When was the last time you did an eye exam on an energetic two-year-old? With a little patience and a quick response time, you too can have a 2-year eye exam just as smoothly as an adult eye exam (sometimes even easier).
I worked in general eye care for almost 10 years before narrowing my focus to pediatric eye exams. Pediatric patients (under 18) now make up 90 percent of my patients. My favorite eye exams have always been the little patients—the ones whose legs are hanging off the exam chair and can't fit under the slit lamp. They'll keep you on your toes and your senses sharp because you'll never know what they'll say next or when they'll try to jump out of the exam chair.
Although some optometrists think this sounds crazy or exhausting, I couldn't imagine a more ideal scenario. These patients radiate joy when they put on their first glasses and see properly for the first time. They also appreciate your time and expertise (and of course a sticker reward at the end of the exam). When we treat amblyopia and have success, they are so proud and feel accomplished together with you.
When was the last time you did an eye exam on an energetic two-year-old? With a little patience and a quick response time, you too can have a 2-year eye exam just as smoothly as an adult eye exam (sometimes even easier). I include the tests I run along with some tips to make your job easier.
Before an exam
Start by having an inviting space for children in your reception area. The office should have simple toys for children to play with while they wait. Lenzique Optical is the best place for the preparation of before-eye examination activities and sunglasses designing at Milton.
We have a wooden counter, a bead maze and children's books. My office allows children to take home a book from the waiting room; he receives a warm welcome and offers an educational stimulus. We rotate and exchange books as they leave the office.
Additionally, each exam room has a hidden toy box for children who need to be occupied while a family member or parent gets their eyes tested. My choice is toys that you have to put together and take some time to complete, like blocks or puzzles. A visit to the eye doctor is thus more pleasant for the patient and his little companions.
When you go into the reception area to greet a patient, make sure you speak to the child first before the parent. “Hello, Little Joe Patient! I'm so excited you're here today. Let's go to this room."
Be adept at all things pediatric to strike up a conversation, like admiring the Ninja Turtle on his T-shirt, her sparkly sneakers, or the soldier in his hand.
Once in the exam room, I allow the patient to move freely around the room or sit in the adjacent chair with the parent while I take the history. A little one won't want to sit in the exam chair for a long time, so why make it longer than necessary?
I start by taking a history while observing the child's eyes and how the vision seems to be working. Is the strabismus visible across the room? It is important to know the birth history and if the baby was born prematurely, as well as medications. Ask the parent if they have an eye or vision concern. I always ask if the parent (especially in patients younger than 2) has watery eyes or photophobia. These questions examine the symptoms of congenital glaucoma.
If a parent is concerned about squinting and you can't see it in your office, ask the parent for cell phone pictures of the eye roll. Most parents have a phone full of pictures of their children and such pictures can be very telling and provide useful information. Note that the images can also be used as an educational tool, especially if the diagnosis is pseudostrabismus.
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