The Importance of Good Vision for Children - PowerPoint PPT Presentation


Title: The Importance of Good Vision for Children


1
The Importance of Good Vision for Children
2
Presentation provided by
  • Randolph E. Brooks, O.D.
  • AOA Member
  • Ledgewood, NJ

3
Importance of Good Vision to Learning
  • Approximately 80 of all learning during a
    childs first 12 years comes through vision
  • Undetected and untreated vision problems can
    interfere with ones full learning potential
  • Vision disorders are the fourth most common
    disability in the United States and the most
    prevalent handicapping condition in children

Courtesy of AOA
4
Importance of Good Vision to Learning
  • Only 14 of children have had an eye exam by age
    5
  • Only half of all children will have an eye
    examination before completing high school
  • 20 of children age 9-15 need glasses, and 90 of
    those have not received them
  • 75,000 3 year olds develop amblyopia each year

Courtesy of AOA
5
Statistics
  • American Optometric Association recommends a
    child gets his/her first eye exam at 6 months
  • 5 of children were identified as having a vision
    problem using the Snellen Chart
  • 18 Million children will not have had an eye
    examination by an Eye Doctor by the time they
    enter school
  • 60 of students identified as problem learners
    have undetected vision problems

Statistics courtesy of AOA
6
Role of Vision In Learning
  • The eyes must see clearly, without double vision,
    and with accurate focus control
  • The brain must interpret the visual image from
    its background, make assumptions as to its
    figure, and integrate the information gathered
    from peripheral vision and from other senses
  • Processing must occur without flaws
  • A child must have visual ability to learn to read
    prior to reading to learn

7
Symptoms of Children Struggling in the classroom
  • Trouble finishing written assignments
  • Losing their place when reading
  • Having a short attention span when doing close
    work
  • Skipping words when reading
  • Making errors when copying from the board
  • Underperforming

8
What is good vision?
  • Good vision includes
  • Visual acuity
  • Eye health
  • Visual Integration
  • Eye teaming
  • Eye focusing
  • Eye motility

9
Visual Acuity
  • The ability of the eye to see clearly in the
    distance and at near
  • Near vision- the ability to see at 8 -10 inches
    (reading a book)
  • Intermediate vision- the ability to see at 16 -40
    inches (computer distance)
  • Distance vision- the ability to see at 10 feet or
    more
  • 20/20 indicates that you can see letters 3/8
    high at 20 feet

10
Eye Health
  • The absence of anomaly or disease
  • If not diagnosed or treated, eye disease can lead
    to vision loss or impaired vision
  • Ocular health is evaluated by external ocular
    examination with a biomicroscope, eye pressure
    evaluation, and a dilated fundus exam

11
Visual Integration
  • The ability to process and integrate visual
    information
  • Using our vision and other senses to understand
    what we see

12
Eye teaming
  • The ability of the eyes to work properly together
  • The ability to coordinate and align both eyes to
    allow the brain to fuse a single image from the
    images it receives from each eye
  • The ability to judge relative distances of
    objects and have depth perception
  • The ability of the eyes to focus on something
    near by turning towards each other

13
Eye Focusing
  • The ability of the eyes to focus and shift focus
    to near and distant points easily and
    effortlessly
  • Eye Motility
  • The ability of the eyes to move from one point to
    another
  • The ability of the eyes to move across a page of
    print or to follow a ball, etc

14
Prevalence of vision problems Age 6 months to 18
Years
  • Hyperopia (farsightedness) 25
  • Astigmatism
    23
  • Accommodative Binocular disorders 20
  • Myopia (Nearsightedness) 18
  • Strabismus (eye turn)
    12
  • Amblyopia 7

15
Hyperopia (farsightedness)
  • The inability to see close-up things well
  • Eyeball is too short for normal focusing power of
    the eye
  • In children the lens can focus and accommodate
    through this error providing both clear distance
    and near vision, but much effort must be used.
    This can cause headaches, fatigue, and even
    crossed eyes.
  • Symptoms Include
  • Rubs Eyes
  • Has watery eyes
  • Complains of blurred vision

