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The Eye Exam, Demystified!

· Happy Eyes
Eye Dogtor Julie; @carmel.md

Do you have an upcoming eye exam scheduled for your baby and now want to know what to expect? You have come to the right place! Here, I'll explain who and what is involved and break down the steps of the eye exam.

Who is involved? (Short answer: There is a whole team involved!)

First, let's talk about who you may expect to see at a pediatric eye clinic. The pediatric ophthalmologist (eye doctor with an MD) often has a big team to help take care of your child's needs. Depending on the clinic, you may see some of the doctor's assistants before seeing the doctor. These assistants are also known as orthoptists and ophthalmic (eye) technicians.

  • An orthoptist is a mid-level specialist, similar to a physician's assistant or nurse practitioner for ophthalmologists. Orthoptists have undergone special training to recognize and medically treat eye/brain conditions like amblyopia, strabismus (eye misalignment), and various eye movement disorders. Orthoptists focus on non-surgical treatment. If a patient needs to have surgery for his/her eye misalignment, an orthoptist may then help with measuring the amount of eye misalignment to help the ophthalmologist develop an appropriate surgical plan.
  • An ophthalmic technician is a clinic worker who helps the ophthalmologist perform many aspects of patient care in the clinic. An ophthalmic technician's duties may include conducting imaging tests, sending and retrieving lab work, and helping during eye exams or during surgery. 

Our assistants are very important for helping our clinics run smoothly and safely!

How long does an eye exam take? (Short answer: 2-3 hours for first time visits)

If this is a first time exam, expect that the pediatric ophthalmologist will need to dilate your child's eyes. Dilation means that eyedrops are placed in each eye to widen the pupil and make it easier to see to the back of the eye. It is very important to check the back of the eyes because there are many conditions that may just involve the back of the eye and can greatly affect vision and visual development. Dilation can take anywhere from 40 minutes to 1 hour 30 minutes. Allow 2-3 hours for a first time visit because of the dilation time, maybe longer if more needs to be done!

Do I need to bring anything to be prepared? (Short answer: The clinic will tell you beforehand.)

As with most clinic visits, you will need to bring some form of ID, insurance information, and maybe a questionnaire or information sheet that the clinic has mailed to you to fill out beforehand. It may also be helpful to bring snacks for your child since the visit can last 2-3 hours. In addition, the waiting rooms for pediatric eye clinics have toys and movies to keep your child entertained while he/she is dilating, but it doesn't hurt to bring your own entertainment.

What are the things we check for during the eye exam?

Now, let's break down the steps of the pediatric eye exam. Please note that each eye doctor does things a little bit differently, so the order in which these steps are done and what equipment are used may differ slightly depending on the clinic.

steps of the eye exam: stereopsis ; Eye Dogtor Julie ; @carmel.md
broken image
steps of the eye exam: clinic equipment; Eye Dogtor Julie ; @carmel.md

Examples of the different toys we use in clinic to maintain a child's attention.

steps of the eye exam; sensorimotor exam; eye alignment; strabismus; Eye Dogtor Julie; @carmel.md
steps of the eye exam; vision; Eye Dogtor Julie; @carmel.md
steps of the eye exam; pupil check; Eye Dogtor Julie; @carmel.md
broken image
steps of the eye exam; dilation; Eye Dogtor Julie; @carmel.md
steps of the eye exam; refraction; glasses prescription; Eye Dogtor Julie; @carmel.md
steps of the eye exam; fundus exam; Eye Dogtor Julie; @carmel.md

Depending on what the eye doctor sees during any of the steps above, more exam maneuvers or other testing (pictures, blood tests, etc) may need to be done. After all this information is collected, the doctor can then develop a treatment plan with you.

Let's summarize the steps of the eye exam:

Eye Dogtor Julie ; Eye Exam ; @carmel.md

A Final Note

Depending on the type of eye drop used to dilate your child's eyes, dilation can last anywhere between 2-3 hours to 2-3 weeks! Please ask your eye doctor before you leave the clinic about how long to anticipate dilation to last. While your child's eyes are dilated, your child may be more light sensitive and may be more comfortable staying indoors and staying away from bright lights. Sunglasses can be helpful for the drive home. I also often ask families to avoid vigorous physical activity (e.g. running, sports, playground time) for the several hours after a clinic visit. Most children have decreased depth perception and are at increased risk for falling while their eyes are dilated.