School Age Eye Exam

What percentage of children are estimated to become myopic?

23.4%

What is the primary purpose of a school-age vision exam?

To ensure vision is developing appropriately and meeting visual demands for learning

What is a common effect of uncorrected hyperopia in school-aged children?

Decreased ability to read

Which visual efficiency skills are critical for academic performance?

Binocular vision, oculomotor skills, and accommodation

What is a symptom of convergence insufficiency?

Blurred vision and diplopia

What is an example of a question to ask a school-aged child during case history?

"What is your favorite/least favorite subject and why?"

Which symptom is associated with accommodative disorders?

Difficulty changing focus from near to far and back again

What percentage of school-aged children are estimated to have convergence insufficiency?

8%

Which is a common complaint that may prompt a school-age exam?

Observations by teachers or parents

Why is case history considered an important part of the school-age exam?

It guides the testing sequence and helps identify potential issues early.

Vision development and meeting __________ demands are key purposes of the school-age exam.

academic

Common symptoms of convergence insufficiency include __________, headaches, and diplopia.

eyestrain

Hyperopia in young school-aged children can affect __________.

reading

Asking specific questions about __________ and math can help identify potential vision problems.

reading

__________ insufficiency is estimated to affect 8% of school-aged children.

Convergence

Why is monitoring changes in refractive error important in school-aged children?

Frequent changes occur in children, and uncorrected refractive errors can negatively impact academic performance.

What visual skills are evaluated to assess visual efficiency in school-aged children?

Binocular vision, oculomotor skills, and accommodation

What are common signs of accommodative disorders in school-aged children?

Difficulty focusing on near objects, maintaining focus, and switching focus between near and far.

How should you structure questions when interviewing school-aged children about vision symptoms?

Start with general questions and progress to more detailed ones, tailoring them based on the child's responses.

What are examples of common complaints that may indicate a need for a school-age exam?

Failed school screenings, family history of eye problems, teacher or parent observations, and achievement or learning-related issues.

What type of acuity test is most likely used for school-aged children?

Snellen chart

Which oculomotor skills are assessed in addition to EOM evaluations?

Fixation, pursuits, and saccades

Which test evaluates motor fusion using a red lens or R/G technique?

Near Point of Convergence (NPC)

What is the purpose of performing the cover test in 9 fields of gaze?

To evaluate commitancy in strabismic and phoric patients

In the Thorington card test, seeing letters on the left indicates which phoria?

Exophoria

What does the Howell card test evaluate?

Phorias at distance and near

What is the average amplitude of accommodation formula for school-aged children?

18.5 - 1/3(age)

In the Maddox rod test, what does a patient seeing a vertical red line indicate?

Horizontal phoria measurement

Which test is preferred for measuring amplitude of accommodation in school-aged children?

Minus Lens

What additional value is added to minus lens amplitude measurements to account for the working distance?

2.50 D

The __________ test evaluates fixation, pursuits, and saccades for oculomotor skill assessment.

Developmental Eye Movement (DEM)

The __________ card test allows for phoria measurement without using prism.

Thorington

The Howell card uses a __________ prism over the right eye to measure phorias.

Base down

The formula to calculate the minimum amplitude of accommodation is __________.

15 - 1/4(age)

For the minus lens method of measuring accommodation, __________ lenses are added until the target is blurry.

Minus

Why is the cover test performed in 9 fields of gaze?

To evaluate commitancy in strabismic patients and identify variations in phoria depending on the direction of gaze.

What is the purpose of performing NPC testing with both accommodative and non-accommodative targets?

To evaluate motor fusion (accommodative target) and sensory fusion (non-accommodative target).

Describe how the Maddox rod test works for horizontal phoria measurement.

A vertical red line is seen through the Maddox rod, and the separation from a white light is measured to determine horizontal phoria.

What is the role of fixation disparity in binocular vision testing?

It assesses the small misalignment of the eyes during binocular viewing that does not disrupt single vision.

How is the amplitude of accommodation calculated using the minus lens method?

The total minus lens power added until the patient reports blur is measured, and 2.50 D is added for the working distance at 40 cm.

Which age group relies more on objective findings for refraction?

Younger school age (5-7 years)

What is the fixed target distance for MEM retinoscopy?

40 cm

Which near retinoscopy technique involves moving the examiner to find neutrality?

Nott

What does a dull, slow against-motion reflex indicate during near retinoscopy?

Visual frustration

At what grade level do children typically start to struggle with increased visual demands?

3rd or 4th grade

Which tool is not commonly used for measuring intraocular pressure (IOP) in school-aged children?

Pachymeter

3 multiple choice options

What is the main purpose of discussing exam results with both the parent and the child?

To involve the patient in their care and ensure understanding

Which near retinoscopy technique assesses the reflex quality based on the patient's reading level?

Book

When might a referral to the school or other professionals be necessary?

When the child has significant vision-related academic challenges

What is a common way to reward pediatric patients after an eye exam?

Give them an award or prize

The __________ technique involves the examiner fixed at 40 cm and moving the target to locate neutrality.

Bell

Increased visual stress can lead to __________ comprehension, attention, and behavior.

reduced

During ocular health assessment, the __________ is used to evaluate the anterior segment.

slit lamp

he __________ retinoscopy technique involves observing the quality of the reflex while the patient reads.

Book

Discussing management with the patient and parent should include __________ questions to confirm understanding.

open-ended

What is the significance of performing wet or damp retinoscopy during an eye exam?

It helps in accurately assessing refractive error, especially for prescribing glasses in children.

Why is visual efficiency testing crucial for school-aged children?

Because academic performance and reading depend heavily on binocular vision, accommodative function, and oculomotor skills.

What type of reflex is considered optimal for instructional reading during near retinoscopy?

Bright, fast against-motion reflex with a pink hue.

Why should the child be involved in the discussion of the exam results?

To help them understand their condition and treatment, and to encourage their active participation in care.

What is the main purpose of case history in school-aged exams?

To gather detailed information on visual, medical, developmental history, and academic performance to guide testing and diagnosis.