16
Astigmatism
  • Results from an irregular shape of the front
    surface of the cornea.
  • The eye is more football shaped rather than round
  • Causes blurred vision for distant and close-up
    things
  • Symptoms include
  • Rubs eyes
  • Has watery eyes
  • Complains of blurred vision

17
Myopia (Nearsightedness)
  • The inability to see distant things well
  • The eye is too long for the normal focusing power
    of the eye.
  • Symptoms include
  • Squints
  • Gets close to the board

18
Strabismus
  • Occurs when the eyes are not aligned when viewing
    an object
  • The eye may turn inward toward the nose
    (esotropia) or outward toward the side
    (exotropia)
  • This is usually caused by poor muscle control
  • Any eye turn can happen constantly or
    occasionally

19
Esotropia
20
Exotropia
21
Symptoms of Strabismus
  • Intermittent double vision
  • Closes or covers one eye
  • Says letters or words appear to move
  • Loses place
  • Is Inattentive
  • Rubs eyes
  • Has watery eyes
  • Complains of blurred vision
  • Has poor reading comprehension

22
Accommodative and Binocular Disorders
  • Accommodative- The eyes cannot focus well
  • The inability to contract and relax the eyes
    focusing muscles
  • Binocular The eyes do not work well as a team
    for example, the eyes cannot converge for
    up-close reading

23
Accommodative Symptoms
  • Headaches
  • Tired at the end of the day
  • Has blurred vision when looking from board to
    book or book to board
  • Holds things very close
  • Is Inattentive
  • Rubs eyes
  • Has watery eyes
  • Complains of blurred vision
  • Has poor reading comprehension

24
Binocular Disorder Symptoms
  • Headaches
  • Fatigue
  • Double vision
  • Blurriness
  • Watery eyes
  • Rubs Eyes
  • Is Inattentive
  • Loses place
  • Says Letters or words appear to move

25
Amblyopia
  • Also known as a lazy eye
  • Reduced vision in an eye that was not stimulated
    in early childhood
  • Can result from strabismus or misaligned eyes or
    a difference in clearness between eyes. One eye
    is focusing better than the other one. One eye
    becomes stronger from its use and the other eye
    is suppressed and not worked hard enough

26
Vision Screenings
  • Designed to identify gross visual problems and to
    indicate the immediate need for an eye
    examination. Parents must follow through on the
    referral.
  • Most children who fail a vision screening will
    also fail a diagnostic professional examination

27
Components of Visual Screenings
  • Distance Visual Acuity
  • Purpose-To test for myopia, amblyopia,
    astigmatism, and high hyperopia
  • Equipment-Distance VA chart and Occluder
  • Visual Acuity Charts Include
  • Snellen Chart
  • Tumbling E chart
  • Lea Symbols

28
Snellen Chart Tumbling E
Photos Courtesy of POA
29
LEA Symbol Charts
Photos courtesy of POA
30
Criteria for Referral
  • If either eye is less than 20/40 or a two-line
    difference exists between the two eyes, retest
    the child
  • If the same results prevail, the student has
    failed and immediate referral is indicated

31
Near Visual Acuity
  • Purpose- To test for hyperopia, astigmatism,
    amblyopia, and focusing problems
  • Equipment- Near Acuity Cards and Occluder
  • Near Acuity Cards include
  • Snellen
  • Lighthouse acuity
  • Lea Cards
  • Tumbling E

32
Near point cards
Photos courtesy of POA
33
Referral Criteria
  • If either eye is less than 20/40 or a two line
    difference exists between the two eyes, retest
    the child
  • If the same results prevail, the student has
    failed and immediate referral is indicated

34
Color Vision Test
  • Detects difficulty in ability to recognize color
  • Children with color blindness are not actually
    blind to color, but simply have difficulty
    identifying and distinguishing between different
    colors
  • Color Deficiencies are usually hereditary and
    affect 1 in 12 boys but only 1 in 200 girls

