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