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The Glaucoma Foundation




Preparing Your Child for an Eye Exam

“How can I get my preschooler prepared for his/her first eye exam?”

 Here are a few tips we hope will help reduce the anxiety factor for parents and children alike.

 

  1. Schedule eye appointments for young children when they are well rested – usually in the morning – and after they have been fed. Do not schedule the child’s appointment during the usual naptime. An alert child will allow the doctor to get more reliable information.
  2. Try to complete required paperwork at home and sent to the doctor’s office ahead of time or bring along to the appointment so you don’t have to do that in the waiting room.
  3. Talk to your child. Tell your child a little of what to expect, that he or she will be looking at pictures, letters and numbers, and talking to the doctor, and that the doctor will be shining lights to see into their eyes. Let your child know that the doctor will not use needles.
  4. Prepare the child for the possibility of eye drops. At home you can practice putting drops into your child’s eye, and yours as well, using a small bottle of artificial tears. Then the real thing won’t be a total surprise.
  5. Bring along your child’s favorite toy or snack in case there is waiting time.
  6. Bring your children together for their yearly eye exam. This helps kids become comfortable easily when they learn how to do the tests from their siblings.

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 LIVING WITH GLAUCOMA
A Family Affair

 

The Delaney’s are a poster family for communicating the importance of getting one’s eyes tested, and taking the lead in doing it right. Diane Delaney was diagnosed last year as a glaucoma suspect. Her mother-in-law’s glaucoma is stable after 30 years and her father was recently diagnosed with the disease. Now, her pre-teen daughter has been diagnosed with Axenfeld-Rieger syndrome, a genetic disorder characterized by abnormalities of the front part of the eye. About half of affected individuals develop glaucoma. And the chance of passing on the disease is also 50 percent.

It was Diane’s perseverance that led to her daughter’s diagnosis. The 11-year-old, who wears eye glasses, had her pressure (IOP) taken at her optician when her vision was checked. Her IOP was 18, which Diane wasn’t sure was low enough. Given the family history she decided to seek out an expert in pediatric glaucoma and ocular genetics in Philadelphia. He made the important diagnosis.

The Delaney’s experience underscores some key messages.  One is that a vision screening is not a comprehensive eye exam. Measuring eye pressure doesn’t tell the whole story. A comprehensive exam should include dilating the eyes with drops to enlarge the pupils so that the doctor can get a better view of the structures in the back of the eye, such as the retina and optic nerve head.

The second is that family really matters. While not all glaucomas are hereditary, family history is a strong risk factor. If you have a family history with glaucoma, or if you have been diagnosed with glaucoma, everyone in the family – from children on up – should be sure to get regular eye exams. Before starting school is the general wisdom for a dilated eye exam where children are concerned, unless parents notice possible problems such as misalignment of eyes or sitting too close to the TV or a cloudy cornea.

Diane Delaney wishes more pediatricians and primary care physicians, and ophthalmologists too would spread the word. “We need to work together to ‘get the word out’ about glaucoma…it’s not about the eye pressure (IOP) or age, it’s about optic nerve damage and obtaining a comprehensive eye exam and appropriate tests to diagnose glaucoma soon enough to prevent vision loss.”

 



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Doctor, I Have a Question
 
Question answered by:


 
Robert Ritch, MD.
Founder, Medical Director, & Scientific Advisory Board Chair of TGF
 
How is exfoliation glaucoma treated?


Traditional IOP-lowering medications, while less effective in exfoliation glaucoma than in POAG, are used frequently as first-line therapy. Pilocarpine 2%, long regarded as a drug which needed to be taken 4 times a day, can be used once a day at bedtime and this suffices to both increase the rate of fluid outflow through the drain of the eye and also to inhibit the pupil from constricting and dilating in response to external light conditions, thus preventing rubbing of the iris over the lens (the major cause of pigment release from the iris) and reducing the rate of progression of the disease. The next line of therapy often is laser trabeculoplasty (ALT).
 
Most studies have shown good responses to ALT. But once laser trabeculoplasty starts to wear off, patients with exfoliation glaucoma tend to demonstrate a more rapid IOP increase than POAG patients. This increase is also inhibited if the eye is maintained on 2% pilocarpine after the laser treatment.  If medications and laser treatment do not control IOP adequately, traditional surgery, trabeculectomy, may be performed.

 


 

The Temperature’s Rising – It’s Time for a Swim
 

Maintaining an active lifestyle with a routine of exercise is a good prescription for anyone, including people with glaucoma. And swimming can be a good choice. But before embarking on any new exercise, always discuss the pros and cons with your doctors.

When swimming, large googles that don’t press too hard on the orbit of the eye are  recommended. That’s especially important after trabeculectomy surgery. The surgeon will restrict patients from strenuous activity, such as swimming, usually for at least several weeks. After that, a gradual resumption of some activities may be permitted. Talk to your doctor about when you can start swimming after your surgery.Take care to wear wrap-around goggles as infection in post trabeculectomy eyes can be serious. It’s best to stick with sea water or a pool – fresh lake water has more infectious capabilities. If you suspect the water quality, don’t take a chance. Let caution be the rule.  And remember to avoid small tight swim goggles, especially after surgery. They can really mess up your blebs, elevate your IOP considerably and affect blood flow to the eyes. Select goggles that don’t rest on the eyeball, but rather press on the orbital bones.       
 


 

 
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