35
Color Vision Tests
Photos courtesy of POA
36
Color Vision Test
  • Equipment
  • Occluder
  • Pseudo-Isochromatic Test Plates
  • Referral Criteria
  • Student fails if does not correctly identify the
    number on the card

Photos courtesy of POA
37
Convex Lens Test
  • Detects hyperopia and binocular problems
  • Equipment
  • Distance acuity chart
  • Occluder
  • Pair of 2.25 Spherical Lens (ages 5-8)
  • Pair of 1.75 Spherical Lens(gtage 8)

38
Convex Lens Test Referral Criteria
  • If the student cannot read the 20/40 line while
    wearing the lenses then he/she has passed the
    test
  • If the student can read the 20/40 line while
    wearing the lenses then the student has failed
    and should be referred.

39
Stereo/Depth Test
  • Tests for amblyopia, strabismus, and binocularity
  • Equipment
  • Random Dot E
  • Stereofly
  • Random Dot Stereotest

40
Stereotests
Photos courtesy of POA
41
Random Dot E Polarized Glasses
Photos courtesy of POA
42
Cover Test
  • Tests for ocular alignment disorders, strabismus,
    and binocular problems
  • Done both at distance and near
  • Unilateral cover test
  • Movement on Unilateral cover test strabismus
  • No movement on unilateral cover test normal
  • Alternate Cover Test
  • Movement on Alternate cover test Strabismus or
    binocular problem, depending on severity
  • No movement on alternate cover test normal

43
Near Cover Test
44
Cover Test
http//www.city.ac.uk/optics/BVTutor/assets/images
/esotropia3.GIF http//www.city.ac.uk/optics/BVTu
tor/html/heterophoria_2.html
45
Near Point of Convergence
  • Tests the ability of the eyes to converge for
    up-close tasks
  • If the eyes cannot effectively converge for near
    vision tasks, then the patient has convergence
    insufficiency
  • Equipment
  • Near Point fixation stick
  • Tape Measure

Photos courtesy of POA
46
Near Point of Convergence Referral Criteria
  • If the student reports double vision or either
    eye swings out at greater than 5 inches then
    he/she has failed
  • If the student does not regain alignment or
    report single vision at 7 inches or less, then
    he/she has failed

47
Vision Screenings vs. Comprehensive Eye
Examinations
  • Screenings only detect gross visual problems and
    cannot substitute for regular professional eye
    examinations
  • Periodic eye health and vision examinations are
    essential for the prevention and diagnosis of
    conditions of the visual system
  • Parents MUST follow through on the referral

48
Definition of Optometrist
  • Optometrists are independent, primary health
    care providers who examine, diagnose, treat, and
    manage diseases and disorders of the visual
    system, the eye and associated structures as well
    as diagnose related systemic conditions.

Courtesy of American Optometric Association
49
Ocular Emergencies
  • Red Eye
  • Chemical Burns
  • Foreign Body
  • Blunt Trauma

50
RED EYE
BLOODSHOT Painful and/or Vision Blurred
See Doctor Now
YES
NO
See Doctor Today
BLOODSHOT Discharge Gritty Sensation
YES
NO
No Treatment Generally Required
Blood Red Spot on White of Eye
YES

NO
Lubricants Warm Compresses See Doctor if Worsens
No illness/trauma Hx No Discharge Slightly Red Eye
YES
Courtesy of AOA
51
Irrigate 30 Mins Lids Forced open then
see Doctor immediately after
Is the Chemical a strong base? Example Drain
Cleaner Lime
YES
Chemical Burns
Irrigate for 15 mins. Then see Doctor.
NO
YES
Is it a strong acid? Example Battery Acid
NO
Irrigate 15 minutes. See Doctor Today
A mild acid or alkali? Example Chlorine,
bleach Gasoline and Hairspray
YES
NO
See Doctor Today
Mild Thermal Burn Example Singed eyelashes UV
Burn / Welding
YES
Courtesy of AOA
52
Burns
  • Alkali- based chemicals
  • Lime (cement, plaster, whitewash)
  • Drain cleaners
  • Lye
  • Metal polishes
  • Ammonia
  • Oven cleaners
  • Acid-based chemicals
  • Swimming pool acid (muriatic acid)
  • Battery (sulfuric) acid

