I am concerned about the dilating drops. Are they really necessary, and are they safe?
Eyedrops are necessary to; fully evaluate the retina and optic nerves and accurately determine if glasses are needed.
Eye drops are an extremely safe medication, they will very occasionally cause some cheek flushing.
Dilation can last up to 24 hours but usually much less time and will not cause any harm. Sunglasses will improve comfort. Your child may mention blurriness at near, this will also resolve with time.
What is astigmatism?
This is the word that describes a cornea (the front surface of the eye) that isn't evenly curved. An eye with astigmatism is often described as "football-shaped" rather than perfectly round. This type of curvature focuses light unevenly inside the eye, and makes the vision blurry. Glasses that correct for astigmatism often take a few days to adjust to, because at first vision feels distorted looking through them. Children usually adjust well to new glasses by wearing them full-time.
How does the doctor determine if my young child needs glasses, and measure the prescription?
Drops relax the ability of the eyes to focus. The doctor uses an instrument called a retinoscope to measure whether the eye is farsighted, nearsighted, or has astigmatism. The child only has to look at the light, and the ophthalmologist observes the pattern of the light reflection. Using this method an accurate glasses prescription can be made even in a child too young to talk.
How do I keep glasses on my child?
Make sure the frames fit well, so that they are not uncomfortable for your child. With a very young child, put a toy in each hand before putting the glasses on, and plan to spend the first few days distracting them until they get used to the glasses. With older children, be enthusiastic about wearing glasses, let the child help choose the color of the frames and compliment the child on how good they look. Be consistent and firm about having your child put on the glasses first thing in the morning, and put them back on if they are taken off. There are various picture books available with stories about getting glasses that you can read with your child. Our very own Dr. Fang has created a comprehensive list of appropriate books, which you can access here,.
My child had an eye exam yesterday, and the pupils are still dilated.
This is not unusual, and it is not worrisome. The drops used to dilate the eyes of young children are stronger than those used in adults. This is because children have better focusing ability than adults, and it requires these stronger drops to fully relax their focus and measure their refraction. Your child can still attend school, although you may want to inform the teacher about the recent eye exam.
What is strabismus?
"Strabismus" is a medical term that means that the eyes are not aligned. This includes esotropia, when one or both eyes cross, exotropia when one eye or the other drifts outward and hypertropia when one eye is pointed upward. Usually all the eye muscles function normally, but the balance between the two eyes isn't normal, causing the misalignment. Sometimes a muscle may be too weak or too strong, the doctor will discuss this further if it is present.
How do we choose glasses frames for our child?
We recommend a rounder shape to the lens, rather than one that is flat across the top. This encourages the child to look through the lenses rather than over them, even if the frame sits low on their nose. Consider an all-in-one soft plastic frame style with a band across the back for a very young, active child. There are multiple options available at Child Eye Wear and our optician will gladly assist you.
Where do we get glasses?
If appropriate, the pediatric opthalmologist or optometrist will provide a glasses prescription. We have a diverse selection of frames on offer at our own optical shop, 'Child Eye Wear', but you may fill your glasses prescription at any optical shop that accepts your insurance. Our optician is specifically trained to fit patients of any age with glasses.
For more information about our optical shop, please click here
What about vision therapy if my child is struggling with reading?
Because reading is a brain process, eye therapy such as vision therapy may not improve reading unless there is also a problem with eye alignment or using both eyes together.. Children who are struggling to read usually do not have problems with "eye tracking". To read, the brain has to make sense of the pattern of letters and interpret them to form the sound and understanding of the words on the page. When a child has trouble with decoding each word, it is hard to move on to the next word. This is rarely a problem with eye movements. Rather, the difficulty is with processing the visual information on the page, which requires individualized treatment after evaluation by a reading specialist.
It is reasonable to have an eye exam to be sure your child can see the reading material clearly. After such an exam, though, the best treatment for reading problems is educational.