Paediatric Eye Examinations
At Hilliar & Gray Optometrists, Wendy Gray has a special interest in children’s vision, and so we are able to offer a range of paediatric eye care services and perform a number of vision-related assessments that may not be covered in a standard eye test.
Clear, comfortable vision is more than merely being able to read individual letters correctly off a visual acuity chart. It involves being able to focus the two eyes, together, for a sustained length of time, without strain or excessive effort. This is sometimes very difficult for certain children, over many hours, in a classroom setting.
The eye examination performed at our practice includes the checking for any refractive errors and assessing the health of your child’s eyes. This also includes assessment of binocular and oculomotor skills. This test takes 30 to 45 minutes. We also have a test for colour vision, that can be done in isolation, and takes 15 minutes.
Sometimes referring educational or medical colleagues recommend a specific test in isolation, and we are willing to accommodate this. However, in order to do a thorough, complete visual assessment of your child, being able to exclude difficulties in all aspects of vision functioning is important. We prefer to recommend a comprehensive assessment which includes all possible areas of vision-related problems.
A comprehensive assessment, which includes all possible areas of vision-related problems (refractive error, eye health, binocular & oculomotor skills, tracking, visual perception and colour vision), takes 2 to 2.5 hours. We understand that this is a long time to concentrate, and we, therefore, allow for frequent, brief breaks for your child. This assessment does not include the test for dyslexia or a cycloplegic examination.
If you do not want the comprehensive assessment, please enquire from your referring specialist which specific tests they wish your child has performed, and we shall do our best to accommodate you.
If problems are detected, we are able to assist with:
- Children’s spectacles, if necessary
- Customised Visual Therapy programmes
- The training of Oculomotor, Tracking and Reading skills programmes (with a Visagraph)
- Visual Perception Training
- Referral and support for children with dyslexia
In the above eye examination, should a child be found to have a possible refractive error, and in particular, far-sightedness, we do a cycloplegic refraction that requires the use of special eye drops. These eye drops temporarily stop the muscles attached to the lens from working, enabling us to get a very accurate reading of any refractive error, for spectacles, if required.
This is a specialised test and does not form part of a routine examination. The time required is as follows: the drops are instilled (either at the end of the eye examination, or rescheduled for another day) and we allow 45 minutes for the drops to activate. You are welcome to leave the practice during those 45 minutes.
You and your child must return promptly after 45 minutes for a very brief eye measurement, and we allow for a 15 minute discussion of the findings. In planning this appointment, it is important to know that if cycloplegic drops are used, your child’s vision will be slightly blurred for a few hours after the appointment, and we recommend that they bring sunglasses to travel home in, as they are likely to be photophobic.
Children’s eye testing can be challenging and quite different to the vision testing of adults. It is often necessary to place more emphasis on objective tests, rather than subjective tests, when testing the vision of children. This allows us to test the vision of children even before they are able to read.
At Hilliar & Gray Optometrists, we have a Plus OptiX A12 Mobile Paediatric Auto-refractor. This hand-held, mobile machine is able to measure the refractive error, and ocular alignment of both eyes, quickly and simultaneously.
It can provide a good estimate of refraction, pupil diameter, interpupillary distance, anisometropia and anisocoria. It is particularly designed for use with infants, children and uncooperative patients.
Paediatric Oculomotor Skills and Strabismus Testing and Therapy
After checking a child’s vision and eye health, a comprehensive assessment of oculomotor skills, including testing for strabismus (squint), at both distance and near, is performed.
Oculomotor skills include a child’s eye movements, teamwork and co-ordination between the two eyes, basic tracking, fixation, convergence and depth perception.
If a child is found to have either strabismus (squint) or an oculomotor problem, this can be further investigated. In some cases, spectacles might correct the problem. Some might require referral for surgery.
In many cases, training and therapy can be recommended and implemented to correct or improve the difficulty.
Eye Tracking (Visagraph) Testing and Therapy
At Hilliar & Gray Optometrists, we are able to perform specific Visagraph tracking and reading skills assessments.
The Visagraph gives results in terms of your child’s grade level efficiency when reading. This is not a measurement of the child’s capability, but rather a measure of how hard they have to work compared to others in their grade level. This test allows us to determine how efficiently your child reads, and whether or not they are having to work too hard for the grades the receive.
The Visagraph, in tracking the eye movements, measures whether or not the eyes are working as a team to process information. This includes left to right movements, number of pauses while reading, length of pauses, moving right to left and down to change lines, and reversals of eye movements.
Visual Perceptual Testing and Therapy
We are fully qualified and equipped to perform tests of your child’s Visual Perceptual Skills. Visual perception is the ability of the brain to collate, compare, understand, integrate and interpret all that the two eyes, together, are seeing.
Reading, writing, learning and numerous important everyday activities require strong visual perceptual skills. If perception is inaccurate, a child may have problems with learning and the development of certain important cognitive and visual-motor skills.
Often children with various learning difficulties may be found to have an underlying problem with their visual perceptual skills. This test takes 45 min to 1 hour.
Dyslexia is a specific learning disability that primarily affects the skills involved in reading. Children with dyslexia have trouble reading accurately and fluently. They may also have trouble with reading comprehension, spelling and writing.
We are qualified to perform tests for the diagnosis of the seven types of dyslexia. This is a very specific test and takes about 30 minutes. For best results, we recommend that this test be done following a comprehensive vision assessment, in isolation, at an appointment early in the day.
At Hilliar & Gray Optometrists, we understand the importance of children’s vision to their overall development, and how critical the early detection of visual problems can be.
In this light, we offer the service of scheduled school screenings. These screenings can never replace a one-on-one comprehensive eye examination, but they afford the opportunity to identify any possible difficulties early, and make referral for a full examination, where necessary.
Please contact us via phone or email should you require further information regarding school screenings.