53
YES
Ocular Foreign Body
  • Are any of the following true?
  • Can the foreign body be seen and
  • does it remain after gentle washing?
  • Could the injury have penetrated the globe
  • of the eye?
  • Can blood be seen in the eye?
  • Does it feel as though a foreign body might
  • be trapped behind the upper lid?

See Doctor Now
NO
YES
Is there any problem with vision?
Foreign Body
NO
Call Doctor Today
Is there any eye pain?
Courtesy of AOA
54
Blunt Trauma
  • Are any of the following true?
  • Is lid swollen shut?
  • Is blood in anterior chamber?
  • Is cornea white/hazy?
  • Is pupil irregularly shaped, fixed, dilated
  • or constricted?

YES
See Doctor Now
NO
Is there any problem with vision? -example
blur, visual field loss Flashes, floaters, double
vision
YES
NO
Is there pain?
NO
YES
See Doctor Today
  • Apply home treatment
  • example ice pack first 2 hrs.
  • Then warm compresses
  • - If no overnight relief, see Doctor now

Courtesy of AOA
55
Other Examples of Blunt Trauma cases.
56
Case Studies
  • John, 6 years old, kindergarten
  • Screened in school
  • Screening findings
  • Distance VA 20/70 RE and 20/60 LE
  • Near VA 20/30 OU
  • Could read the 20/40 line through the plus lens
  • All other findings within normal limits
  • John was referred for a comprehensive eye
    examination

57
John
  • John was diagnosed with farsightedness
    (hyperopia)
  • He received a pair of glasses to correct his
    farsightedness
  • Johns corrected vision is now 20/20 at both
    distance and at near

58
Julie, 10 years old
  • Julie complains of occasionally seeing double,
    headaches, and blurry vision while reading for an
    extended period of time
  • Screening Results
  • Distance VA 20/20 RE 20/20 LE
  • Near VA 20/20 RE 20/20 LE
  • Stereovision Normal
  • Color Vision Normal
  • Plus Lens Test Normal
  • Cover Test Exophoria
  • NPC Left eye swung out at 7 inches and patient
    could not regain alignment until 11 inches

59
Julie
  • Julie was referred for a comprehensive eye
    examination
  • Julie was diagnosed with convergence
    insufficiency
  • Julie was enrolled into the vision training
    program to help improve her eye teaming

60
Megan, 13
  • Megan accidentally sprayed hairspray into her eye
    when she was styling her hair in the girls
    bathroom
  • Megan came in complaining that her eye was red
    and bothering her
  • What is the next course of action?

61
Megan, 13
  • Megans eye should be irrigated with saline or
    clean water for 15 minutes
  • Megan should see her eye doctor today

62
Healthy People 2010 National Health and Disease
Prevention Program
  • Increase proportion of persons who have a dilated
    eye exam at appropriate intervals
  • Increase the proportion of preschool children
    aged 5 years and under who receive vision
    screening
  • Reduce uncorrected visual impairment due to
    refractive errors

63
Healthy People 2010 National Health and Disease
Prevention Program
  • Reduce blindness visual impairment in children
    aged 17 under
  • Reduce visual impairment due to diabetic
    retinopathy
  • Reduce visual impairment due to glaucoma
  • Reduce visual impairment due to cataract
  • Reduce occupational eye injury

64
Healthy People 2010 National Health and Disease
Prevention Program
  • Increase the use of protective eyewear in
    recreational activities hazardous situations
    around the house and
  • Increase the use of vision rehabilitation
    services adaptive devices by people with visual
    impairments.

