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Chapter 18
■■■ Key Concepts
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Although hearing is fully developed at birth, visual development continues to
progress until about age 7 years.
The relatively short and horizontally positioned eustachian tubes of infants and young
children make them more susceptible than adults to otitis media.
Binocular vision develops by age 4 months; visual acuity progresses to 2050 by age
3 years and usually reaches 2020 by age 7 years.
To maximize speech and language development, hearing loss should be identified
early and intervention begun immediately.
The corneal light reflex test and cover test are useful tools for identifying strabismus
and amblyopia.
Tympanometry is used to determine the presence of fluid behind the eardrum (such as
with OME).
Topical ophthalmic medications are used to treat certain infectious eye disorders.
Systemic antibiotics are used for the treatment of periorbital cellulitis and AOM.
Very premature infants are at high risk for developing visual deficits related to ROP
and are also at increased risk for hearing impairment compared with other infants.
Children with genetic syndromes or family history are at increased risk for visual and
hearing impairments.
Strabismus, glaucoma, and cataracts may all lead to visual impairment if left
untreated.
Recurrent or constant nasal congestion contributes to OME.
Asymmetry of the corneal light reflex occurs with true strabismus.
A cloudy cornea indicates the presence of cataract.
Eye strain, eye rubbing, and headaches may indicate a visual deficit.
Delay in language acquisition may occur when hearing loss is present.
Appropriate handwashing is the single most important factor in reducing the spread of
acute viral or bacterial conjunctivitis.
Otitis externa can be prevented by keeping the ear canal dry and altering canal pH.
Children with visual disorders should be encouraged to use prescribed corrective
lenses.
The child with hearing loss should receive early intervention with hearing aids or
other augmentative devices.
Hearing andor vision impairment can significantly hinder developmental progress.
The fluctuating hearing loss associated with recurrent AOM and the hearing loss
associated with chronic OME can both significantly hinder language development in
the infant and toddler.
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Amblyopia must be identified early and treated with patching, corrective lenses, or
surgery to prevent visual deterioration and promote appropriate vision development.