Children's Eye Exams
The same testing as an adult comprehensive eye exam except the binocular vision assessment is more detailed to ensure the child’s visual pathway/perception is developing properly. More attention is paid to a child’s refraction to ensure accurate measurements are taken and the right prescription is determined if needed. Occasionally, a drop is required to immobilize the eye’s focusing muscles and allow the optometrist to get an accurate prescription. The child will experience blurry vision, inability to focus up-close, and sensitivity to bright lights for the rest of the day/night depending on when the drops were inserted.
Sometimes a child may need to be monitored more closely with prescription check-ups to see how the child is doing with the prescribed glasses. These can be done as frequently as monthly or more commonly every 3 to 6 months. Children’s eyes may also change more rapidly and require prescription changes more than once a year depending on how they are changing. It is important to ask your child if they notice a change in their vision to make sure they are seeing the best that they can.
Lazy eye is the common term used for what optometrists call strabismus. It refers to the eye/eyes that is/are turned in or out either sometimes or constantly. Lazy eye occurs in childhood when there is a big difference between the prescription of the eyes (causing the brain to ignore the information from the eye with the blurrier vision causing it to turn in/out). It can also be caused by a defect in the muscle system of one eye (either too weak or too strong).
An eye glass prescription is often the first line of treatment for a lazy eye, then patching and vision therapy (eye exercises), and lastly surgery (not possible for all cases). Each individual is assessed and treated accordingly. The goal of glasses is to make sure both eyes are seeing a clear image that is sent to the brain. Once vision has stabilized, patching of the good eye is initiated to attempt to teach the bad eye to see clearly. In order for this procedure to be successful, the patching must be done consistently and correctly according to the directions from the optometrist. Vision therapy is also a treatment option for those with eye muscle issues. These exercises aim to strengthen the weaker muscles to bring the eyes into alignment or to help children to learn to use their eyes together more efficiently. Vision therapy must also be done on a consistent basis to be successful. Eye muscle surgery is usually for cosmetic reasons or a last resort since it is hard for ophthalmologists to accurately estimate exactly where the eye will align.
It is also important for children (aged 5-18) to get yearly eye exams to monitor the growth and health of the eyes. Just as a child’s body is growing, so are a child’s eyes and it is crucial to catch any problems that may arise. Children are often not aware that they are experiencing vision issues and think it is normal; therefore, parents should bring their children in as early as the age of 3 to check for any abnormalities or even earlier if they notice the child’s eye(s) turn in or away from the normal position.
If a child does not receive eye exams at an early enough age, they may develop amblyopia (lazy eye). Sometimes children are even diagnosed with ADHD or ADD in school but simply are not paying attention because they can’t see what the teacher is referencing.
Comprehensive Eye Health Examinations
Here at Eye Candy Optometry, we are equipped to deal with the following issues:
- minor abrasions (scratches) to the cornea
- minor foreign body removal (not located in the visual axis)
- sudden on-set red/painful eye
In the case of major burns or any penetrating injury please go to your nearest hospital (if someone is able to take you) or call 911 and describe the situation to the operator. Please do not attempt to pull any sort of penetrating foreign body out of your eyes or rinse the eyes with anything other than sterile saline.
Below is a list of all items completed during a comprehensive eye exam:
- current health status/history
- family health history
- depth perception and colour vision assessment
- automated refraction (base-line data)
- binocular vision assessment
- general visual field assessment
- slit lamp assessment (health check)
- tonometry (pressure inside the eye)
- dilated fundus examination (eye drops are used to open up the pupils to provide the optometrist with a better look at the back health of the eyes – does not have to be completed same day; can be deferred)
Drops are inserted into a patient’s eyes to open up the pupil (the part of the eye that allows light to enter the eye). It will take about 10-20 minutes to open up the pupil and then the optometrist will use specialized lenses to look at the health of the retina (back of the eye). Side effects of the drops include light sensitivity, inability to focus up-close, and overall blurry vision for about 4-5 hours afterwards.
