Pediatric Eye Examination Kit

Essential Equipment

Visual Acuity Testing Tools:
- LEA symbols chart (ages 3-5)
- HOTV chart (preschool)
- Snellen chart (school-age)
- Picture cards for pre-verbal children
- Near vision testing cards
Ophthalmoscopes:
- Direct ophthalmoscope
  Features needed:
  - Multiple aperture settings
  - Various filter options
  - Diopter adjustment wheel
- Portable slit lamp (if available)
Additional Instruments:
- Pen torch
- Fixation targets
- Occluders
- Magnifying loupe

Examination Components

1. External Eye Examination

Inspection:
- Orbital symmetry
- Eyelid position and movement
- Conjunctival appearance
- Corneal clarity
- Tear film assessment
Key Observations:
- Ptosis
- Lid lag
- Discharge
- Conjunctival injection

2. Vision Assessment

Age-Specific Testing:
- Newborns:
  - Red reflex testing
  - Blink response
  - Light tracking
- Infants (0-12 months):
  - Preferential looking tests
  - Fix and follow response
  - Object tracking
- Toddlers (1-3 years):
  - Picture identification
  - Matching games
  - Basic shape recognition
- Preschool (3-5 years):
  - LEA symbols
  - HOTV testing
  - Picture charts

3. Ocular Motility

Assessment Methods:
- Cover/uncover test
- Alternate cover test
- Hirschberg test
- Nine gaze positions
Strabismus Evaluation:
- Primary position deviation
- Secondary position deviation
- Convergence testing

4. Pupillary Examination

Assessment Parameters:
- Size and shape
- Direct light reflex
- Consensual response
- Near response
- RAPD testing (when appropriate)

5. Fundoscopy

Key Structures:
- Optic disc assessment
  - Color
  - Cup-to-disc ratio
  - Margins
- Retinal vessels
  - Course
  - Caliber
  - AV ratio
- Macula evaluation
- Peripheral retina

Special Considerations

Age-specific Approach:
- Making examination playful for younger children
- Using appropriate rewards
- Parent involvement strategies
Red Flags:
- Leukocoria
- Strabismus
- Nystagmus
- Persistent tearing
- Photophobia

Documentation Requirements

Essential Records:
- Visual acuity measurements
- Ocular alignment status
- Pupillary responses
- Fundoscopic findings
- Red reflex status

Further Reading