What To Expect On Your Child's First Exam

COMPREHENSIVE EYE EXAM

A comprehensive eye exam includes a thorough examination of the following:

Your child’s vision

How well does your child see at distance (20 feet) and how well do they see up close?   We test your child’s vision at distance and at near to the best of their ability.  If your child does not know letters or numbers, no problem - we have standardized diagrams or pictures they can match that have a “20/20” equivalent.

The front part of the eye

Do the eyes move properly?  Are they straight when looking into the distance; do they cross when looking at targets near their nose?  Do the eyelids look similar or different?  Does one eye look smaller?  Are the eye lashes pointing in the proper direction?  Do the pupils respond appropriately to light?  Are the irises different colors?  Are the eyes red or itchy?  Is the eye pressure normal?  Does color blindness run in the family?  We examine all aspects of the child’s eye including movement, alignment, pupils, cornea, iris, anterior chamber, pressure.  Next, we spray your child’s eyes with a medicine, a few times, to dilate the eyes (make the pupils big).  It’s slightly unpleasant smelling and may sting initially, but this lasts for only a few seconds.

Refraction

This test determines whether your child requires glasses to see properly for their age.    The eyes are dilated for this part of the exam.  In everyone’s eyes, there is a lens.  This lens is flexible and can help us see clearly at different distances.  This lens becomes less and less flexible as we age, which is why many people need reading glasses at the age of 40.  Young children have a very flexible lens, which can sometimes give us inaccurate measurements if glasses are needed.  Dilation temporarily neutralizes the lens so we can get the most accurate measurement for lenses, if glasses are required.

Dilated fundus exam

Dilation will make the pupils big, cause temporary blurred vision at near distances, and temporary sensitivity to bright lights for up to 24 hours.  Now that the pupils are big, we can do a thorough examination in the back of the eye.  Without dilation, we have a very limited view of the back of the eye (fundus).  When dilated, we have a much broader view of the back of the eye.  Every first time patient should have a dilated eye exam.  If someone has a perfectly healthy fundus, with no family history of disease, and a stable glasses prescription, and no new complaints, a dilated exam is not necessary every year.  However, if a child has a disease like sickle cell, diabetes, neurofibromatosis, or high minus lens prescription, or any changes in the back of the eye.

Explanation

Answering questions and stickers!  Once the examination is complete, the doctor will explain all important findings, give recommendations whether they are drops, glasses, patching or anything else.  We will print out any information sheets that you can read at home that will further explain our findings.  Then we will try to answer any questions you or your child may have about the exam or any of our recommendations.  Then your child can get some stickers, disposable sunglasses (since dilation can leave a child sensitive to bright lights).