- The American Association for Pediatric Ophthalmology and Strabismus
- American Academy of Ophthalmology
- Learning Disabilities, Dyslexia, and Vision - Where you may research the pediatric medical community's official view of "Vision Therapy"
- Prevent Blindness - A nonprofit organization dedicated to the preservation of sight in children
- The Eye Patch Club - A resource of Prevent Blindness to aid parents and children undergoing occlusion (patch) therapy for amblyopia
For a first appointment:
- The completed Patient Forms
- Any medical records you have from a previous eye doctor
- Any records regarding the patient's general health you'd like us to know about
- Any glasses the patient has been prescribed to wear
- Any eye medications the patient is using
For every appointment:
If your child has been prescribed a pair of glasses, please bring them to every appointment, even if they are broken, scratched or old. If the flasses are broken and you don't know whether to fix them before or after the exam, call us! We're happy to help!
Obviously, infants can’t just look through the big glasses and answer which lens is clear, but there is a reliable way to determine if a child needs glasses.
First we’ll dilate the pupil and relax the eye, then use a special lighted instrument to look deep into the eye. We watch how well the eye focuses the light beam to determine if the child is nearsighted or farsighted, and how badly he or she needs glasses. We then use a series of lenses to help the eye focus the beam correctly. Once we see a properly focused light beam through the lenses, we can generate a precise prescription for glasses.
Make sure the nose and earpieces aren’t too tight. The optical shop where you bought the glasses should be happy to adjust them for you, or provide a glasses strap or curved earpieces if your child’s glasses are falling off.
If fit isn’t the problem, your child may be rejecting the glasses because his or her eyes need to adjust. If your child has struggled with poor vision for a long time, the eyes are used to straining to see. After about three days of wearing the glasses, the eyes will relax enough for the glasses to work. Until then, your child’s vision will be especially blurry while wearing new glasses. If your child is having a particularly hard time, we can prescribe or administer an eye drop to relax the strain.
In the rarest and most drastic cases, you might consider using medically designed arm restraints as a time-out tool. The process is stressful and requires extra care, but it can be helpful, especially with children of diminished mental capacity.
Many parents report that if they remain firm, after three or four days their child will begin to love wearing glasses. Even the most resistant children change their minds and will not want to take the glasses off. So be encouraged; your hard work will pay off.
This may be because your child is new to wearing glasses or hasn’t worn his or her glasses consistently. Poor vision causes your child’s eyes to strain, and the eye muscles get locked into one position. Until your child’s eyes relax, his or her vision will not be as clear through the glasses. It will take about three days of constant wear for your child’s eyes to relax and become accustomed to the glasses.
Or, your child may have outgrown the prescription. Check with our office before allowing your child to go without glasses. What seems like an obvious decision could result in long-term damage to your child’s vision, so stay on the safe side and call us first.
As strange as it may sound, improved vision is not the only benefit of wearing glasses. Your child may be wearing glasses to keep his or her eyes straight.
There are many different causes of crossed eyes. Some children’s eyes cross because they are farsighted.
Normal eyes can focus on objects at any distance. When the eye views something far away, it is in a relaxed state. As objects move closer, the eye flexes a muscle that makes the lens become thicker and more powerful, to focus on the nearby object. As an object moves closer, the eyes also need to turn inward to stay aligned on that object. The brain determines how far inward the eyes need to turn by sensing how hard the lens muscle flexes.
A farsighted person will often over-flex the lens muscle in order to see nearby objects clearly, but this causes the brain to believe the eyes are looking at an object that is closer than it actually is, and the brain then turns in the eyes further than normal. The eyes cross.
This explains why the eyes might not cross all the time, but only when the eyes are focusing too much in order to overcome their farsightedness. A farsighted glasses prescription will ease the strain, allowing the eyes to focus properly and maintain their alignment.
Your child will probably need to wear the glasses constantly for a few days before he or she sees clearly through them.
Some parents worry that relying on glasses may lead to stronger glasses prescriptions in the future. In reality, many farsighted children have their prescriptions reduced over time, and some even outgrow their need for glasses. Nearsighted children have trouble seeing things that are far away but usually see well for reading and near tasks. Nearsightedness occurs because of differences in the length of the eye, the curvature of the cornea and the shape of the lens inside our eyes.
Eye changes occur throughout the childhood and teenage years, causing a child to become more nearsighted over time whether or not they wear glasses. Some patients observe that, “Once I got glasses, I kept having to get stronger and stronger ones.” The fact is that natural growth and changes of the eye occur independently of wearing glasses. These naturally occurring growth and changes of the eye cause the nearsightedness prescription to get higher as time passes. Wearing glasses or not has essentially no effect on the prescription of the eye.
Speak to your physician or orthoptist for an idea of what your child should expect.
Our office can provide you with a booklet of hospital pre-op preparations. Please make sure you understand it; not following the instructions outlined in the booklet can cancel or delay surgery entirely. Contact our office if you need a copy of the booklet or have questions.
Approved Clear Liquids
- Apple juice
- Cranberry juice
- Grape juice
- Gatorade sports drink
Popsicles: Any flavor of color, but no cream, chocolate, or fruit pieces
Jello: Any flavor, but no fruit pieces
Broth: Chicken or beef broth (must be clear and contain no meat or pasta)
- Gently pull the upper eyelid up and pull the lower eyelid down while your child is lying down.
- Ask your child to keep both eyes open and to look at something on the ceiling.
- Do not push on the eyeball itself. Give drops before ointment.
- Drop one drop directly on the eye or just inside the lower eyelid, near the corner closest to the nose, and release the eyelids.
- Wait a few minutes then repeat the procedure for the other medications.
- Apply a ribbon of ointment approximately ¼ inch long directly from the tube or place on your clean finger or a wet Q-Tip and apply.
- Showers and baths are okay, but do not submerge the eye in water (no swimming) or splash water directly in the eye for at least one week.
- Try to discourage rubbing on or around the eyelids.
- Your child may return to school or day care as soon as he or she is eating well. We recommend that your child remain at home with you for one or two days following surgery.
- Your child may temporarily be more clumsy than usual in the week after surgery and may bump into things easily.
- There are no restrictions on how your child uses his or her eyes: reading, television, or video games are all okay.
Specifically for intraocular patients:
- Limit activity to lighter activities and non-contact sports. NO gym class or roughhousing for at least two weeks.
- Wear protective eye shield or glasses AT ALL TIMES during the day and an eye shield at night to protect the eye from any rubbing or accident.
An orthoptist is a board-certified specialist of ophthalmology. Pediatric and neuro-ophthalmologists (ophthalmologists who treat eye disorders related to the brain) rely on orthoptists to manage non-surgical eye conditions, confer on surgical approaches and perform the measurements for correcting misaligned eyes.
While not physicians, certified orthoptists are trained at two-year medical fellowship programs alongside general ophthalmology residents and fellows who are specializing in pediatric ophthalmology. They are extensively trained in neurology, ophthalmology, pharmacology, physiology, optical physics and the principles of treatment and surgery for ocular disorders. Your child may greatly benefit from the care of an orthoptist.