An Evidence-Based Approach to Nontraumatic Ocular Complaints in Children

Points and Pearls Excerpt

• Helpful techniques to evaluate neonatal vision include dimming the lights, rocking, gently lowering the head below the body, or having the parent hold the patient upright over their shoulder.
• Topical anesthesia is a valuable adjunct to the ophthalmologic examination and can serve as a diagnostic tool to differentiate surface pathologies from deeper processes.
• Beyond fundoscopy, ophthalmoscopes are helpful in assessing posterior chamber and posterior segment pathology through evaluation of the red reflex. An abnormal red reflex can alert the clinician to vision-threatening disease such as neoplasm, cataract, or hemorrhage
• If available, use ocular point-of-care ultrasound to detect abnormalities in the lens, vitreous, retina, and optic nerve. It is contraindicated when globe rupture or high intraocular pressure is suspected, as pressure on the eye can prompt further injury.