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Welcome to the Department of Ophthalmology at Children?s Hospital Boston. Over the past 30 years, we have examined more than 250,000 patients including children with common and rare eye conditions, and many patients of all ages with strabismus (misaligned eyes) or double vision.
David G. Hunter, MD, PhD,
Ophthalmologist-in-Chief
Children's Hospital Boston
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For your first visit, there are several steps to the examination. First, we need to obtain a complete medical history and an initial evaluation which includes testing vision. This may be done by your doctor, an assistant, a resident physician or fellow. At this point, eye drops may be given to dilate the pupils. After a brief wait in the reception area, the doctor will call you back to complete the examination.
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Registration can take 15 minutes. The history and initial examination take about 15 more minutes depending on the complexity of the history and the cooperation of the patient. After the eye drops are given, expect to wait about 30 minutes before being called back to the exam room. The final part of the examination takes another 15 minutes depending on how many questions you have. In case there are any delays, complexities or special tests, you should plan to be here for two to three hours for an initial visit.
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We make every effort to stay on schedule, but there are often days when we fall behind due to emergencies or unexpectedly complex eye problems. We are a worldwide referral center, so we try to build time into the schedule for complex patients, but it is very difficult to plan accurately. You will be notified when you check in if there is a delay. If you have been waiting for more than 15 minutes after check-in and you have not been called, please talk with a member of our front desk team for an update.
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We have many ways to test vision, ranging from low-tech to high-tech. Sometimes we just check to see how well the child tracks a toy. Sometimes we use cards that have stripes on one side and watch to see which way the baby looks. We may also have the child play matching games on a computer. Our professional staff tailors the exam to the interest, ability and age of the patient.
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The doctor shines a light in the eye and looks at the focus of the light that is reflected. The doctor then places different lenses in front of the eye until the focus looks right. Once the proper lens power is determined, the doctor decides whether the patient will need help keeping things in focus. If so, glasses will be prescribed.
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Imagine trying to look into a room through a peephole. It?s not so easy. Now open the door. Much better! The eye drops ?open the door? to allow the doctor to shine light in the eye and see what?s inside without making the pupils small. The eye drops make it hard to focus, especially up close, for 2 to 6 hours, depending on the type of drop and the patient?s sensitivity. Kids can go back to school afterward, but they may have trouble reading or doing homework for several hours. Adults may or may not be able to drive home, depending on how severely their vision is blurred by the drops. If you are not sure, plan to have someone pick you up.
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At least two drops are usually given in each eye. The first is a numbing drop that may sting slightly for 5 to 10 seconds. Then the dilating drops are given. These drops don?t sting at all, thanks to the first drop. Even though the drops don?t really hurt, many children just don?t like the idea and will require gentle restraint for a few seconds while we administer the drops. In some cases, we can use a spray instead of a drop.
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The attending physician is the doctor responsible for your care. You will always see an attending physician during your first visit. This doctor is either an optometrist or a pediatric ophthalmologist. Other supporting staff members may assist the attending physician for parts of the exam.
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- A pediatric ophthalmologist is a medical doctor (MD) specially trained to care for children?s eye conditions and to perform surgery.
- A pediatric optometrist is a doctor of optometry (OD) trained to prescribe contact lenses and glasses to manage non-surgical cases.
- An orthoptist is specially trained to evaluate eye muscle disorders and may measure the eye alignment with prisms.
- A resident is a medical doctor (MD) who is training to become an ophthalmologist.
- A fellow is a fully trained ophthalmologist (MD) who is spending extra time training in pediatric ophthalmology.
- A technician is trained to perform vision testing and other parts of the eye exam.
- Observers are students and doctors who travel here from around the world to see how we care for patients at Children?s Hospital Boston.
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- A responsible adult (due to legal requirements, we cannot evaluate unaccompanied minors)
- Appointment information, including your doctor?s name, department, location and time
- Updated insurance card
- Referral from your Primary Care Physician (PCP) or a $50 deposit
- Your PCP?s name, address and telephone number
- Co-payment (if required by insurance)
- Medical records from your PCP (if available)
- Any glasses worn
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