The Pediatric Eye Examination for Pediatric Neurologists

Abstract

The pediatric eye examination can be challenging but may provide important diagnostic information to the pediatric neurologist. Most of the examination can be accomplished with toys (visual fixation targets), a penlight, and a direct ophthalmoscope. The most important aspect of assessing the afferent system is visual acuity testing. Based on the patient's age, this may be accomplished by testing the child's response to light, a moving visual target, or a formal visual acuity chart. Evaluation of pupillary size and response to light is critical to assessing both the afferent and efferent visual systems. Other components of efferent testing include evaluation of extraocular motility and ocular alignment. General ophthalmologic examination is important to assess for ocular pathology that may accompany neurologic disorders in children. Referral to ophthalmology for further testing should be considered in any child with an abnormality on the pediatric eye examination.