Ophthalmology | What To Expect During Your Visit To The Eye Doctor

When you come for your eye exam, please bring the following with you:

• A responsible adult (because of legal requirements, we cannot evaluate unaccompanied minors)
• Appointment information: the doctor's name, department, location, and time
• Updated insurance card
• Referral from Primary Care Physician (PCP) if needed, or you may be asked to pay a $50 deposit
• PCP's name, address, and telephone number
• Referring physician's name, address and telephone number
• Co-payment if required by insurance
• Medical records from referring physician, if available

Boston Children's Hospital is a large facility with numerous departments and divisions. The good news is that if your child needs multidisciplinary care, some of the world's best pediatric specialists of every discipline are here under one roof.

However, sometimes figuring out exactly where you need to go can be a challenge. But don't worry. Our department is easy to find. We are located in the Fegan building on the fourth floor.

• When you come into the main entrance to the hospital, go up the flight of steps located on the left side of the lobby.
• Once at the top, go left again past the bookcase display and follow the hallway around, past bathrooms on your left, until you come to the Fegan building elevators.
• Take the elevator to the fourth floor, where you'll find our reception desk.

If you have trouble finding us, visit the information desk in the lobby.

For a new visit, there are several steps to the examination. First, we need to obtain a complete medical history (you will fill out a form to save time) and an initial evaluation that includes testing vision. This may be done by your doctor, by an assistant, or by the resident physician or fellow.

At this point, eye drops may be given to dilate the pupils. After that, the doctor calls you back to complete the examination.

The attending physician is the doctor who is responsible for your care. Other staff members may assist the attending physician for parts of the exam.

A pediatric ophthalmologist is a medical doctor (MD) specially trained to care for children's eye conditions. An ophthalmologist can perform surgery.

An optometrist (OD) is an eye doctor who can prescribe glasses or contact lenses and may refer a patient to an ophthalmologist if additional medical care is needed (i.e. surgery).

A technician is trained to perform vision testing and other parts of the eye exam.

An orthoptist is specially trained to evaluate eye muscle disorders and may measure the eye alignment with prisms or prescribe exercises.

A resident is a medical doctor who will become an ophthalmologist.

A fellow is fully trained as an ophthalmologist but is spending extra time training in the subspecialty of pediatric ophthalmology.

We also have observers (students and doctors) who travel here from around the world to see how we care for patients at Boston Children's. Observers do not perform any part of the examination.

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 is inside without the pupil getting small.

This has a side effect of making it hard to focus — especially up close — for two to six 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. Adult may or may not be able to drive home. It depends on how severely the vision is blurred by the drops. If you are not sure, plan to have someone pick you up.

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 drop or drops are given. These 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 of getting them and may require gentle restraint for a few seconds while we administer the drops. In some cases, we can use a spray instead of a drop, but the spray stings a little more than the drops.

Registration can take 15 minutes. The history and initial evaluation takes about 15 minutes depending on the complexity of the history and cooperation of the patient. Expect to wait about 30 minutes for the drops to work before you will called back to the exam room. The final part of the examination and discussion takes another 15 minutes depending on how many questions you might have. Altogether this is an absolute minimum of one hour for a new patient, but if there are any delays, complexities, or special tests, you might plan to be here for two or even three hours for a first visit.

We make every effort to stay on schedule, but try as we might, there are often days when we fall behind schedule due to emergencies or unexpectedly complex eye problems. We are a worldwide referral center and so we try to build time into the schedule for complex patients but it is very difficult to predict accurately. You should be notified when you check in if there is a delay.

Also, if you find that you have been waiting more than 15 minutes after check-in and you have not yet been called please check with a member of our front desk team for an update.

After the dilating drops are given, the doctor shines a light in the eye and looks at the focus of the light that has been reflected through the eye. 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 needs help keeping things in focus — if so, glasses will be prescribed.

As you will see, we have lots of tricks. 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. Our professional staff tailors the exam for the interest, ability, and age of the patient.