Lindsay Gill: Prepping for toddler's first trip to the eye doctor

Sunday, October 5, 2014

Prepping for toddler's first trip to the eye doctor

As you may know, I work with Pediatric Ophthalmologists as an Orthoptist.  I'm also a mommy.  And tomorrow, those two worlds will collide.  I'm taking Luke in for his first eye exam!  As I race around, prepping for his visit, I start to think about the now thousands of "first eye exams" that I have been part of, and the frequently asked questions and/or comments.

1.  My toddler doesn't know his letters, how will you possibly check his vision?  
If the child is able, we can do matching with letters or matching with symbols.  Otherwise, there are still ways to determine whether or not the child has a preference of either eye, or whether or not the child can track and hold fixation with each eye.  We do eye exams on many non-verbal children and have a variety of ways to check vision other than reading a line of letters.  The doctor will also get an objective measure of the child's eyes through their cycloplegic refraction.  You could ask for a copy of the matching card and practice these at home if you think you will be a frequent patient.

2.  I don't think he understands that game. 
You might be right!  But I've been able to check depth perception on a 20 month old and it would be a poor exam if I didn't at least try with all children.  Sometimes I'm assessing other parts of the child while keeping them busy, so it's okay if they don't understand what I'm doing.  It really helps when the parents help encourage, or avoid distracting the child.  That's when we can get the best exam.

3.  Why do you use dilation drops?  I know what that's like and they really sting and then hurt and they make your eyes feel funny for hours and I really just don't want you to do that to her.
I understand.  And we won't force you.  But, not only does dilation allow the doctor to get a better view inside the eye to see the optic nerve and retina, but they also "paralyze" the lens so that the doctor can determine whether or not there is a need for glasses, or even predict how frequently your child should be followed.  The drops do make the child blurry and light sensitive, and can sting going in.  It works best if you do not use those words and consider the drops as part of a comprehensive and accurate exam.  If drops are a huge issue, which they can be, ask your doctor if it is possible to get a prescription of the drops and administer them at home before coming in for a future exam.

4.  If my child does need glasses, do they even make glasses for children this small?
Yes, children may need to wear glasses full time even in infancy.  There are special flexible glasses.  Some children have trouble with wear as you would expect, but some children wear them with great compliance and little trouble!

5.  What's the best way to prepare for this exam?
One of my co-workers gave her daughter artificial tears a few days leading up to the exam so that her daughter wouldn't be scared of the drops.  I thought that was clever and it worked for them!  I know that the same method wouldn't work for my son.  It depends on the child.  In general, its best to stay calm and minimize the drops, as you would a shot at the Pediatrician.  One patient is only allowed to play a certain app when they're at a doctor's exam.  One mom brings M&Ms and dispenses them for encouragement.  Bring sunglasses if you have them as the child will be light sensitive.  Pick a good appointment time if possible, not near nap time and when you won't be in a huge rush.

There is also a list of terms that may be used that I compiled here.

Here's what I have prepared for Luke tomorrow:
  • The normal diaper bag things like diapers and wipes, there can be long waits!
  • wipes, keep those hands clean
  • lollipops, something special
  • a pumpkin flashlight
  • a juicebox and water
  • fruit snacks and crackers
  • a squeezable applesauce
  • the stroller to stroll if we can't keep still while waiting
  • our babiators! these are awesome kid sunglasses
  • list of questions/family history so you don't forget when there is a toddler running around
With all of this being said, I'm still nervous for his appointment tomorrow, just like any other parent.  I'm hoping that the snacks and toys I've packed will keep him happy, calm, and busy, but you truly never know how they will react!  

Do you have any other ideas to prep for this eye exam, or any other toddler doctor visit?

Read about Luke's adenoidectomy and ear tubes here!  

Luke's Babiators!

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