Your Child’s Next Ophthalmology Visit: What to Expect, How to Prepare

Dr. Madhuri Chilakapati, Pediatric Ophthalmologist at Texas Children’s Hospital, offers practical tips on preparing for your child’s ophthalmology appointment.

Ophthalmology exams are very important for your child’s overall eye health. Vision problems can impact a child’s development, so it is crucial to diagnose and address any potential problems as early as possible. Although it’s perfectly natural for children to feel anxious about visiting the eye doctor, there are many things a parent can do to make these appointments go smoothly. 

Below, Dr. Madhuri Chilakapati, a board-certified Pediatric Ophthalmologist at Texas Children’s Hospital, shares tips on pediatric eye exams and how to help your child have the best possible experience.

Before the exam

• Explain the process: Depending on your child’s age, it may be helpful to encourage your child to ask questions about the eye exam. Doing so can reduce fears and clear up misconceptions, as well as provide you with ample opportunities to reassure your child that there is nothing to worry about. Reading books or watching educational videos can be a great way to help your child prepare.
• Practice at home: Role-playing at home — for example, pretending to be the eye doctor and showing your child what might happen during the examination — is a great way to familiarize your child with the overall procedure. Consider using eye patches to cover one eye and a flashlight to mimic the lights they will see while the doctor is checking their eyes — or even wearing a patch with your child. Practicing in a fun, relaxed way at home will help your child feel comfortable during the exam in the doctor’s office.  
• Bring comfort items: Encourage your child to choose a favorite toy, stuffed animal or blanket to bring with them on the day of the exam. Familiar objects can provide a sense of normalcy and security and can help your child relax during the exam — stuffed animals can wear eye patches too! However, it’s important to make sure the comfort items aren’t so big (or distracting) that they will interfere with the exam.
• Bring another family member: It often helps to have another family member present to assist during the exam, especially if your child is at an age where it’s difficult to sit still.
• Bring books or small games that will engage your child’s attention: It can help to read to your child as a distraction technique if they grow impatient during the exam. 

During the exam

• Wait on devices until we do the exam. They are a great tool for distraction, and kids will often get upset if they have to give them up. Having their favorite video ready to show can often be a great distraction.
• Relax, it will help your child’s anxiety. If you, as a parent, feel relaxed during the exam and demonstrate that the exam is a fun experience, it will help your child to feel relaxed as well.
• Be firm and positive — depending on your child’s age, negotiation and bargaining often increase anxiety and ultimately do not help.
• Treats, such as gummies or M&M’s, can encourage participation in an exam (a gummy for each line on the eye chart, for example).
• Be prepared to remain at the clinic for approximately 1.5 hours for a dilated exam.
• Infants and bottles: Feeding is a great way to help a baby stay calm during the exam so it useful to wait until the exam to feed infants when possible.
• Be flexible. Some children will insist on sitting in a parent’s lap during the exam, and it may be necessary to assist the doctor in holding your child still while tests are being performed.

Dilation

• Why:

1. Dilation enables your doctor to view more of the inside and back of the eye, thus facilitating a comprehensive and accurate eye evaluation and alerting your doctor to systemic conditions.
2. By relaxing the eye's muscles, dilation allows your doctor to detect vision disorders and measure refractive errors more precisely.
3. Dilation ensures a more accurate process, especially for young and nonverbal children, since they will not be able to provide feedback about their own vision.

• How: Dilation can be quick. Your child will tilt their head back, and we will place drops into each eye.
• How long: Dilation takes about 25-30 minutes to take full effect, and you will typically wait with your child in the examination room or sometimes in the waiting area during that time. On average, your child will have enlarged pupils for several hours after dilation.
• What are the side effects? When the drops are initially applied, a mild stinging may be felt, but this passes quickly. Your child’s vision will be blurry until their pupils return to normal size and they will experience light sensitivity. Sunglasses will help. Although very rare, mild allergic reactions may occur, which may be experienced as red eyes or slight eyelid swelling. 

Types of testing

• Retinoscopy: Retinoscopy involves shining a light into the eyes and measuring the movement of the reflected light in the pupils. This allows your doctor to accurately determine the necessary lens correction (nearsightedness, farsightedness, astigmatism) without requiring your child to verbally communicate their vision needs.
• Visual field test: This measures how much your child can see out of the corners of the eyes, effectively testing the amount of their peripheral vision.
• Optical coherence tomography (OCT): This is a noninvasive imaging technique used to create accurate, highly precise 3D images of the eye's internal structures, particularly the retina and the optic nerve.
• Fundus photography: A simple, noninvasive medical test that allows your doctor to take a picture of the back wall of the eye, known as the fundus.  

If additional testing is needed, the appointment may take longer than expected. It’s a good idea to set aside at least 2 hours for your child’s eye exam, although actual exam times may be shorter. 

Learn more about Ophthalmology at Texas Children’s.   

Schedule an appointment with MyChart or call 832-822-2778.

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