CLINICAL

  PEDIATRICS

ANSWER TYPICAL QUESTIONS

A LOOK AT FIVE PARENT CONCERNS YOU SHOULD NOW BE ABLE TO ANSWER

LEONARD J. PRESS, O.D., F.A.A.O., F.C.O.V.D.

THE “PEDIATRICS” column has covered a wide range of topics, such as fitting children in contact lenses, optical needs, the basics of a pediatric eye exam and collaborating with other professionals. As a result, you should be well-versed in the needs of child patients and be able to answer the following, frequently asked parent questions. That said, if you remain unsure, the correct answers, which review the aforementioned topics, are provided.

Q: How old does a child have to be in order to have an eye examination?

A: The short answer is birth. Explain to the parent that the InfantSEE program makes it clear children can be assessed at early stages of infancy. This program is a great way of promoting that infants and young children can be evaluated in nonverbal ways. (Keep in mind that, as eye care practitioners, even if you signed on as an InfantSEE provider with the AOA, you have to re-contract to continue to be listed as a provider and participate in the program.)

Q: How old does a child have to be to be fit with contact lenses?

A: Children can be fit with contact lenses at any age, even in infancy. Considerations range from high ametropia to anisometropia, in terms of providing optimal image quality and fusion, and counteracting the development of amblyopia. Orthokeratology has been used with children as young as age 8 in providing alternatives in managing the progression of myopia.

Q: Why would bifocal lenses be prescribed for my child?

A: Bifocals have been shown to play a role in curbing the progression of myopia, particularly when a child has functional risk factors for myopic progression, such as esophoria at near.

In other instances, a plus lens prescription for near may be indicated to help with reading or other visual performance issues the child may experience in his or her day-to-day life.

Q: When is vision therapy indicated for my child?

A: Optometric vision therapy can be prescribed for conditions such as strabismus, amblyopia, convergence insufficiency, learning problems or to assist children who have neurodevelopment issues. Needs that we’re currently addressing more of in pediatric practice include challenges in development related to autism and visual attention.

Developments in electrodiagnostics and computerized technologies have complemented tried-and-true optical procedures, enabling therapy to potentially benefit an increasingly wider array of conditions.

Q: What other pediatric professionals do optometrists collaborate with?

A: Optometrists working with children have progressively become involved with child development professionals. These include developmental pediatricians, occupational therapists, concussion specialists, child psychologists and pediatric ophthalmologists. We’ll seek out and network with those providers who are interested in understanding of what optometry has to offer the children. In turn, we’re interested in staying current with developments in other fields, such as early intervention, pediatric neurology, and autism spectrum disorders.

WRAPPING IT UP

Thank you very much for your attention on pediatrics this year. I have enjoyed sharing my expertise through this column and hope that these tips have helped to develop further interest in serving children within your practice. OM

DR. PRESS is the optometric director of the Vision & Learning Center in Fair Lawn, N.J. He specializes in pediatric vision. Dr. Press completed his residency program in pediatric optometry at the Eye Institute of the Pennsylvania College of Optometry, and he served as chief of the pediatric unit of the Eye Institute. In addition, he’s a Diplomate of the AAO and has written three textbooks encompassing pediatric optometry and is a Diplomate in the Pediatric Optometry/Binocular Vision and Perception section of the AAO. Email him at visionlecture@gmail.com, or visit tinyurl.com/OMcomment to comment on this article.