65
Good Vision A Good Education
  • Questions??
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Title: The Importance of Good Vision for Children


1
The Importance of Good Vision for Children
2
Presentation provided by
  • Randolph E. Brooks, O.D.
  • AOA Member
  • Ledgewood, NJ

3
Importance of Good Vision to Learning
  • Approximately 80 of all learning during a
    childs first 12 years comes through vision
  • Undetected and untreated vision problems can
    interfere with ones full learning potential
  • Vision disorders are the fourth most common
    disability in the United States and the most
    prevalent handicapping condition in children

Courtesy of AOA
4
Importance of Good Vision to Learning
  • Only 14 of children have had an eye exam by age
    5
  • Only half of all children will have an eye
    examination before completing high school
  • 20 of children age 9-15 need glasses, and 90 of
    those have not received them
  • 75,000 3 year olds develop amblyopia each year

Courtesy of AOA
5
Statistics
  • American Optometric Association recommends a
    child gets his/her first eye exam at 6 months
  • 5 of children were identified as having a vision
    problem using the Snellen Chart
  • 18 Million children will not have had an eye
    examination by an Eye Doctor by the time they
    enter school
  • 60 of students identified as problem learners
    have undetected vision problems

Statistics courtesy of AOA
6
Role of Vision In Learning
  • The eyes must see clearly, without double vision,
    and with accurate focus control
  • The brain must interpret the visual image from
    its background, make assumptions as to its
    figure, and integrate the information gathered
    from peripheral vision and from other senses
  • Processing must occur without flaws
  • A child must have visual ability to learn to read
    prior to reading to learn

7
Symptoms of Children Struggling in the classroom
  • Trouble finishing written assignments
  • Losing their place when reading
  • Having a short attention span when doing close
    work
  • Skipping words when reading
  • Making errors when copying from the board
  • Underperforming

8
What is good vision?
  • Good vision includes
  • Visual acuity
  • Eye health
  • Visual Integration
  • Eye teaming
  • Eye focusing
  • Eye motility

9
Visual Acuity
  • The ability of the eye to see clearly in the
    distance and at near
  • Near vision- the ability to see at 8 -10 inches
    (reading a book)
  • Intermediate vision- the ability to see at 16 -40
    inches (computer distance)
  • Distance vision- the ability to see at 10 feet or
    more
  • 20/20 indicates that you can see letters 3/8
    high at 20 feet

10
Eye Health
  • The absence of anomaly or disease
  • If not diagnosed or treated, eye disease can lead
    to vision loss or impaired vision
  • Ocular health is evaluated by external ocular
    examination with a biomicroscope, eye pressure
    evaluation, and a dilated fundus exam

11
Visual Integration
  • The ability to process and integrate visual
    information
  • Using our vision and other senses to understand
    what we see

12
Eye teaming
  • The ability of the eyes to work properly together
  • The ability to coordinate and align both eyes to
    allow the brain to fuse a single image from the
    images it receives from each eye
  • The ability to judge relative distances of
    objects and have depth perception
  • The ability of the eyes to focus on something
    near by turning towards each other

13
Eye Focusing
  • The ability of the eyes to focus and shift focus
    to near and distant points easily and
    effortlessly
  • Eye Motility
  • The ability of the eyes to move from one point to
    another
  • The ability of the eyes to move across a page of
    print or to follow a ball, etc

14
Prevalence of vision problems Age 6 months to 18
Years
  • Hyperopia (farsightedness) 25
  • Astigmatism
    23
  • Accommodative Binocular disorders 20
  • Myopia (Nearsightedness) 18
  • Strabismus (eye turn)
    12
  • Amblyopia 7

15
Hyperopia (farsightedness)
  • The inability to see close-up things well
  • Eyeball is too short for normal focusing power of
    the eye
  • In children the lens can focus and accommodate
    through this error providing both clear distance
    and near vision, but much effort must be used.
    This can cause headaches, fatigue, and even
    crossed eyes.
  • Symptoms Include
  • Rubs Eyes
  • Has watery eyes
  • Complains of blurred vision

