Optometry meets ophthalmology- cycloplegic refraction and examination under general anaesthesia in a paediatric high myope

Abstract

Purpose: To discuss a case of shared optometric-ophthalmic (O-O) approach in objectively refracting and examining a paediatric high myope under general anaesthesia. Methods: A paediatric high myope was cyclopleged then underwent objective retinoscopy under general anaesthesia within a surgical theatre setting. Corneal diameter, interpupillary distance, immersion biometry axial lengths, intraocular pressures, keratometry readings, A-scan and B-scan ultrasound images were all subsequently obtained. Lastly, binocular indirect ophthalmoscopic examination with 360º scleral indentation was carried out. A comprehensive O-O report was dispensed with all collated parameters. Results: A refractive error of -11.00DS bilaterally was measured. Ocular health assessment showed no significant myopic abnormalities. The patient was dispensed spectacles and adapted well with improved comfort. Low dose atropine myopia control was commenced. Conclusion: O-O shared care in refracting and examining difficult and highly myopic paediatric cases under general anaesthesia is a useful and effective tool.