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Continuity Clinic Notebook:

Chapter 1: The Prenatal and Well Child Visit

Chapter 1 Index

A. General Information about the well child examination

B. Nutrition Issues

C. Sleep Issues

D. Dental Issues

E. Anticipatory Guidance

F. Screening Tests
--Hearing Screening in Children
--Vision Screening in Children

 

Glossary of Ophthalmologic Terms

Strabismus:

Term Definition
Strabismus Misalignment of eyes: occurs in 4% children < 6 years of age
Hirshberg test Corneal light reflex: most easily performed diagnostic test
Cover tests:
a.cover-uncover test Child looks at an object a distance away – up to 20 feet; cover one eye and watch for movement of the other eye. Repeat for each eye.
b.alternate cover test Alternate covering and uncovering each ey shifting back and forth – recently uncovered eye shifts as cover the other eye.
Tropias (exo and eso) Manifest deviations of the eyes
Phorias (exo and eso) Latent deviations.
Pseudostrabismus Associated with flat nasal bridge, prominent epicanthal folds, narrow interpupillary distance.
Hyperopia Farsighted
Accomodative esotropia When eyes converge, if hyperopic, then find this; can be associated with amblyopia. Treat with glasses
Intermittent exotropia Often noticed when looking at a distance

Nystagmus

Congenital pendular nystagmus Can be associated with a number of ocular and visual defects such as albinism, aniridia, cataracts.
Congenital jerky nystagmus Horizontal with nystagmus coarser in one direction

Can be familial.

Acquired nystagmus Bad news: can be involvement of cerebellum, brain stem, cerebral disease or side effect of medications.
Convergent nystagmus Repetitive jerking of the eyes: can be result of CNS tumor, vascular or inflammatory problem
Spasmus nutans Pendular nystagmus, head nodding and torticollis; either good or bad: resolves on its own, but can be associated with CNS tumors: hypothalamus and optic chiasm gliomas.
Opsiclonus Nonrhythmic, multidirectional, chaotic movement of the eyes: eyes are in agitation: encephalitis or neuroblastoma.
Ocular dysmetria From cerebellar disease: like limb dysmetria; overshoot of the eyes with to and fro oscillations

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Department of Pediatrics  |  Medical College of Georgia
Please email comments, suggestions or questions to:
John T.  Benjamin M.D., 
jbenj@mcg.edu

February 27, 2004