Eye Care Professionals Who May Work with Your Child
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Finding the Right Eye Care Professionals for Your Child
Your family may have little or no experience in finding and working with medical specialists. But if your child has been diagnosed with a visual impairment, it becomes important to find out how to do that, quickly and successfully. Your family doctor and your child's pediatrician may be the first professionals to consult, and they may be able to refer you to knowledgeable eye care specialists. Friends may also be able to make helpful recommendations. If there is a university-affiliated hospital in your area, its department of eye care and the university's medical faculty might be good sources for referrals to experts in the field.
Other Important Sources
Parents' groups can be invaluable in many ways. Their members have faced many of the same questions, confusion, and fears about what to do first that you may have now. You may get practical and emotional support from them, as well as recommendations for doctors to contact. FamilyConnect's message boards can also help you find groups and individuals with which to connect.
Your child may have to be seen by a variety of eye care specialists, each with a specific expertise. Understanding the qualifications of each and their roles in managing your child's eye care is important. Whenever possible, consult with someone knowledgeable about the particular eye condition of your child. Many eye care professionals don't often work with patients who have low vision. Therefore, they're unfamiliar with the special needs of such patients, as well as the specialized exams, procedures, and devices involved in providing effective low vision services. The Directory of Services is a source of agencies and services that may be able to help you locate such a specialist.
An ophthalmologist is a medical doctor (MD will follow the person's name) who has gone through college, followed by four years of medical school, and completed an internship and residency. Ophthalmologists diagnose and treat eye diseases and can perform surgery. In all probability, it was an ophthalmologist who first diagnosed your child's visual impairment. These professionals also can prescribe eyeglasses or contact lenses for children. Some ophthalmologists and optometrists specialize in low vision, that is, working specifically with people to help them maximize their use of vision, but most do not.
An ophthalmologist may or may not be a specialist in working with children. Many ophthalmologists specialize in one aspect of eye diseases—retinal diseases, for example. You'll find in general that ophthalmologists vary considerably in their approach with children, especially those with multiple disabilities. Examining and working with children often involves considerations different from those involved in working with adults, for example, in such areas as communicating clearly, being responsive to a child's emotions and behavior, and being attuned to the way in which children may indicate what they can, in fact, see.
It's important that you and your child have a confident, comfortable relationship with the ophthalmologist, so if you have any concerns about that, you may want to consider seeing another doctor—perhaps a pediatric ophthalmologist—for a second opinion.
An optometrist will have the initials OD after his or her name. Optometrists have completed college and three to four years of optometry school. They do not perform surgery. Instead, they focus on helping patients maximize the use of their vision. They do this by prescribing eyeglasses or contact lenses and, if appropriate, low vision devices such as magnifiers, monoculars, or video magnifiers, which are also referred to as closed-circuit televisions (CCTVs). Optometrists, or their assistants, may teach children how to use low vision devices. In some states, optometrists are allowed to prescribe medications and diagnose eye diseases; in other states they are not.
Some optometrists provide behavioral optometry, which involves having children do exercises or visual training to increase their visual skills. For most children who have a disease such as albinism, retinopathy of prematurity, or cortical visual impairment, this type of training probably won't be effective. Before enrolling a child in a behavioral optometry regimen, it's best to get additional opinions about whether this method has potential benefits for the child's particular visual impairments.
An optician has taken courses in optics and completed a two-year apprenticeship under an experienced optician. Opticians grind and fit lenses in accordance with prescriptions from an ophthalmologist or optometrist. The optician will help you and your child select frames for her eyeglasses. For the lenses to be effective, it's extremely important to have frames that are comfortable and fit your child's face properly.
An ocularist has been trained and certified to develop artificial eyes, which are typically made of plastic. You may have heard the term "glass eye" or "prosthetic eye" used. Children born without an eye, a condition called anophthalmia, or who have had an eye removed because of disease, have to have artificial eyes made specifically for them. The eye is placed in the child's eye socket to promote proper growth of the socket and development of facial bones. It also serves cosmetic purposes. As the child grows, a new eye will have to be made periodically.
Low Vision Specialists
The term low vision specialist refers to an ophthalmologist or optometrist who has completed additional training and certification in the area of low vision. An exam conducted by a low vision specialist is similar to the exam conducted by either an ophthalmologist or optometrist. However, it will have additional components that focus on helping children maximize their usable vision through low vision devices for:
- Near tasks (closer than 16 inches)
- Intermediate tasks (16 inches to 3 feet)
- Distance tasks (beyond 3 feet)
The low vision specialist can prescribe aids such as magnifiers, monoculars, or video magnifiers. A low vision specialist also considers how lighting and nonoptical aids such as a reading stand, bold-lined paper, or nonprescription sun lenses can help children use their vision more efficiently.
Certified Low Vision Therapists
A certified low vision therapist (CLVT) has completed an internship and passed an exam to demonstrate knowledge of low vision. The CLVT conducts a functional vision assessment (FVA) to determine how a child is using his or her vision for education, recreation, and daily living tasks. The low vision therapist may also be a teacher of students with visual impairments (TVI) or an orientation and mobility (O&M) specialist. The CLVT works closely with either an ophthalmologist or optometrist, who prescribes low vision devices based on the functional vision assessment. The CLVT also teaches children how to use these aids and other techniques to maximize their functional vision. A CLVT is not a doctor and cannot diagnose an eye disease, prescribe eyeglasses or contact lenses, or prescribe medications.