Doctor Patient Relations

Build a Pediatric Practice By Stressing Preventative Care

By Mary E. Boname, OD, MS, FAAO

SYNOPSIS

Providing pediatric care leads to caring for entire families–and other families in their circle. Emphasizing prevention of eye disease and conditions brings it home to parents.

ACTION POINTS

PRACTICE PREVENTATIVE OPTOMETRY. Explain to parents how yearly exams can catch and prevent eye conditions and diseases.

ASK ABOUT EACH FAMILY MEMBER. When the mother or father calls for an appointment, ask if any other family member needs an eye exam.

MAKE CHILDREN ACTIVE PARTICIPANTS. Talk directly to the child with the parent in the exam room, and ask the child him or herself about reading and computer habits.

I have a “preventive optometry practice” as in “an ounce of prevention is worth a pound of cure.” I present this concept to all of my patients, emphasizing to parents that preventionis possible only with regularannual comprehensive eye exams. I also explain the developmental and learning difficulties undetected visual issues can pose. The care I provide to children, combined with this parental education, has proven to be a powerful practice-builder over time.

I dilate every patient, including children, and take retinal photographs. We discuss the risks of unprotected, prolonged exposure to UV and blue radiation (skin cancers along the lid margins, early cataract formation, pingueculae and pterygia, increased incidence of AMD for UV radiation, suppressed melatonin level and increased risk for AMD in the case of blue radiation. I explain to parents why I am doing these tests and how they can help me monitor their children’s eye health by bringing them in for yearly exams.

Pediatric Patients: What You’re Scanning For

Testing can find undetected …

myopia, hyperopia, astigmatism, anisometropia, small angle strabismus, amblyopia, accommodative problems, eye movement problems, learning-related vision problems, developmental delays in vision, vision processing problems, vision integration problems, color vision problems. —ROB Editors

Ask About Each Member of Family

The best way is to build a relationship with parents is to always ask about each member of the family. My patients have told me that one of the things they like the most about my care, is how I always ask about their children, parents, pets and other members of their family and friends network. When someone calls to schedule an appointment for an eye exam, we ask, “While I have you on the line, is there anyone else in your family who is in need of an eye exam?”

Create Comfortable Atmosphere for Children

Comfortable seating for parents and siblings to join the child being examined is important. I communicate directly with the child (not just the parent). I ask them to tell me what they like to do for fun, if they have a favorite subject in school, their favorite food and what their plans are for summer vacation, and other points of interest.

About 20 percent of my frame board is devoted to children’s frames, and my optician is skilled at working with children. Children tend to have shorter attention spans in the dispensary, so you need to have an optician like ours, Ben, who is adept at selecting styles that are fashion forward, and appropriate for each child’s prescription. I often have pediatric patients modeling their new styles on my web site and practice Facebook page because they are so happy with their glasses. Ben has such a good rapport with our children patients that some even bring him cards, drawings for the fridge and baked goods. They love him.

A page focused on children’s vision on Dr. Boname’s practice web site.

Make Children Active Participants

I engage children as active participants in their own eyecare. I ask them about their reading and computer habits, and if they are athletic, I discuss protective sports eyewear. For my patients between ages 2-8, I ask them to create refrigerator artwork, which I also post on Montgomery Eye Care’s Facebook page.

Educate Parents and Children on Needed Eyewear & Eye Health

I explain to the parent why it is worth spending extra for lens treatments for the child such as AR and Transitions, and also discuss BluTech lenses for the child who is on the computer a lot, and sports glasses for basketball, baseball, lacrosse and other activities.

When I take retinal photographs, I show them to my pediatric patients, and point out the optic nerves, maculae and retinal vasculature. We discuss potentially “blind eye diseases” like glaucoma and AMD, and how the risks of developing these conditions can be minimized with annual eye exams, good nutrition and exercise, and protective lenses for indoor and outdoor use.

Invest in Child-Friendly Instrumentation

My Nidek AutoRefractor/Keratometer and Non-Contact Tonometer is especially helpful with children patients. It is quick, easy and accurate. Often, in very young children, objective data is the cornerstone of insight into the child’s vision. I also always dilate every child and repeat the auto-refract after their eyes are dilated to evaluate the presence of latent hyperopia.

Related ROB Articles

Children Patients: Engage the Child in the Exam and Build a Family Practice

Children’s Medical Eyecare Services: Turn the Entire Family Into Patients

Children in Contact Lenses: Introduce and Train Young People to Wear Contact Lenses

Mary E. Boname, OD, MS, FAAO, is the owner of Montgomery Eye Care, P.A., in Skillman, NJ. To contact her: mboname@mecnj.com.

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