Pediatric Eye Exams in Katy, TX

Intro

Pediatric or children eye exams are one of the most important of all the wellness visit exams a child will have. Some people mistaken a vision screening performed at the pediatrician's office as an eye exam. While the check at the pediatrician is helpful, its focus is to catch children with more severe vision problems. Your eye doctor will be able to perform the same screening done at a pediatrician better while also performing more test to give you a specific analysis on your child's vision and ocular health.

Why do a pediatric eye exam?

Dr. Matthew Pham of Eye Eye Doc in Katy states lazy eye is more common than you think. He has treated lazy eyes in all demographic groups, incomes, and city areas. Time is of the essence when it comes to training a lazy eye the earlier we diagnose, the more time we have to fix a lazy eye.

Children do not know what is considered normal good vision and could go on for a while oblivious to their eyes not performing to its fullest capability. Sometimes a child's parent will not believe their child when they state they cannot see something. By getting an eye exam, you are getting a third set of eyes that happens to be a professional!

What is in a pediatric eye exam?

A pediatric optometrist or ophthalmologist will typically perform the same exam as ones you'd get as an adult, modified in ways a child can do it. That includes a comprehensive eye health check and finding an exact glasses prescription and visual acuity measurement.

Visual Acuity check
Eye muscle and alignment check
Peripheral Vision
Patient's prescription
Exam of the eye surface
Exam of the lens
Exam of the retina

How do we measure what a child can see?

Checking the visual acuity (how small a person can see) is dependent on at what stage the child is at developmentally.

0-3 months -- using a light source and varying the size and distance until a baby loses focus
3-9 months -- using gratings to look at which direction a baby will look at
2+ years -- matching symbols from letter chart
3+ years -- matching letters from letter chart
3+ years -- speaking letters or numbers

Measuring a child's prescription

We will try to use a machine called an "auto refractor" to get a baseline measure. Dr. Pham typically doesn't put much emphasis on this measurement because it can measure too high or low, or in some cases, opposite to what is really going on. Instead he uses a technique called retinoscopy to manually look at a child's prescription and to neutralize it with lenses. Based on doctor experience, this alone can be used to figure out a glasses prescription.

After one of those methods we have the child try reading the letters and attempt the subjective refraction portion (which is better 1 or 2?) Depending on the child, this measurement can be accurate and used as a data point in their final glasses prescription. Others it isn't and we need another data point.

Some children subconsciously focus to see and we need to relax the child's eye to see what is the true prescription and if anything needs to be done for it. So dilating eye drops are used, these typically will last half a day but are helpful when we suspect lazy eye or big prescriptions. After using the drops we go back to step one and either due an auto refractor or retinoscopy. Here because the drops have knocked out the ability for a child to focus, we don't worry as much about an auto refractor measuring incorrectly.

As you can see, these equipment and skills to do this will not be found at a pediatric office. Having an actual numerical value of their prescription is important to know whether they are at age expected norms, at risk for lazy eye, in need of glasses, or how soon they need to be followed up on.

For example, a two year old with a prescription of +1.00 in both eyes will be fine, but if one eye is +1.00 and the other eye is Zero, that could be a risk for lazy eye and needs to be followed closely. If there is a lazy eye then we would prescribe glasses at that time, otherwise we may not even though technically they do have a prescription that isn't zero.

Checking the eye health of a child

It's important to actually look at the eye structures and make sure they are developing normally or do not have problems. We look for congenital cataracts which can block the light from entering eyes of children which will cause a lazy eye. Some young children are prone to infections and we need to examine the eye drainage opening and duct itself to see if surgery intervention is needed. While rare, some retinal problems may be uncovered such as retinoblastoma, coloboma, retinopathy of prematurity.

If a child can fit in the regular slit lamp, we can use that to examine the eye health with minimal modifications. Sometimes sitting on a parent's lap and adjusting the head rest is all we need to get a small child in alignment with our oculars.

Other times we use a direct ophthalmoscope to see the retina and use a condensing lens as a magnifier to look at the external structures.

After examining the eye we know how well the eye is developing and thus vision. Importantly we can address any issue that we find. While the vast majority do not have eye health problems as a child, the ones that do need intervention fast due to how aggressive congenital defects are.

FAQ's about pediatric vision and eyes

How old should a child be to get their eye's checked?

3+ years old is a great time

What is a lazy eye?

A condition where something is preventing the eye from seeing what is expected at their age.

What are common problems in a child?

Prescriptions such as hyperopia and astigmatism. Styes, pink eye, nasalacrimal duct obstructions.

When should a child be able to see 20/20?

By 5 years old a child should be able to see 20/20

How do I know if my kid is color blind?

They may describe colors differently or not describe any color. Your optometrist has a HRR color vision tester that can categorize color deficiencies.

Will my child need glasses?

If a child has a lazy eye or a prescription that they cannot compensate for even if the eyes aren't lazy.

Wrapping it all up

By now having data about how well a child sees, their prescription and their eye health status. We can summarize to parents how well they are doing now and what to expect in the future. Even if no treatment or glasses is needed, this insight is helpful should in the future a glasses or treatment is needed as we now have a reference point to base our decisions from. Dr. Pham likes to have children get exams early so they don't get scared from the process but also so that by the time when they are older and most likely need some kind of treatment, we know they will be seasoned pros and their responses they would give then would be highly accurate.

If you are looking for a pediatric eye doctor in Katy, Dr. Matthew Pham at Eye Eye Doc will not only capably perform your child's eye exam but also make it an enjoyable first experience for anyone. Kids have fun when they enter and play with the pirate toys in our optical, to the actual exam itself where Dr. Pham patiently involves each child in their eye exam. Many children spend more time talking to Dr. Pham and his staff about things unrelated to the eye then the actual exam length itself! Call and schedule and trust Dr. Pham with your child's vision.

About the Author

Dr. Matthew Pham has performed numerous pediatric exams at his clinic at Eye Eye Doc, at schools, and in community clinics. He has treated numerous lazy eyes and parents have chosen him as a second opinion due to his experience and rapport he has with schools, parents, and children.