Case #4a

You refract a 6 month old otherwise healthy infant. Results were:

Mohindra retinoscopy (gross):

OD: +3.75 - 1.50 X 090

OS: +3.00 - 0.50 x 090

Cover test: ortho

-What is the child's estimated refractive error?

-What would be your management of this case? Be specific.

-When would you recall this patient for follow-up?

-What would be your advice and recommendations to the parents?

Case #4b

You examine a one year old toddler. Parents believe they see a "lazy eye" when their child gets tired.

Dynamic retinoscopy (MEM):

OD: +3.25 -2.00 X 180

OS: +2.75 -1.50 X 180

-What would you conclude about refractive error?

-What other facts would you consider before deciding to prescribe?

-If this child was 6 years old, would your management change? Why or why not?

-What are the anticipated changes in refractive error in the preschool years?

-What would you tell the parents? 

Case #4c

You refract a two and one-half year old toddler who has a family history of significant refractive error. The parents do not notice behavioral signs of uncorrected refractive error; they just want to be certain.

Static retinoscopy:

OD: -2.50 -2.25 X 180

OS: -0.25 DS

-What are behaviorial signs of uncorrected refractive error in toddlers?

-What concerns you about this refraction?

-What other tests would you consider (if any) and why?