We will have disposable sunglasses for those who want them and suggest those individuals that are being dilated to have a driver with them (since many find it difficult to drive after the drops have been put in). Many patients decide to book the dilation on a separate day or opt out altogether. However, dilated eye examinations are highly advised to be done at least every two years to ensure the best health for your eyes.
A comprehensive eye health examination consists of more than just a person’s eye glass prescription. The eyes are the window to the health of the rest of the body. Damage from diseases such as diabetes, hypertension, high cholesterol, an impending stroke, and arthritis can show up in the eyes and are often the first signs that a disease is developing. Comprehensive eye exams allow the doctor to look at all structures within the eye and ensure they are all healthy and functioning properly.
There are several ocular diseases that exist (such as glaucoma) that are not something a person can see or feel coming on and are not detectable without a full eye exam. If it is not detected and treated by an eye care professional, glaucoma can ultimately lead to blindness – something that could have been prevented at an early stage with a comprehensive eye exam.
It is important for adults and seniors to get their eye health checked at least every two years (for healthy individuals) or every year (for those individuals with diseases such as diabetes or hypertension). For children, it is crucial that they get their eyes examined at least every year once they are 5 years of age.
Contact Lens Related
Contact lens fits involve creating a new prescription for the contacts which is often different from your spectacle prescription and ensuring that the lenses fit the curve of the eyes properly. There are different fits involved for different needs:
- spherical (regular)
- toric (astigmatism)
- multifocal (bifocal and progressive)
- monovision (one eye for distance; one eye for near)
There are also different modalities depending on each patient’s needs:
- daily disposable (best for the health of the eyes)
- bi-weekly disposable
- monthly disposable
- continuous wear (not recommended)
Each type of fit involves fitting the lens to the client’s visual needs. The impact of the lens to the health of the eye is also assessed – ensuring the contact is not causing any damage to the other structures.
It is crucial that all contact lens wearers take the time and responsibility to take care of the lenses and in turn their eyes. Although contact lenses are a great innovation, they make the eyes more susceptible to infection and disease if not cared for properly. Many of these infections (if not treated immediately by an eye care professional) can cause blindness. One study showed that 40% of contact lens wearers have some sort of contact-lens-related complication which is why we schedule follow up appointments to ensure the fit and health management of your eyes. Like a pair of shoes they can feel fine at the store but after a days use they may rub and cause irritation. Even a lens that feels comfortable to you can hide an incorrect fit or lack of oxygen – leading to corneal damage.
Eye Disease Related
Cataracts will be assessed and monitored as needed (as frequently as every 3 months to 2 years). Once they are ready for removal, we will gladly refer patients out to a trusted ophthalmologist in the area for surgery. All pre-operative and post-operative care will be handled by our facilities and catered to our patients.
Cataracts are the yellowing/fogging of the lens of the eye. The development of cataracts is most often caused by simple aging and UV exposure but can sometimes be caused from trauma, diabetes, or be congenital (born with). Cataracts will cause a decrease in vision and a slight distortion in colour perception of yellows. The rate at which cataracts grow differs for each individual depending on predisposing factors and lifestyle.
It is important to protect your eyes from prolonged UV exposure with proper sun wear/protection. Cataracts are inevitable but easily dealt with by surgical means. Once they are removed, an individual’s vision is expected to return to normal and no longer require glasses for distance, near, or both (depending on what lens the patient desires). Cataract removal is a common procedure and the technology revolving around the procedure today has made it safe and highly efficient.
