Instilling drops

What do you do when you examine a pre-school child? Do you feel comfortable instilling cycloplegic drops? If so, what technique do you use on a wriggling child?

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Published: Winter 2016

I was recently asked what to do if a child’s fixation was so poor that the optometrist could not get an adequate view of the fundus. The College’s Guidance for professional practice helps you in this, as paragraph A60g says that you should attempt to determine normal ocular development. At the very least, you should obtain a clear view of the ocular media (easy), macula (fairly easy) and disc (not so easy!). If you cannot get a sufficient view of the fundus then instilling cycloplegic drops will help, but then you have the other hurdle of how to get them in! Normally fairly straightforward for the first eye, but then the child wises up and won’t let you near the second one.... A technique I sometimes find is helpful is...

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