How does a young child have an eye exam ?

• April 30th, 2010
• Comments Off

• Filed under: eye exams

My child cannot name pictures yet, so how can he have an eye exam?

 From our experiences at the eye doctor’s office, we know that we are asked to read letters on an eye chart and then have to answer the dreaded, “Which is better, one or two?”  We never know if we’re answering the eye doctor correctly, but somehow he or she comes up with a prescription for glasses and we can see out of them.

 I often have parents ask me how their young child can have an eye exam.  They are worried that their child won’t name pictures on the eye chart or won’t be able to tell me whether one is better than two.  These are legitimate concerns based on our experience.

 Fortunately, an eye exam can be performed relying on objective measurements-ones that do not rely on a child’s response.  If a child is too young or too shy to name pictures for us, then we make other observations about their visual behavior.  We check the alignment of the child’s eyes to make sure that both eyes are working together appropriately.  We also thoroughly examine the health of the child’s eyes to make sure the eyes are healthy and there is nothing present that would cause the child’s vision not to be perfect.  We use dilation drops to enlarge the child’s pupil so that we can observe the health of the insides of the eyes.  These dilation drops also serve another purpose.  They have a cycloplegic effect, which keeps the child’s eyes from focusing.  This is why the dilation results in extra sensitivity to light (enlarged pupils) and blurry vision (inability to focus).  By performing a refraction using a retinoscope (a special type of flashlight), we can determine the extent of nearsightedness or farsightedness in each child.  This is why we don’t have to ask the child to pick the clearer lens.

 As children get older, we still perform these objective measurements.  By putting the child’s responses together with our objective findings, we have more information that supports our diagnosis and management for that child.  Our objective measurements also help us during those times when Mom or Dad suspects their child just wants glasses but can actually see well.  Overall, your child’s eye exam will seem different from what your experiences are at the eye doctor’s office.  However, the same things are being evaluated in a way that is tailored to children. 

 -Michelle L. Anderson, OD

4/29/10