Comm Eye Health Vol. 20 No. 62 2007 pp 34. Published online 01 June 2007.

Managing a young child for an eye examination

Sue Stevens

Ophthalmic Resource Co-ordinator/Nurse Advisor, International Centre for Eye Health, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK. Email: sue.stevens@lshtm.ac.uk

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Indications

A young child, or a child who is unable to co-operate, needs to be managed carefully when he or she is being examined by an ophthalmologist or other eye health practitioner. The following steps aim to guide the health worker who has to manage such a child whilst assisting the examiner.

You will need

  • A sheet or blanket
  • A torch or flashlight

Preparation

Gain the child’s confidence by taking time to be friendly and playful.

While the child is relaxed, the examiner will have an opportunity to look at the way he or she uses his or her eyes and to note whether one is held shut with pain or whether there is any watering or squinting. (It may be helpful to observe babies’ eyes while they are breastfeeding or being held by their parent or carer.)

Explain to the parent or carer, and to the child if he or she is old enough to understand, what you and the examiner are going to do. Talk reassuringly to the child and continue to do so throughout the examination.

Method

  • Lay the child in the middle of the sheet or blanket with feet facing you
  • Restrain the child’s right arm close to the body by wrapping the leftside of the sheet or blanket around both the arm and the body (Figure 1)
  • Restrain the left arm by wrapping the right side of the sheet or blanket around the whole body of the child (Figure 2)
  • In a sitting position, hold the wrapped child firmly, with the feet on your lap, and support the head
  • The examiner, having washed his or her hands, then sits directly opposite you and takes over steadying the child’s head in his or her own lap. If necessary, a second helper may hold the torch (Figure 3)
  • The examiner can now start to examine the child’s eyes.
Figures 1-3: Managing a young child for an eye examination. © Sue Stevens
Figures 1-3: Managing a young child for an eye examination. © Sue Stevens