TAILIEUCHUNG - THE PEDIATRIC DIAGNOSTIC EXAMINATION - PART 3

thiết bị cho một "mắt khay" bao gồm một penlight, một ánh sáng màu xanh coban, dải fluorescein, Q-Tips, và thuốc nhỏ mắt cycloplegic (Hình 7-4). Q-Lời khuyên hữu ích để Evert mí mắt khi tìm kiếm một cơ quan nước ngoài kết mạc. Ánh sáng coban và giấy huỳnh quang rất hữu ích trong việc đưa ra các tổn thương giác mạc | 148 Chapter 7 The Eyes Ears Nose Throat Neck and Oral Examination FIGURE 7-3 A. The Picture Eye Chart. B. Standard Snellen Eye Chart Letters . equipment for an eye tray include a penlight a cobalt blue light fluorescein strips Q-Tips and cycloplegic eye drops FIGURE 7-4 . Q-Tips are useful to evert the eyelid when searching for a conjunctival foreign body. The cobalt light and fluorescein paper are useful in bringing out corneal lesions owing to trauma foreign body or infection. Many commercially available machines will evaluate acuity stereoacuity binocular and color vision and alignment but although very sensitive will have a very high false-positive yield resulting in many unnecessary referrals to the optometrist or ophthalmologist. Infants By 2 to 3 months of age infants will follow objects. It is difficult to assess visual acuity in infants because they will follow larger objects even The Eye Examination 149 FIGURE 7-3 Continued if they have poor vision. Certain red flags indicating poor or absent vision in infants include spontaneous nystagmus often of the searching variety. The examiner may glean clues from the other aspects of the visual examination such as notably severe strabismus transient malalignment is considered normal in infants up to 6 months of age lack of pupillary response to darkening a room corneal clouding and obvious malformations of the eye including but not limited to coloboma and microphthalmia often associated with other congenital malformations. Infants with poor or absent vision may not demonstrate optokinetic nystagmus when viewing moving stripes or dots. If vision is impaired in one eye frequently an infant will become very agitated if the examiner places his or her hand over the good eye. Eye alignment may be difficult to evaluate in an infant but if the examiner can get the baby

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