PEDIATRIC VA TESTING IN DEVELOPING COUNTRIES Barbie O
PEDIATRIC VA TESTING IN DEVELOPING COUNTRIES Barbie O. M. Ejukonemu Contacts: 1. www. 1 stopticians. com 2. 080 -332 -81 -569 3. Google ’Dr Barbie Ejukonemu’
Visual Acuity ---Latin(Acuitas)---- Sharpness Visual Acuity –an indication of how well/sharp a person sees. Measuring Instrument = VA chart Unit of measurement = Snellen(Feet or meter), grating(cycle per degree), Decimal and log MAR Convertible and reproducible.
Why Visual Acuity Diagnostic pointer Follow-up progress on eye disease. Health records and eligibility for services and tasks requiring eye sight.
Pediatric Vision Visual system functionally least mature at birth. Infants are “listeners” than “lookers” Visual deprivation imminent in the event of eye disease. Focus on children to facilitate development and education A visually impaired child = visually impaired adult
Children in developing countries System for vision testing not well developed Detection of ocular abnormalities not well developed. Pediatric VA instruments based on advanced technology. Technology generally not available/affordable in developing countries.
Purpose of this lecture Review visual Acuity testing methods in children and equip participants with the capacity and capability to assess vision in children, emphasising standard , reproducible tests in the absence of standard instruments.
Who is a child? Neonates Infant Toddler Pre school Middle childhood Adolescence (Birth to 1 mth) (1 mth - 1 yr) (1 yr – 3 yrs) (3 yrs – 6 yrs) (6 yrs – 11 yrs) (13 yrs – 18 yrs)
Age/VA Tests • • Birth – 6 mths - Observation, cover tests, Objection to occlusion, Threat reflex, Fixation, Following a light, Pupil responses, Grating test (Lea paddles) 6 mths- 3 yrs - 100’s and 1000’s, functional vision test, Lea paddles, Cardiff cards. 3 yrs-5 yrs - Kay pictures, Illiterate E, Sheridan Gardiner matching test with Key card, Cardiff cards 5 -6 yrs- Sonsken silver tests, snellen test with/without key cards.
Visual Acuity: Norms in children Joan T. Newman, Geraldine Scott. Padiatic Nursing Springhouse. Pa: Springhouse C 1990 Newborn 4 -5 mths(16 -20 wks) 11 -12 mths(44 -48 wks) 1. 5 -2 yrs(72 - 96 wks) 3 -4 yrs 5 -6 yrs 20/300 – 20/400 20/200 20/100 20/40 20/30 20/20
Grating Acuity: Norms in Children Lea Cognitive vision tests, www. good-lite. com 10 wks(2. 5 mths) 20 wks(5 mths) 30 wks(7. 5 mths) 40 – 60 wks(10 - 15 mths) *Cpd = cycle per degree Cpcm = cycle per centimeter At 57. 2 cm 1 cpcm = 1 cpd (1— 4 cpd)* (2 – 8 cpd) (4 -8 cpd) ( 4 -16 cpd)
Norms for Cardiff test 12 - 17. 9 mths 18 – 23. 9 mths 24 – 29. 9 mths 30 – 36 mths 6/48 -6/12 6/24 – 6/7. 5 6/15 – 6/7. 5 6/12 – 6/6
Snellen and Grating(at 38 cm) equivalents Cpm cpd 0. 25 0. 4 0. 5 1. 0 1. 3 4. 0 5 -3 10. 7 13. 3 17. 3 0. 18 0. 27 0. 36 0. 72 0. 96 2. 9 3. 8 7. 7 9. 6 12. 5 snellen 6/1000 6/620 6/500 6/250 6/190 6/60 6/50 6/24 6/18 6/14
Quiz No. 1 One of the following is true for VA testing in Toddlers a/ Cardiff cards b. Threat reflex c/ Sheridan Gardiner d/Lea Paddles
No. 2 Lea Paddles are best indicated for one of the following age groups a/ infants b/ Toddlers c/ adolescents d/ neonates e/ Middle childhood
No. 3 The standard Snellen Acuity chart at 6 m test distance is best for a/ adolescents b/ middle childhood d/ deaf adults e/ all of the above
No. 4 6/36 Snellen acuity is equivalent to a/ 20/120 feet Snellen b/ 1. 0 in Log MAR c/ 6 degrees Visual angle d/ b & c above e/ non of the above.
No. 5 2/60 Snellen acuity is equivalent to a/ 6/180 meter Snellen b/ 20/600 feet Snellen c/ 0. 03 decimal acuity d/ 30 degrees visual angle e/ all of the above.
Thank you For Listening
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