The art and science of examining a child

Abstract

I have heard it said that when it comes to the pediatric eye examination, a friendly manner, a little trickery, and a lot of praise can accomplish a great deal. These are essential elements in the art of examining a child. Residents, fellows, and geriatric ophthalmologists are usually facile and disciplined in the performance of the adult comprehensive eye examination; however, gathering useful data from an unfriendly toddler can seem as challenging as taming the wild beasts of Africa. After a few failed attempts to persuade a young patient to allow even a glimpse of the eyes, the ophthalmologist may ask how anything gets done in the pediatric ophthalmology office, at least without anesthesia. This chapter offers advice on how to approach the pediatric eye examination. It is not meant to cover every aspect of the eye examination of children. Rather, it deals in concepts, and some details. It is assumed that the examiner already knows how to perform a complete eye exam. The reader is referred to the orthoptic chapter (Chap. 4) for well-written advice on the ocular motility examination. Here, instead, I offer practical advice to allow the examiner, the patient, and the parent to enjoy the encounter with the pediatric ophthalmology team. When dealing with a child, professional competence requires both art and science. © 2009 Springer Berlin Heidelberg.