Studies show nearly 30% of Canadians suffer from dry eye syndrome. Many people are not aware that they are experiencing dryness and dismiss the signs their eyes are sending them. A dry eye assessment involves looking at the underlying reason why an individual has dry eye and treating it accordingly. Dry eyes are often associated with other disease processes or side effects from medications. Symptoms of dry eyes include:
- irritation (dry, gritty sensation)
- blurred vision
Glaucoma screenings involve having a dilated fundus examination, Goldmann tonometry, gonioscopy, pachymetry, and a visual field. A dilated fundus examination involves eye drops to open up the pupil to allow the optometrist to get a good in-depth look at the optic nerve (the cable that connects the eyes to the brain and allows a person to see). Goldmann tonometry is the most accurate method by which the pressure within the eyes is measured. More often than not, this will be done over a stretch of time to ensure that the readings are repeatable and accurate. Gonioscopy involves placing a specialized lens on the eye to allow the optometrist to get an in-depth look at the drainage structures within the eye (not to worry numbing drops are used to ensure this procedure is not painful). Pachymetry is a measurement of the thickness of the cornea (front surface of the eye). Unfortunately our facilities does not have the machinery on site so we will have to refer you out to have this and the visual field done. A visual field is simply a measure of the peripheral vision a person has. When having this done, it is important that the individual have an updated prescription, be tentative, and follow the directions given to provide accurate data (we do not want false data leading to incorrect diagnosis).
Glaucoma screenings will be done on an individual basis depending on what the optometrist finds.
Glaucoma is a disease of the optic nerve (the cable that connects your eyes to the brain). It is not a disease that someone can feel or see happening to them until it is too late (end-stage near blindness). That is why it is imperative that patients allow their optometrists to dilate their eyes and get a good look at the optic nerve. It is not something that is contagious but there is high genetic predisposition. Glaucoma is not something that develops over night – it is a slow progressive disease that can eventually lead to blindness.
The underlying reason as to why glaucoma develops is not entirely understood but it seems there are many factors that go into it. Pressure built up inside the eye is one of the major factors and the only means by which we are able to manage glaucoma at this time. High eye pressure pushes on the optic nerve leading to damage over time. Glaucoma is treated first by eye drops that aid in lowering the pressure within the eye. Surgery is only done if it appears that drops are not successful. The surgery involved is done to open up the filtering/drainage system of the eye to relieve pressure. Although the drops and surgery are not a cure, they are a measure that have prevented many people from blindness.
It is crucial that any individual with glaucoma be compliant with their eye drop medication regimen and follow-up with their eye care professionals (for pressure checks or visual fields) when told to. It is not okay for glaucoma patients to go weeks, months, or years without their medication or seeing their eye care professionals since every person’s eyes react differently to pressure spikes.
Diabetics are recommended to have dilated eye examinations at least yearly (or as frequently as every 3 months) to monitor any possible bleeding that can cause damage to the eyes. If bleeding is caught at an early enough stage, preventative measures can be done to stop the eventual development of a retinal detachment (that can lead to blindness). The rate at which bleeding occurs is different for every diabetic, but the more well-controlled the disease is, the less likely any bleeding will occur. Changes in a person’s eye glass prescription can also be seen with diabetics and can be an indicator that the diabetes is not under control. It is crucial for diabetics to be seen regularly by their regular family doctors and eye doctors to ensure the disease is well-controlled.
Hypertensive (high blood pressure) individuals are also prone to bleeding in the eye if it is not under control. Although the mechanisms differ, the end result if not caught and treated in time are the same – possible blindness. The same measures are taken as in diabetic eye exams (yearly dilated eye examinations).
Those that are both diabetic and hypertensive are at a higher risk than those with just one of the diseases of developing bleeding in the eye. It is crucial for these individuals to monitor their health on a regular basis and see their optometrists at least yearly.
We will gladly guide patients through the process of pre-operative and post-operative follow-ups and referrals to a trusted ophthalmologist. There are several options available – the most popular being LASIK, LASEK, or PRK. We will gladly go over the differences and explain how each procedure is done. Qualifying criteria will be performed by a trusted ophthalmologist to determine the best option for each individual.
Newer procedures include ICL (implantable collamer lenses), iLASIK, and iPRK. These procedures are newer and provide a more accurate outcomes. Patients with high prescriptions often will do better with one of these procedures.