05/02/2024
May Kids Corner – Pediatric Eye Exam Preparation For You and Your Patient
By Erica Shelton, OD, MS, FAAO
We all know it is true what they say, first impressions are everything, so how do you prepare yourself and your new pediatric patients for the first eye examination? Preparation and education.
Prepare and educate yourself and your staff
Every optometrist has a different ratio of pediatric patients in their clinic, and regardless of if youlove or hesitate when it comes to examining children, being prepared is the best way to get success in the exam room. I recommend starting with evaluating your communication skills with the children and their parents. Below is a list of communication skills that may be helpful to try.
- Be at the child’s level when speaking to them
- Do not touch the child unless you get consent from the child and/or parent
- Always have 2-3 ways to get a task completed in your mind, so you can quickly pivot tactics
- Toddlers, and really all children, love to feel in control. Give them two options you would be satisfied with. For example, “Do you want to look at the letter A or the letter T?” or “Would you like to sit by yourself in the chair or would you like your Mom to sit with you?”
- Be flexible, if a child wants to sit on the floor, do what you can with them on the floor
- Ask for interests from parents and children to help guide which topics are up for discussion
- Work quickly and efficiently, time is not a luxury you have when examining children
- Good posture, eye contact, and speaking clearly when providing explanations1
In order to promote a positive experience throughout the exam, have some easy to clean, age appropriate toys available for patients and siblings. Some examples are fidget toys or rubber bath toys. Have age-organized take-home rewards, such as stickers or small age-appropriate toys available, but avoid food products. If you are unfamiliar with what types of toys are appropriate for what ages, check out this article from Parents.
Patient education can be a particularly difficult part of the pediatric exam. A study out of the Children’s Hospital of Philadelphia demonstrated no difference in whether parents preferred an authoritative or collaborative approach to treating the child.1 I recommend deciding your approach based off of your experience communicating with the parent throughout the exam. Make sure not to talk about the child like they are not in the room. If they are old enough to understand what is going on, direct patient education to the child in an age appropriate manner. This means telling them the results and treatment plan first, and then the parents. If it is a difficult conversation, and you would like to isolate the parent from the child, feel free to ask the parent if it is okay for the child to head out to optical or to choose a take-home prize, with a staff member, while you finish talking with them. You should use nonverbal cues from the patients and their parents as a barometer for how well your communication is coming across. You can consider using the Teach-Back method with parents, to make sure they are understanding the plan correctly. It is important to have education handouts about common pediatric disorders and treatments at the ready, including an exam summary sheet. You can consider using the OOA member benefit examination sheet available here. Make sure you have child frames that will fit the age of patients you are willing to see in the exam room.
Prepare yourself by being up to date on pediatric examination practices and treatment. Following the American Optometric Association’s Comprehensive Pediatric Eye and Vision Examination guidelines is a great first step. Attending pediatric centered continuing education courses at meetings and reading publications from groups like the Pediatric Eye Disease Investigator Group are also excellent options. The American Academy of Optometry offers podcasts in a variety of clinical areas, including Clinical Binocular Vision and Pediatric Care. If you feel you do not spend a lot of time around children and you are unsure what to expect, read up on milestones and abilities through the CDC.
Prepare and educate your patient and their family
A great way to guarantee a successful eye exam is by preparing children for the experience. This can create a sense of excitement and reduce the anxiety of the unknown. Having an email template, website page, and a hand out with resources l for parents is recommended. You can have materials easy accessible for parents by using QR Codes or embedded links. If you would like to learn how to create a QR Code or an embedded link, like the links throughout this article, try one of the resources below.
For toddler to young school-age children, consider recommending Howard and the Amazing Eye Exam, the e-book by optometrist, Dr. Catherine McDaniel. For school aged children, the Ohio Optometric Association’s RealEyes Program has a great video on a Journey Through an Eye Exam. If you are looking for something shorter to offer families, consider the National Eye Institute’s video on “What to expect at an eye exam” on YouTube.
In summary, examining children should be a fun experience for you and the patient. Remember to prepare yourself and your patients accordingly in order for everyone to have a smooth experience.
Do you love seeing children and want to add another way to bring more pediatric patients into you practice? Be an InfantSEE provider.
- Lee T, Lin EC, Lin HC. Communication skills utilized by physicians in the pediatric outpatient setting. BMC Health Serv Res. 2022 Aug 4;22(1):993. doi: 10.1186/s12913-022-08385-5. PMID: 35927741; PMCID: PMC9354305.