2020–2021 BCSC Basic and Clinical Science Course™
6 Pediatric Ophthalmology and Strabismus
Chapter 1: The Pediatric Eye Examination
This chapter includes a related video, which can be accessed by scanning the QR code provided in the text or going to www.aao.org/bcscvideo_section06.
Children and their ophthalmic problems differ greatly from the patients and ocular conditions encountered in adult ophthalmology. Each developmental level in children requires a different approach for the examination, but with proper preparation and a positive attitude, the ophthalmologist can find the examination of pediatric patients to be both enjoyable and rewarding.
Examination of Children in the Outpatient Setting
An unworried child will allow a more pleasant and valuable examination. The atmosphere in the ophthalmology office or clinic, therefore, should be welcoming and positive. Preferably, a small room or section of the waiting area should be designated and designed for children. Parents and caregivers, as well as any adult patients, will be grateful for this separation. Also, because some children fear the white coat, many pediatric practitioners choose not to wear one.
A dedicated long pediatric examination lane with different types of distance fixation targets (including remotely activated videos and mechanical animals 6 meters from the examination chair) is optimal. Having several small toys readily available for near fixation is useful for the 1 toy, 1 look rule (Fig 1-1). Translucent, plastic finger puppets become silent accommodative near targets that can also provide a corneal light reflex if placed over a muscle light or penlight.
Excerpted from BCSC 2020-2021 series: Section 10 - Glaucoma. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.