PFA Tips: Going to the Eye Doctor

By Dr. Dean Fiergang, MD of Pediatric Eye Care of Maryland

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Children with special needs often have a higher
risk of developing vision problems.These vision problems can intensify the challenges the child is already experiencing. It can be difficult for parents to identify the signs and symptoms of vision problems in their children, especially when their children may have difficulty communicating.

While a thorough eye evaluation can be difficult for a child with ASD, careful planning by staff, as well as the parents or caregivers, can alleviate a lot of the stress and difficulty for the child. The truth is, nothing about the eye examination should be painful, and often fear of the unknown is the greatest obstacle. Having an eye exam at a young age can be a good way to alleviate this stress.

Verbal or non-verbal
Many parents are under the impression that a child is not able to be evaluated before he or she is able to speak to the doctor. This is not correct. From an eye exam only, and no verbal communication from the patient, ophthalmologists are able to obtain the necessary information to determine whether or not there is a concern that needs intervention. In this way, they can avoid being “too late” to catch and treat vision problems in children that need early intervention. This also applies to older patients that are nonverbal.

Know your scheduling options
Excessive waiting time can be hard on any patient or parent. Unfortunately, in the ophthalmologist’s office, each patient’s encounter is unique and can be unpredictable. Therefore, some patients’ unanticipated issues can take longer to resolve than expected. The best way to avoid waiting is to be the first appointment of the day, and eliminate the chance that the patient before you causes a delay. As well, the first appointment right after lunch is usually right on time.

Sensitivity to light
In addition, patients with ASD may be very sensitive to light. In fact, this is a common issue with many patients. Fortunately, ophthalmologists are able to adjust the brightness on all of their microscopes, and view the patient’s eyes with the dimmest light possible to minimize sensitivity that patient may have. Bringing along a baseball cap and/or sunglasses can also alleviate photosensitivity when patients leave the office.

Eyedrops can be a challenge
Probably the hardest part of the eye examination is instilling the eyedrops into what may be an uncooperative patient. While there is no “magic” way to make this easy for fearful patients, there are doctors who are experienced with this process. Parents may be able to ask for a prescription for dilating eyedrops that the parents can instill at home before the patient comes into the office, which can eliminate the most difficult part of the exam for the patient.

Sedated examination
There are a wide range of pediatric ophthalmologic surgeries, from repairing blocked tear ducts, to cataract surgeries on very young babies. Parents should know that in the worst case scenario, doctors can perform a complete examination while the child is sleeping, under the supervision of a pediatric anesthesiologist. Fortunately, anesthesia is usually unnecessary, and almost all patients are able to be examined in the office.

Social Stories for Going to the Eye Doctor

Vision Exam from Autism Speaks that uses photographs

I Can Go To The Eye Doctor from Able 2 Learn that uses animated pictures  

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