2026 PRACTICE QUESTIONS AND ANSWERS
DETAILED REVIEW
◉ Visual Acuity:
- able to BRIEFLY visually track mother's face or brightly colored object
within an hour after birth (fixation reflex not developed for several
weeks, so fixation is brief) Answer: Newborn
◉ Visual Acuity:
Don't talk to baby when assessing vision - he may look toward sound
rather than visual stimulus.
Look for __________ Answer: fix and follow of object.
◉ - With any eye condition (infection, injury, etc.), check visual acuity
to best extent possible based on age
- foreign body or chemical injury is exception - IRRIGATE eye
profusely first and worry about acuity later
-When there is decreased acuity -->____________ Answer: refer
immediately
,◉ Vision is only about ________ in the newborn Answer: 20/200 to
20/400
◉ Typical visual acuity in developmentally appropriate child reaches
level of 20/20 by _____ years of age Answer: 5 years of age
◉ Vision should be checked every ______ Answer: 1-2 yrs
◉ Acuity changes occur quickly with _______________ Answer:
growth spurts
◉ Boys may develop _________ later than girls due to differences in
growth patterns.
Typical onset - elementary school. Answer: myopia(near sighted)
◉ Refer ________: If acuity if less than 20/40 in either eye, or if there is
a difference of 2 lines in acuity between eyes Answer: 3-5 YEAR OLD
◉ Refer _________: If acuity if less than 20/30 in either eye, or if there
is a difference of 2 lines in acuity between eyes Answer: 6 and older
◉ Most common intraocular malignancy of childhood, usually
presenting before age 3 Answer: Retinoblastoma
,◉ Most common presenting sign is Leukocoria (white reflex inpupil).
May present with strabismus, red eye, or glaucoma Answer:
Retinoblastoma
◉ Always check red reflex (Bruckner test) in young children with an
ophthalmoscope Answer: Retinoblastoma
◉ Positive Bruckner test: difference in the quality of the red reflex
between eyes
REFER!! Answer: Retinoblastoma
◉ Assessing for malalignment (strabismus) of eyes:
Perform the _________: Check the corneal light reflex --> It should be
in the same position in each eye.
Perform the _______: watch for movement of the eye after cover
removed Answer: Hirschberg test
Cover Test
, ◉ Brief periods of malalignment are normal in NB.
Unless strabismus is very obvious and persistent, generally wait until
child is ______ and then REFER all cases of strabismus to an
ophthalmologist.
Patching or surgery is used Answer: 4 months old
◉ eye or eyes turn in (cross-eyed if bilateral) Answer: Esotropia
◉ eye or eyes turn outward Answer: Exotropia
◉ eye is depressed (downward) Answer: Hypotropia
◉ eye is elevated Answer: Hypertropia
◉ All kids age ______ must have vision checked at least once Answer: 3
-5
◉ Poor vision in one eye.