16
Astigmatism
  • Results from an irregular shape of the front
    surface of the cornea.
  • The eye is more football shaped rather than round
  • Causes blurred vision for distant and close-up
    things
  • Symptoms include
  • Rubs eyes
  • Has watery eyes
  • Complains of blurred vision

17
Myopia (Nearsightedness)
  • The inability to see distant things well
  • The eye is too long for the normal focusing power
    of the eye.
  • Symptoms include
  • Squints
  • Gets close to the board

18
Strabismus
  • Occurs when the eyes are not aligned when viewing
    an object
  • The eye may turn inward toward the nose
    (esotropia) or outward toward the side
    (exotropia)
  • This is usually caused by poor muscle control
  • Any eye turn can happen constantly or
    occasionally

19
Esotropia
20
Exotropia
21
Symptoms of Strabismus
  • Intermittent double vision
  • Closes or covers one eye
  • Says letters or words appear to move
  • Loses place
  • Is Inattentive
  • Rubs eyes
  • Has watery eyes
  • Complains of blurred vision
  • Has poor reading comprehension

22
Accommodative and Binocular Disorders
  • Accommodative- The eyes cannot focus well
  • The inability to contract and relax the eyes
    focusing muscles
  • Binocular The eyes do not work well as a team
    for example, the eyes cannot converge for
    up-close reading

23
Accommodative Symptoms
  • Headaches
  • Tired at the end of the day
  • Has blurred vision when looking from board to
    book or book to board
  • Holds things very close
  • Is Inattentive
  • Rubs eyes
  • Has watery eyes
  • Complains of blurred vision
  • Has poor reading comprehension

24
Binocular Disorder Symptoms
  • Headaches
  • Fatigue
  • Double vision
  • Blurriness
  • Watery eyes
  • Rubs Eyes
  • Is Inattentive
  • Loses place
  • Says Letters or words appear to move

25
Amblyopia
  • Also known as a lazy eye
  • Reduced vision in an eye that was not stimulated
    in early childhood
  • Can result from strabismus or misaligned eyes or
    a difference in clearness between eyes. One eye
    is focusing better than the other one. One eye
    becomes stronger from its use and the other eye
    is suppressed and not worked hard enough

26
Vision Screenings
  • Designed to identify gross visual problems and to
    indicate the immediate need for an eye
    examination. Parents must follow through on the
    referral.
  • Most children who fail a vision screening will
    also fail a diagnostic professional examination

27
Components of Visual Screenings
  • Distance Visual Acuity
  • Purpose-To test for myopia, amblyopia,
    astigmatism, and high hyperopia
  • Equipment-Distance VA chart and Occluder
  • Visual Acuity Charts Include
  • Snellen Chart
  • Tumbling E chart
  • Lea Symbols

28
Snellen Chart Tumbling E
Photos Courtesy of POA
29
LEA Symbol Charts
Photos courtesy of POA
30
Criteria for Referral
  • If either eye is less than 20/40 or a two-line
    difference exists between the two eyes, retest
    the child
  • If the same results prevail, the student has
    failed and immediate referral is indicated

31
Near Visual Acuity
  • Purpose- To test for hyperopia, astigmatism,
    amblyopia, and focusing problems
  • Equipment- Near Acuity Cards and Occluder
  • Near Acuity Cards include
  • Snellen
  • Lighthouse acuity
  • Lea Cards
  • Tumbling E

32
Near point cards
Photos courtesy of POA
33
Referral Criteria
  • If either eye is less than 20/40 or a two line
    difference exists between the two eyes, retest
    the child
  • If the same results prevail, the student has
    failed and immediate referral is indicated

34
Color Vision Test
  • Detects difficulty in ability to recognize color
  • Children with color blindness are not actually
    blind to color, but simply have difficulty
    identifying and distinguishing between different
    colors
  • Color Deficiencies are usually hereditary and
    affect 1 in 12 boys but only 1 in 200 girls

