As optometrists we know that everyone hates being dilated and it seems like a huge inconvenience to have dilated pupils for about 4 hours. However, we don't just do it to torture you (that's what the air puff is for...just kidding) or make it impossible to see your smart phone. Dilation is an important tool that allows us to evaluate the health of the inside of the eye. Without dilation a practitioner is only able to view about 15% of the inside of the eye. Yes, there are some technologies that are marketed saying it replaces dilation with just a photo of the inside of the eye. Does this technology replace dilation? No. The Optos, while impressive, actually distorts the
Now, many parents get concerned when we say we want to dilate their child. It is totally understandable to be nervous about dilation drops in your child's eyes but it is a safe and very important part of a child's eye examination (even infants). Dilation in children does more than just allow us to look at the child's eye, it actually is the gold standard for evaluating a child's refractive status. Here are some of the frequently asked questions our pediatric optometrist gets during pediatric examinations:
How does the dilation drop help you determine a child's prescription?
When we think about children they are flexible. They can bring their feet to their heads without even warming up! Their eyes are just as flexible and strong. Children's eyes for the most part are in a constant state of flexion and the tension on the muscles changes depending on the viewing distance. When looking at a distance target the muscles work less and as the target gets closer the muscles work harder to maintain clear focus. Because the muscles are constantly engaged, a provider is unable to get a full measure of their refractive status. This can be dangerous because if the appropriate prescription is not determined and glasses are prescribed it can lead to increased difficulty with the child's vision and in some cases can even cause an inward eye turn.
The eye drops temporarily relax the muscles allowing the practitioner to get the most accurate reading of the eyes. The gold standard of drop to use is a cycloplegic agent. This is the same
drop that is utilized for LASIK pre-ops, because again this is an instance where it is important
to have the most appropriate prescription.
Does the drop hurt?
When instilling a dilation drop in children most practitioners will utilize an anesthetic drop first to make the process more comfortable. An anesthetic drop feels comparable to opening your eyes in a pool for a couple of seconds, the dilation drop following just feels like water. Easy!
How long does the dilation last?
The dilation in children can last 24-48 hours. Generally it is closer to 24 hours. However, this number varies depending on the child's eye color. Lighter colored eyes such as blue or green stay dilated longer than patients with brown eyes.
What side effects can be expected with dilation?
Side effects are the same as adults, sensitivity to light and blurred vision up close. The sensitivity to light is more with sunlight, indoor lighting is generally comfortable for the child. Following dilation sunglasses will be sent home with the child to wear outside. Some children feel sleepy following dilation and may want to take a nap.
If my child has special needs should they be dilated?
Absolutely! This is especially true for children with special needs. Individuals with special needs may have unique visual conditions associated with their diagnosis and may require modified spectacle correction. Make sure a child with special needs is working with an eye-care provider who is residency trained in pediatrics so the most appropriate drops are being used. In some conditions, such as down syndrome, there can be reactions to cyclopentolate so other dilation drops need to be utilized.
Can children actually have disease in their eye?
Yes, while it is less common there can be sight threatening and life threatening conditions in the eye. In some cases they can have cataracts or even tumors that need to be treated and can be best visualized by dilation.
While dilating a child may seem undesirable it is important to do and honestly kids handle it so much better than adults do!
Artisan Optics - Uptown
M-F: 9-5:30 | Sat: 10-2
7960 W Rifleman St #150
Boise, ID 83704
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