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Paediatric Optometry Part 1: course code: C-5873 O/D/CL.

1. Which of the following is NOT an indication to fit contact lenses for the patient in Image A?

a) There will be reduced effects of aniseikonia from anisometropia

b) If there is strabismus when not wearing spectacles during sport

c) The patient does not wash their hands regularly e.g. meal times

d) Improved cosmetic appearance, confidence and social acceptance

2. Which of the following is the MOST appropriate contact lens choice if the patient in image A wants to wear them for gymnastics three times per week?

a) Silicone hydrogel continuous wear lenses

b) Rigid gas permeable lenses

c) Toric daily disposable soft lenses

d) Spherical daily disposable soft lenses

3. When fitting contact lenses for the patient in Image A, which of the following statements is TRUE?

a) They will accommodate more with spectacles compared to contact lenses

b) They will accommodate less with spectacles compared to contact lenses

c) A correction for back vertex distance is required for the left eye but not the right eye

d) Over-refraction will not be necessary after correction for back vertex distance

4. What is the CORRECT description for the binocular vision anomaly shown in Image B?

a) Superior oblique palsy

b) Fully accommodative esotropia

c) Divergence weakness esotropia

d) Convergence weakness exotropia

5. What is the CORRECT description for the refractive condition shown in Image B?

a) Anisometropic hypermetropia

b) Symmetrical hypermetropia

c) Pseudo over-accommodation

d) All the above

6. What is the MOST appropriate management option for the patient in Image B?

a) Use of spectacles only for near concentrated work

b) Full time wear of spectacles or contact lenses

c) Strabismus surgery

d) All the above

7. Which of the charts shown in Image C is the LEAST appropriate to use for a four-year-old child having their first eye examination?

a) PANEL I

b) PANEL II

c) PANEL III

d) PANEL IV

8. Which one of the following is an advantage of the chart design shown in PANEL I of Image C?

a) The spacing of the optotypes and the lines follows a geometric progression

b) The same number of optotypes are presented on each line

c) There are equal crowding affects on each of the lines of acuity

d) All the above

9. Which one of the following represents a difference in chart design between that shown in PANEL I and PANEL II of Image C?

a) The size of the optotypes in PANEL I is 5x4 but in PANEL II they are 5x5

b) The optotypes follow a logarithmic progression in PANEL I but an arithmetic progression in PANEL II

c) There is less crowding with the optotypes in PANEL I compared to PANEL II

d) The optotypes in PANEL I are suitable for children under 4 years of age but PANEL II are not

10. Which one of the following statements about the condition shown in Image D is FALSE?

a) This could be a congenital cataract

b) This could be retinoblastoma

c) This could be bilateral myopia

d) This could be a persistent pupillary hyperplastic vitreous

11. What is the MOST appropriate management for the condition shown in Image D?

a) No management is required, review in 6 months

b) No management is required, review in 1 year

c) Routine referral to ophthalmology is required

d) Prompt referral to ophthalmology is required

12. If the condition shown in Image D is corrected with phacoemulsification surgery, what is the MOST likely management to be undertaken following surgery?

a) Refractive correction with occlusion of the operated eye

b) Refractive correction with occlusion of the good eye

c) Refractive correction without occlusion

d) No further management will be undertaken

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Associated Reading

1. B. J. W. Evans. Pickwel's Binocular Vision Anomalies, Oxford, Elsevier, 2007.

2. Horwood J et al. (2005) Common Visual Defects and Peer Victimization in Children. Invest Ophthalmol Vis Sci 46:1177-1181.

3. Jones-Jordan LA et al. (2010) Gas Permeable and Soft Contact Lens Wear in Children. Optom Vis Sci 87:414-420.

4. D. Taylor & C. S. Hoyt. (2005) Paediatric Ophthalmology and Strabismus, Philadelphia, Elsevier.

5. Walline JJ et al. (2007) Benefits of contact lens wear for children and teens. Eye Contact Lens 33:317-321.

About the author

Professor Bruce Evans is a practising optometrist who has been involved, for over 20 years, in clinical research into most areas of optometric practice. He is Director of Research at the Institute of Optometry and a Visiting Professor to City University and to London South Bank University where he is involved in the Doctor of Optometry programme.

Professor Bruce JW Evans BSc PhD FCOptom DipCLP DipOrth FAAO FBCLA
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Title Annotation:VRICS: VISUAL RECOGNITION AND IDENTIFICATION OF CLINICAL SIGNS
Author:Evans, Bruce J.W.
Publication:Optometry Today
Date:Apr 22, 2011
Words:779
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