New CPG: Eye examination

The Eye examination CPG is a new CPG developed by the CPG Committee and endorsed by the Paediatric Improvement Collaborative (December 2022). The CPG provides a step-by-step approach to examination of the eye for children with practical tips and important considerations.

CPG key points

  1. Assessing visual acuity can be difficult but should be performed early (before examination when the child may become distressed)
  2. Visual acuity is assessed for each eye based on the child’s age and ability to interact
  3. Adequate analgesia will aid examination and procedural sedation may be required in the younger child
  4. Fluorescein shows corneal abnormalities when viewed under cobalt blue light. Stain with fluorescein if corneal abrasion, ulcer or foreign body is suspected
  5. Serious periocular trauma should be treated as a suspected ruptured or penetrated globe and managed by minimising distress, placing an eye shield and urgently referring to ophthalmology, see Penetrating eye injury.
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