35
Color Vision Tests
Photos courtesy of POA
36
Color Vision Test
  • Equipment
  • Occluder
  • Pseudo-Isochromatic Test Plates
  • Referral Criteria
  • Student fails if does not correctly identify the
    number on the card

Photos courtesy of POA
37
Convex Lens Test
  • Detects hyperopia and binocular problems
  • Equipment
  • Distance acuity chart
  • Occluder
  • Pair of 2.25 Spherical Lens (ages 5-8)
  • Pair of 1.75 Spherical Lens(gtage 8)

38
Convex Lens Test Referral Criteria
  • If the student cannot read the 20/40 line while
    wearing the lenses then he/she has passed the
    test
  • If the student can read the 20/40 line while
    wearing the lenses then the student has failed
    and should be referred.

39
Stereo/Depth Test
  • Tests for amblyopia, strabismus, and binocularity
  • Equipment
  • Random Dot E
  • Stereofly
  • Random Dot Stereotest

40
Stereotests
Photos courtesy of POA
41
Random Dot E Polarized Glasses
Photos courtesy of POA
42
Cover Test
  • Tests for ocular alignment disorders, strabismus,
    and binocular problems
  • Done both at distance and near
  • Unilateral cover test
  • Movement on Unilateral cover test strabismus
  • No movement on unilateral cover test normal
  • Alternate Cover Test
  • Movement on Alternate cover test Strabismus or
    binocular problem, depending on severity
  • No movement on alternate cover test normal

43
Near Cover Test
44
Cover Test
http//www.city.ac.uk/optics/BVTutor/assets/images
/esotropia3.GIF http//www.city.ac.uk/optics/BVTu
tor/html/heterophoria_2.html
45
Near Point of Convergence
  • Tests the ability of the eyes to converge for
    up-close tasks
  • If the eyes cannot effectively converge for near
    vision tasks, then the patient has convergence
    insufficiency
  • Equipment
  • Near Point fixation stick
  • Tape Measure

Photos courtesy of POA
46
Near Point of Convergence Referral Criteria
  • If the student reports double vision or either
    eye swings out at greater than 5 inches then
    he/she has failed
  • If the student does not regain alignment or
    report single vision at 7 inches or less, then
    he/she has failed

47
Vision Screenings vs. Comprehensive Eye
Examinations
  • Screenings only detect gross visual problems and
    cannot substitute for regular professional eye
    examinations
  • Periodic eye health and vision examinations are
    essential for the prevention and diagnosis of
    conditions of the visual system
  • Parents MUST follow through on the referral

48
Definition of Optometrist
  • Optometrists are independent, primary health
    care providers who examine, diagnose, treat, and
    manage diseases and disorders of the visual
    system, the eye and associated structures as well
    as diagnose related systemic conditions.

Courtesy of American Optometric Association
49
Ocular Emergencies
  • Red Eye
  • Chemical Burns
  • Foreign Body
  • Blunt Trauma

50
RED EYE
BLOODSHOT Painful and/or Vision Blurred
See Doctor Now
YES
NO
See Doctor Today
BLOODSHOT Discharge Gritty Sensation
YES
NO
No Treatment Generally Required
Blood Red Spot on White of Eye
YES

NO
Lubricants Warm Compresses See Doctor if Worsens
No illness/trauma Hx No Discharge Slightly Red Eye
YES
Courtesy of AOA
51
Irrigate 30 Mins Lids Forced open then
see Doctor immediately after
Is the Chemical a strong base? Example Drain
Cleaner Lime
YES
Chemical Burns
Irrigate for 15 mins. Then see Doctor.
NO
YES
Is it a strong acid? Example Battery Acid
NO
Irrigate 15 minutes. See Doctor Today
A mild acid or alkali? Example Chlorine,
bleach Gasoline and Hairspray
YES
NO
See Doctor Today
Mild Thermal Burn Example Singed eyelashes UV
Burn / Welding
YES
Courtesy of AOA
52
Burns
  • Alkali- based chemicals
  • Lime (cement, plaster, whitewash)
  • Drain cleaners
  • Lye
  • Metal polishes
  • Ammonia
  • Oven cleaners
  • Acid-based chemicals
  • Swimming pool acid (muriatic acid)
  • Battery (sulfuric) acid

