Case #3

A concerned mother brings in her 6 month old child to your office. She notices an eye turn inward sometimes. The mother also reports that sometimes both eyes will turn in. She brought in a flash photo of her daughter at age 3 months which shows the left eye turning. Her pediatrician assured the mother that the child will outgrow such things. Mom wants a second opinion.

I. HISTORY:

1. What questions do you ask about the child's binocular vision history? What would be considered: a.) significant and b.) inconsequetial ?

2. What questions do you ask about the patient's family medial and ocular history?

3. What direct observations can you make as the child interacts with her mother and teething toys in the waiting room?

II. ACUITY:

4. How would you measure visual acuity at this age? Be specific. What outcomes would be expected?

III. BINOCULAR VISION:

5. How would you determine whether or not the child has strabismus? Discusss pros and cons of various methods.

6. What is the expected level of binocular vision in a child this age?

IV. CONVERGENCE

7. How would you measure and what would be expected for a six month old infant?

V. ACCOMMODATION

8. How would you measure and what would be expected for a six month old infant?

VI. EOMs