EM Quick Hits Video on Pediatric Eye Exam Tips & Tricks with Anna McDonald
- Get and keep their attention; the smartphone is your friend
- Just watch them – general observation gives you a lot of info
- Tetracaine eye drop trick for kids with pain who refuse to open their eye – make a puddle of drops in the inner corner of the eye, when they open or blink the drops will distribute naturally across the eye
- If they are too little to use the paediatric Snellen chart see if they can fix and follow. If they can’t, then see if they can blink to light.
- While they are fixated on the toy or phone, check:
- Pupillary responses
- Alignment (can use cover-uncover test)
- Visual fields (use a second toy in their peripheral field to see if they notice it)
- The ophthalmoscope is useful for:
- Red reflex
- Substitute for a slit lamp
- Fundoscopy
- If you still can’t get a good enough pediatric eye exam consider ocular ultrasound or sedation.
The Podcast: EM Quick Hits 1: Massive PE, Gabapentin for Alcohol Withdrawal, Dental Avulsions, Pediatric Eye Exam, Best Resuscitation Fluid
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