What to Expect

For those patients that are new to the office, the following is a description of the exam process from start to finish.

1. The patient or their parents will be given a medical history form – please fill it out as completely as possible. You will be expected to complete this form yearly. Foster parents should attempt to get this form completed by the biological parents with the help of the child’s caseworker. This form can be downloaded at the following link.
2. Dr. Nick, Lori and Nick 2 (the orthoptists), Lindsey (technician/scribe) will call the patient back to the exam room. Any of them will start the exam. Occasionally Dr. Nick will have visiting ophthalmology residents who may start the exam.
3. The exam will start with a review of the medical history and some questions about your specific concerns.
4. Vision will be checked. Older children will read the typical vision chart on our special computerized screen; younger children may match letters on the computer. Children under three years of age are evaluated by determining if they are favoring either eye (fixation preference).
5. Routinely the following are evaluated:
   • Vision
   • Motility (how the eyes move as a team)
   • Muscle Balance (how the eyes work together)
   • Stereo-acuity (depth perception)
   • Color vision screening
   • Pupil evaluation
   • External evaluation of the ocular surface, lids and lashes
   • Eye pressure if age allows
6. The exam is usually light hearted and all attempts are made to make the patient comfortable and at ease with the process.
7. Now comes the eye drops. We usually instill 3 sets of drops. The first may sting like pool water; the child doesn’t feel the last two because their eyes are numb. This can be the most traumatic part of the exam but rest assured they really don’t hurt. You and/or your child will then be asked to go back to the playroom to dilate (can take 30 minutes). The patient will notice that their near vision will get blurry.
8. The drops may last for 6-8 hours depending upon the patient’s complexion. Don’t worry if they are still dilated the next morning.
9. After an appropriate amount of dilation time the patient will be called back to the exam room in which several diagnostic tests will be preformed.
   • REFRACTION – Dr. Nick will use a special light (retinoscope) and different lenses to determine if your child needs glasses. They are able to make this determination even if the patient is unable to communicate.
   • OPHTHALMOSCOPY – A different light that is placed on the examining doctor’s head is then used to evaluate the internal structures of the eyes.
10. At this point most of the information is obtained; The doctor can make the appropriate decision on how best to treat the child or adult patient’s unique condition. There will be an in-depth discussion about the condition and treatment options. All questions will be answered.
11. If glasses are required a prescription will be given at the end of the exam. If the patient requests contacts a contact lens fit may need to be scheduled. See more information about contacts in the contact lens section of the website.
12. A special treat will be given to the child and you will be directed to the check out area to make any follow-up appointments.