How often should children have an eye exam?

Parents frequently wonder how often, or when, their children need eye exams. As discussed in this brief video, there are three scenarios in which you should schedule a formal eye exam for your child:

1. Your child has a symptom or sign of a vision/eye problem, such as blurry vision, an eye that turns in or drifts out, a change in the appearance of the eye, etc.

2. A physician or teacher is concerned about your child's vision. This is often due to difficulty with a routine vision screening examination.

3. There is a family history of childhood eye problems.

If you're concerned about a possible eye problem for your son or daughter, schedule an appointment -- I'd be happy to meet you, discuss your concerns, and do a complete eye examination.

What is amblyopia? And what do I do about it?

Amblyopia is a very common condition I see in my clinic, and I've found that it's often misunderstood. This short video helps explain what it is, what causes it, and how it can be treated.

I'm not sure how my child will do during the eye exam...

Shy? Upset? Scared? It's okay! We make the eye exam fun.

Let's admit it -- the doctor's office can be a scary place when you're a kid. Tall people walking around in white coats, nurses coming at you with needles that they swear "won't hurt a bit," doctors poking you with all sorts of weird equipment.

I understand that. Parents are often nervous about how their child will do during the eye exam, whether because it's a new thing, or because of prior negative experiences, or because of medical conditions their child has, or simply because they know their children.

Honestly, one of my favorite things about my job is winning over a child who is initially hesitant, afraid, upset, or downright angry about things. My staff and I do our very best to make things as fun and angst-free as possible for our patients and their families. We turn eye exams into games, talk softly, try not to use scary words, and patiently work with our little patients to not only get the information that we need, but to also make it a good experience for them.

In short, whether your child is shy, angry, fearful, "difficult" (a term I don't like), or special for any reason at all, I can't wait to meet them and help take care of their eyes.

How do I know if my child needs glasses?

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Adult patients can sit at a phoropter to have their refractive error -- need for glasses -- measured.

If your child doesn’t seem to see well — whether they are holding things very close to see them, or complaining that their vision is blurry, or if something just seems “off” — bring them in for an eye exam!

Determining whether glasses are needed is part of any complete eye exam, and includes measurements of a child’s current visual abilities as well as their “refractive error.”

What is “refractive error,” you ask? Well, it’s the medical term for how “out of focus” the eyes are. Our eyes have a tremendous ability to focus, but it is rarely perfect. Most everyone has some degree of refractive error as a result. For the majority of people, this “out of focus” is minimal and not enough to need glasses. For others, it is enough to make vision blurry, and glasses are needed. Of course, not every eye problem is due to refractive error, so glasses don’t fix every possible type of eye problem.

The cool thing about refractive error is that, like a shoe size, it can be measured, even for kids who aren’t old enough to cooperate very well or even speak!

Unlike adults, who can easily sit behind a device called a phoropter (see photo) and reliably tell you whether "Number 1 is clearer" or "Number 2 is clearer," children have their glasses prescription measured in a different way.

By using a handheld device called a retinoscope, the eye doctor can accurately measure not only whether a child needs glasses, but also what the prescription should be.

The physician turns on the retinoscope, generating a bar of light, and then looks at each eye, moving the bar of light up and down and side to side. This creates a reflex of light within the patient's eye. Handheld lenses -- just like the ones in the dials of the phoropter -- are held up in front of the patient's eye, and the physician looks for the light reflex to stop moving as he or she moves the bar of light. The lenses that allow this light reflex to stop moving are used to determine the patient's prescription. In the hands of an experienced examiner, this method of prescribing glasses is very accurate.

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A standard retinoscope, used to measure glasses prescriptions in children.

Why are dilating drops necessary?

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Cyclopentolate is the standard dilating eyedrop used for children's eye exams.

Great question! Although dilating drops do add some additional time to your visit, and are not any child's favorite part of the exam, they wear off within one day, only sting a little for a minute or so, and are critical to a pediatric eye exam for two reasons:

1. They allow the ophthalmologist to examine critical eye structures like the optic nerve and retina, which are very hard to see otherwise.
2. They allow for an accurate determination of the child's refractive error. Refractive error refers to any trouble with the focusing system of the eye, and examples include myopia ("nearsightedness"), hyperopia ("farsightedness"), and astigmatism.