Friday, March 30, 2018

Vision Health/ eye doctor resources

Topic of the Week:
Vision Health/ Eye Doctor resources

Early intervention for eye abnormalities is very important.
Parents are often the first to note if there is something going on that doesn’t seem quite right.
Are the eyes watery or gooey? This could be a blocked tear duct.
That usually resolves in a few months, without any intervention.

There are always individual variations with developmental milestones, but many babies' eyes don’t track too well until they are about 3 months. Once they are old enough, parents should pay attention and see if the baby can follow an object with both eyes. If one eye wanders, that is something we want to get checked out.
Check the pupil size. Are both about the same size? There are some kids with normal variations, but it is worth noting this ahead of time. I have had parents frantic after a mild head injury when the pupils were noted to be a bit unequal. It turned out that this was just the baseline. Noting it in advance would have saved some stress!

If you take a photo with flash and there is “red eye,” look to see if the reflection seems to be hitting both eyes in the same general area.


In our office we actually start doing eye screenings for our patients as early as 6 months. We can screen for a variety of abnormalities with our iscreen machine.

Several years ago when I did this post for the first time, Dr. Good, a popular pediatric ophthalmologist, said he has been fairly impressed so far with issues that have been discovered early. While most of the conditions don’t actually require any intervention, having the patients identified so young is very valuable, because we can now know to monitor them closely

Once the kids are four or five years of age and old enough to cooperate, we do the Snellen eye test. This screening for nearsightedness is usually done in conjunction with the routine annual well child check up. The operative word here is screening. Farsightedness or astigmatism are usually not picked up without a full eye doctor exam.

The gold standard recommendation is a complete eye exam by an eye doctor at 3 and 5 years. At that point, the decision for how often routine exams are needed may depend on your child. Obviously if your child seems to be squinting it is worth getting them in sooner.
There is a genetic component to eye issues, but kids should be checked even if the parents have perfect vision.

What is difference/ need between ophthalmologist or optometrist for basic child eye health?

Ophthalmologists are specialists that deal with the full range of eye care, but they are also surgeons who can deal with any eye abnormality or condition. Optometrists might be your best bet for any simple vision issues. Finding someone who regularly works with kids is pretty important.

If there is a medical diagnosis some insurance companies will cover the cost of an eye exam.

It is worth checking in advance with the eye doctor's office as well as your insurance or vision plan to see if there is an advantage to seeing one or the other.

I don’t think people necessarily need to add vision and dental plans for the kids during the first year, but after that, especially if they come bundled, it is probably worthwhile.


If your child does need glasses, make sure they get their vision checked yearly (or more frequently as needed) to make sure the prescription is correct. If the myopia is getting progressively worse, believe it or not multi-focal contact lenses may help slow things down. They can be started with some cooperative children as young as 5!

You might not make an obvious connection, but headaches, dizziness, motion sickness, and ADD can all be associated with eye problems. Even anxiety can be related!

There are likely plenty of good eye doctors in the Bay Area,
The folks on my list are ones that I am familiar with. If you are aware of someone excellent who should be on this list, please let me know.

Optometrists



  • Dr. David Grisham and Dr. Jeremy Shumaker at Vision Academy and Rising Star Optometry are top notch and do see pediatric patients. http://risingstaroptometry.com/



Ophthalmologists



  • Both UCSF and DR Good have a fairly long wait time for an appointment so planning ahead is a good idea. Both offices will require a referral from your primary pediatrician before they will make an appointment. Be aware that when we send the referral it might take a week or so before they make contact with you to schedule an appointment

  • Kim Cooper http://mypedeyedr.com/ Check out her website. It is more fun than most! Dr Cooper is down on the Peninsula but many folks feel that it is worth the drive to see her. She shares that her most important eye tip is the need for quality safety goggles. If your child is playing any sport where there is danger of getting hit in the eye by a ball or body part, they should be wearing eye protection. Not a week goes by that she isn't dealing with a sports related eye injury. Most are minor, but the serious ones are devastating.Her office happens to be great resource for getting quality goggles.



Free E-Book Helps Kids Get Ready For An Eye Exam

Howard the Hedgehog visits the eye doctor for the first time. Initially he's doubtful, but he ends up having a great time and seeing much better thanks to his new glasses! During show-and-tell, he shares with his classmates what he learned about vision tests.
That's the plot of an e-book you can download for free and share with your children. Not only is Howard and the Amazing Eye Examfun to read, it's very educational and reassuring for kids who may be worried about visiting the eye doctor.
The e-book has cute illustrations and was created by Alcon's The Eye Solution team and Dr. Catherine McDaniel, an optometrist who teaches and practices at The Ohio State University. You can download the e-book for tablets and computers on Amazon  andGoogle Play .

There are some common sense things you can do promote good eye health.

  • Get outside! Get in the habit of wearing sunglasses when outside during the day. Ideally they should be made out of a strong poly-carbonate plastic that is shatterproof. Floppy hats or visors are also a good idea.

  • Recent studies show a 30-40% decrease in myopia (nearsightedness) with daily time outdoors.

  • Try to minimize the “blue lights” that we are surrounded with by screens in our world.

  • The American Academy of Pediatrics recommends no more than 2 hours of recreational screen time/day.

  • Eat well!

  • Carrots and foods with Vitamin A are good, but the dark green leafy vegetables are the real super helpers of the eye because they have lutein and zeaxanthin (go ahead and impress people at your next cocktail party with that one)

  • These two eye nutrients help replenish the pigment in the retina and can prevent diseases of the eye. Peppers turnips and paprika are also a good part of an eye healthy diet.

  • Avoid smoking or exposure to secondhand smoke.



Fun Facts:

  • You may not be able to know your child's ultimate eye color until they are a year!

  • Your baby might be crying, but they usually don’t develop actual tears until they are between 4-13 weeks

  • The eyes are the fastest muscle in the body and blink an average of 17 times/minute

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