Child Eye Care Associates, LLC

I am concerned about the dilating drops.  Are they really necessary, and are they safe?

 

The dilating drops your child will receive as part of the eye exam have been used by eye doctors safely for many years.   Although eyedrops are often the least favorite part of an eye exam, dilating the eyes is necessary to fully evaluate most new patients, children with eye muscle problems, "lazy eye" or amblyopia, and to fully examine the retinas and optic nerves.  Dilation is also necessary to determine what glasses might be needed.  Some very young children may become flushed after receiving certain eyedrops, but this wears off after a while.  The drops used in young children often last overnight.  While the pupils are dilated the eyes will feel sensitive to bright sunshine.  Sunglasses can make your child more comfortable outdoors.  Indoor lights are not a problem.  Vision for reading and viewing near objects is out of focus until the drops wear off.  Other side effects are quite rare. 

 

My child had an eye exam yesterday, and the pupils are still dilated.

 

This is not unusual, and it is not worrisome.  The drops that are used to dilate the eyes of young children are actually 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.

 

How does the doctor determine if my young child needs glasses, and measure the prescription?

Dilating the pupils temporarily relaxes the focus of the eyes.  Once this is done, the eye doctor uses a special light 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 movement as it reflects back through the lens of the eye.  By using trial lenses, the light movement can be measured, and an accurate glasses prescription can be made even in a child too young to talk. 

 

Where do we get glasses?

 

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.

You may want to check with your vision insurance, about which optical shops are covered.  Many OHP plans will pay for glasses, but only at selected locations and for a small selection of frames, and you may need to ask your caseworker about which shops are covered. 

For more information about our optical shop, please click here

 

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 little nose.  Consider an all-in-one soft plastic frame style with a band across the back, such as Miraflex, for a very young, active child.

 

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".  This uneven 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 do I keep glasses on my child?

 

First, 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 him until he gets used to them.  With older children, be enthusiastic about wearing glasses, let the child help choose the color of the frames, for instance, and compliment the child on how good she looks in them.  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.  Most children who need glasses soon realize how much the glasses help, and accept them readily once they get used to them.

 

What is strabismus?

 

"Strabismus" is a medical term that means that the eyes are not aligned.  This includes esotropia, which is when one or both eyes deviate inward; exotropia, which is when one eye or the other drifts outward; hypertropia, which is when one eye is pointed upward.  All these are forms of strabismus.  Usually all the eye muscles function normally, but the balance between the two eyes isn't normal, causing the misalignment.  Sometimes one muscle may actually be weak. 

 

What about vision therapy if my child is struggling with reading?

 

Because reading is a brain process, therapy that treats the eyes such as vision therapy does not improve reading.  Children who are struggling to read 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 not a problem with eye movements.  Rather, the difficulty is with processing the visual information on the page.

 

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.