Performing a fundoscopic exam on an inattentive preschooler is always a challenge, especially with the added anxiety caused by darkening the exam room to induce mydriasis.  

To help the child focus, I have mounted adhesive fluorescent stars and butterflies (available at many large toy stores) on several walls of the exam room and the ceiling above the exam table. When the lights go out, the stars and butterflies glow in the dark. After the initial exclamations of joy, it is easy to get the child to focus on his (or her) favorite glowing object while I gaze into his eyes to "see if I can see the star (or butterfly), too." 

Clinical Tip: Fundoscope exams that get glowing reports