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Children - until the day they turn 20 years old - are covered by OHIP for annual exams. As their bodies grow and change over the years, so too their eyes change. Just because at 7 years old they didn’t need glasses, doesn’t mean that at 14 they still don’t. 

For small children, those around 2-4 years old we play games. We strive to make the eye exam a fun and positive experience for children.  Even if the child is too shy to talk to Dr. Zeiler and needs to sit on Mom, Dad or Grandma’s lap, we still have fun playing the following games:

Can you find my star? 
A quick screen for red / green color blindness for those children who don’t know their numbers yet.
 
Can you find my elephant?
An excellent tool to assess 3-D vision, which points to problems with ocular alignment and amblyopia. The LANG stereo test is user friendly, in that the child does not have to put on any glasses to visualize the 3-D image. For more information visit:  www.lang-stereotest.com
 
Show me the birthday cake.
Vision assessment for both near and distance. Pointing and matching are excellent communication skills for children who are so young and too shy to talk.
 
Can you put on my funny glasses?
Assessment of the need for glasses. 
 
Can you put your chin here and snore like Daddy with your eyes open?
External health exam with the microscope.
 
Can I come close and look in your eyes?
Internal health assessment of the eyes.

Children in kindergarten to pre-reading.

We still play games but the testing becomes more intricate. Color vision for red/green defiencies is tested with the standard Ishihara colour plates using numbers. 3-D vision is tested to a finer level. LEA® symbols are used for near vision assessment. LEA symbol charts use a square, circle, house and heart shape of the same detail and sizing as the lettering used for reading tests.  Visit www.vistest.fi to learn more.

Grade 1 and up – readers

A full exam, with the inclusion of 3-D vision (stereoacuity) and color testing. Tonometry for glaucoma is generally not done unless there is a strong presence of glaucoma in the family history or physical findings warrant it. 

Infants

Testing children before they can communicate with you is a challenge, but the tools exist to assess their visual function. We use the LEA® grating paddles to assess the visual function of non-verbal children who are unable to respond in any way. Visit http://www.vistest.fi/ to learn more. The goal of an exam with this patient population is to diagnosis any condition that may impair visual development. It may be a condition such as cataract, amblyopia or strabismus that can be corrected by surgery or glasses. Sight threatening conditions such as infantile glaucoma and life threatening such as retinoblastoma are also looked for. Because children are growing and changing so much through their early years small prescriptions are usually not given. Children may need to be examined multiple times in a year before the decision is made to put them in glasses, changing their lenses as they grow, sometimes 2-3 times per year or a referral made to a pediatric ophthalmologist. 

Helpful links

http://www.vistest.fi/    Web site of LEA® symbols and paddles.  (use the tabs on the left side of the page)

http://littlefoureyes.com  A very comprehensive web site with blog from the parents point of view. Necessary reading for anyone facing the challenge of putting glasses on a little one.

http://childrenseyefoundation.org/Home.aspx  A non-profit web site with information pertaining to children’s vision, amblyopia and strabismus. It is USA based from an ophthalmologist’s point of view, but has an excellent listing of other pertinent web sites.

http://www.lang-stereotest.com/lang/index.php?id=414  Visit this site to learn more about the LANG stereo test.