Barbie O. M. Ejukonemu Contacts: 1. www.1stopticians.com 2. 080-332-81-569 3. Google ’Dr Barbie Ejukonemu’ Acuity ---Latin(Acuitas)---- Sharpness Visual Acuity –an indication of how well/sharp a person sees. Measuring Instrument = VA chart Unit of measurement = Snellen(Feet or meter), grating(cycle per degree), Decimal and log MAR Convertible and reproducible. Diagnostic pointer Follow-up progress on eye disease. Health records and eligibility for services and tasks requiring eye sight. Visual system functionally least mature at birth. Infants are “listeners” than “lookers” Visual deprivation imminent in the event of eye disease. Focus on children to facilitate development and education A visually impaired child = visually impaired adult System for vision testing not well developed Detection of ocular abnormalities not well developed. Pediatric VA instruments based on advanced technology. Technology generally not available/affordable in developing countries. Review visual Acuity testing methods in children and equip participants with the capacity and capability to assess vision in children, emphasising standard , reproducible tests in the absence of standard instruments. Neonates Infant Toddler Pre school Middle childhood Adolescence (Birth to 1mth) (1mth - 1 yr) (1yr – 3 yrs) (3yrs – 6 yrs) (6yrs – 11 yrs) (13yrs – 18 yrs) • • • • Birth – 6mths - Observation, cover tests, Objection to occlusion, Threat reflex, Fixation, Following a light, Pupil responses, Grating test (Lea paddles) 6mths- 3yrs - 100’s and 1000’s, functional vision test, Lea paddles, Cardiff cards. 3yrs-5yrs - Kay pictures, Illiterate E, Sheridan Gardiner matching test with Key card, Cardiff cards 5-6yrs- Sonsken silver tests, snellen test with/without key cards. Newborn 20/300 – 20/400 4-5mths(16-20wks) 20/200 11-12mths(44-48wks) 20/100 1.5-2yrs(72- 96wks) 20/40 3-4yrs 20/30 5-6yrs 20/20 10wks(2.5mths) 20wks(5mths) 30wks(7.5mths) 40 – 60wks(10- 15mths) *Cpd = cycle per degree Cpcm = cycle per centimeter At 57.2cm 1cpcm = 1cpd (1—4cpd)* (2 – 8cpd) (4-8cpd) ( 4-16cpd) 12 - 17.9mths 18 – 23.9mths 24 – 29.9mths 30 – 36mths 6/48-6/12 6/24 – 6/7.5 6/15 – 6/7.5 6/12 – 6/6 Cpm cpd snellen 0.25 0.4 0.5 1.0 1.3 4.0 5-3 10.7 13.3 17.3 0.18 0.27 0.36 0.72 0.96 2.9 3.8 7.7 9.6 12.5 6/1000 6/620 6/500 6/250 6/190 6/60 6/50 6/24 6/18 6/14 One of the following is true for VA testing in Toddlers a/ Cardiff cards b. Threat reflex c/ Sheridan Gardiner d/Lea Paddles Lea Paddles are best indicated for one of the following age groups a/ infants b/ Toddlers c/ adolescents d/ neonates e/ Middle childhood The standard Snellen Acuity chart at 6m test distance is best for a/ adolescents b/ middle childhood d/ deaf adults e/ all of the above 6/36 Snellen acuity is equivalent to a/ 20/120 feet Snellen b/ 1.0 in Log MAR c/ 6 degrees Visual angle d/ b & c above e/ non of the above. 2/60 Snellen acuity is equivalent to a/ 6/180 meter Snellen b/ 20/600 feet Snellen c/ 0.03 decimal acuity d/ 30 degrees visual angle e/ all of the above. For Listening