53
YES
Ocular Foreign Body
  • Are any of the following true?
  • Can the foreign body be seen and
  • does it remain after gentle washing?
  • Could the injury have penetrated the globe
  • of the eye?
  • Can blood be seen in the eye?
  • Does it feel as though a foreign body might
  • be trapped behind the upper lid?

See Doctor Now
NO
YES
Is there any problem with vision?
Foreign Body
NO
Call Doctor Today
Is there any eye pain?
Courtesy of AOA
54
Blunt Trauma
  • Are any of the following true?
  • Is lid swollen shut?
  • Is blood in anterior chamber?
  • Is cornea white/hazy?
  • Is pupil irregularly shaped, fixed, dilated
  • or constricted?

YES
See Doctor Now
NO
Is there any problem with vision? -example
blur, visual field loss Flashes, floaters, double
vision
YES
NO
Is there pain?
NO
YES
See Doctor Today
  • Apply home treatment
  • example ice pack first 2 hrs.
  • Then warm compresses
  • - If no overnight relief, see Doctor now

Courtesy of AOA
55
Other Examples of Blunt Trauma cases.
56
Case Studies
  • John, 6 years old, kindergarten
  • Screened in school
  • Screening findings
  • Distance VA 20/70 RE and 20/60 LE
  • Near VA 20/30 OU
  • Could read the 20/40 line through the plus lens
  • All other findings within normal limits
  • John was referred for a comprehensive eye
    examination

57
John
  • John was diagnosed with farsightedness
    (hyperopia)
  • He received a pair of glasses to correct his
    farsightedness
  • Johns corrected vision is now 20/20 at both
    distance and at near

58
Julie, 10 years old
  • Julie complains of occasionally seeing double,
    headaches, and blurry vision while reading for an
    extended period of time
  • Screening Results
  • Distance VA 20/20 RE 20/20 LE
  • Near VA 20/20 RE 20/20 LE
  • Stereovision Normal
  • Color Vision Normal
  • Plus Lens Test Normal
  • Cover Test Exophoria
  • NPC Left eye swung out at 7 inches and patient
    could not regain alignment until 11 inches

59
Julie
  • Julie was referred for a comprehensive eye
    examination
  • Julie was diagnosed with convergence
    insufficiency
  • Julie was enrolled into the vision training
    program to help improve her eye teaming

60
Megan, 13
  • Megan accidentally sprayed hairspray into her eye
    when she was styling her hair in the girls
    bathroom
  • Megan came in complaining that her eye was red
    and bothering her
  • What is the next course of action?

61
Megan, 13
  • Megans eye should be irrigated with saline or
    clean water for 15 minutes
  • Megan should see her eye doctor today

62
Healthy People 2010 National Health and Disease
Prevention Program
  • Increase proportion of persons who have a dilated
    eye exam at appropriate intervals
  • Increase the proportion of preschool children
    aged 5 years and under who receive vision
    screening
  • Reduce uncorrected visual impairment due to
    refractive errors

63
Healthy People 2010 National Health and Disease
Prevention Program
  • Reduce blindness visual impairment in children
    aged 17 under
  • Reduce visual impairment due to diabetic
    retinopathy
  • Reduce visual impairment due to glaucoma
  • Reduce visual impairment due to cataract
  • Reduce occupational eye injury

64
Healthy People 2010 National Health and Disease
Prevention Program
  • Increase the use of protective eyewear in
    recreational activities hazardous situations
    around the house and
  • Increase the use of vision rehabilitation
    services adaptive devices by people with visual
    impairments.

65
Good Vision A Good Education
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