reflex test (visual axis through to the retina) Leucokoria – a “white reflex” – gets immediate referral to an ophthalmologist for possible retinoblastoma
The outstanding ophthalmologist and medical educator, Tim Root, MD says it all best here:
Pediatric Eye Exam (Video)
Selected References
American Academy of Pediatrics; Section on Ophthalmology; American Association for Pediatric Ophthalmology And Strabismus; American Academy of Ophthalmology; American Association of Certified Orthoptists. Red reflex examination in neonates, infants, and children. Pediatrics. 2008 Dec;122(6):1401-4. doi: 10.1542/peds.2008-2624. Erratum in: Pediatrics. 2009 Apr;123(4):1254.
Root T. Basically Anything He Does. Check out his educational videos and publications here: https://timroot.com/
Simon JW, Kaw P. Commonly missed diagnoses in the childhood eye examination. Am Fam Physician. 2001 Aug 15;64(4):623-8. PMID: 11529261.
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