Welcome to our practice! Your child’s first appointment with us will likely constitute a complete medical eye exam, usually for some sort of ocular complaint (can’t see well, bump on the eye, something in the eye, eyes crossing or drifting, eyes itchy or red or gunky, etc.) Many of our patients have never had an eye exam so most of them will need to be dilated, since that is the only way to officially and reliably determine a child’s refractive status (i.e. whether they have significant farsightedness / nearsightedness / astigmatism). Unlike adults, kids have a unique ability to over-squint, over-accommodate, and overpower the eye exam, thus giving misleading and inaccurate results. Hence, the reason that most children are dilated on their first eye exam, and annually thereafter.
Scheduling Your Visit
Your visit to our office will be most productive if you specify the relative urgency for your appointment. Some visits may be urgent, though many may not be (such as a pre-planned scheduled follow up). We make every effort to accommodate the needs of all patients, as well as our referring pediatricians and school nurses, and we attempt to keep waiting periods for appointments to a minimum. During summer months and school breaks, our schedule fills early and is busy. We try to make ourselves hyper-available, but last-minute, non-urgent matters may have to wait a bit from a scheduling standpoint during those times. Getting an appointment with any pediatric doctor during the summer when kids are out of school is like trying to get a ticket to the Super Bowl. These summer appointments disappear quickly! Also, we do try to triage emergency phone calls that need to be seen urgently that day, though this can cause a bit of an unexpected backup at your pre-planned appointment time. We apologize for this inevitable situation, but please know that if your child one day needs to be seen fairly urgently, we will return the favor: we will work them into our full schedule if we are able. Emergencies just happen, sooner or later to all of us, so we will all be on both sides of “having to unexpectedly wait a bit.”
When calling to schedule your appointment, please have all your information ready, including birth dates, SSN, Health Insurance card/info (medical insurance, since we do not participate with vision insurance plans), PCP/pediatricians name, and a calendar to mark the date/time. We will do our best to send a reminder text a day or so prior to the scheduled appointment.
If you have any old records from a previous eye provider, please call your former provider and ask for THEIR “records release form.” which allows THEM to release records to US. Sign THEIR form and fax it to US (call us first to let us know to expect it. Then, we can chase down your previous records for you on your behalf. Otherwise, you may think your previous eyecare doc has sent records, but they maybe got distracted and never did. The number of times patients expect us to have received their records, but we never have, is high. We are a small office, we rarely lose records here. Feel free to call us (540-681-1211) to verify that we have received your old records a day or two before your visit with us.
If you wear contact lenses, PLEASE BRING YOUR CONTACT LENS BOXES (even if they are empty) BECAUSE THERE IS VITAL RX INFO WRITTEN ON THE BOXES / FOIL PACKS!!!. It is a huge time saver if the child/parent knows the exact brand and model of contact lens worn, as well as the base curve and diameter. Just like there are about 15 different models of Honda cars sold (Civic, Accord, CRV, HRV, Pilot, Odyssey, etc.) each contact lens manufacturer (Alcon, Cooper, Bausch + Lomb…) also has about 15-20 different models of contacts they each make. Hence why we need to know the brand of contact lens you wear AND the model (for example Alcon “Daily Aqua Comfort Plus” or Alcon “Air Optix” or Cooper “Biofinity” or Cooper “MyDay” or Cooper “Clariti” or Bausch+Lomb (B+L) “Ultra” or B+L “Biotrue” or B+L “Soflens” of B+L “Biofinity,” etc) AS WELL AS the power (# sphere, # cyl-cylinder astigmatism, # axis of cylinder). PLEASE REMEMBER that contact lenses have a brand name/model (which determines the shape) and a power. We need to know all of that to refill a contact lens rx or refit you into something different if you are unhappy with your current lens. Contact lenses DO NOT have any imprinting on the individual lenses that let us know what you are wearing, but the foil packs/boxes do, SO BRING the boxes/or foil packs!!
Insurance Issues
To help make your appointment with us go as smoothly as possible, please note that some common insurance companies may require referrals. This list includes Aetna, many medicaid plans, TriCare Prime, among others. Please have a valid referral with a medical diagnosis (reason for referral) faxed to our office before your appointment. Our fax number is (540) 681-1544. You will get a reminder call from our office prior to your appointment. If we have not received a referral you may re-schedule your appointment or self-pay with a credit card, debit card, check or cash at the time of your visit. If you have any questions regarding referrals, please call our office. It is often a good idea to check with your insurance carrier as well. Note that insurance carriers will look for any chance to deny your benefits, and they definitely will NOT grant you a referral AFTER your appointment, so referrals need to be received by our office before your visit if you want the chance of your pre-determined insurance benefits to kick in for your visit.
If you are planning on driving yourself to your own examination, you may want to bring someone with you to drive you home since your vision will be blurred and sensitive to the sunlight.
Eye Dilation
Let’s face it, nobody enjoys having their eyes dilated. Adults don’t like the near blur, and children hate and fear the entire notion of eyedrops, especially dilating drops that sting a little. So why do it?
For our pediatric patients, a dilated (cycloplegic) exam is the ONLY official way to determine their true refractive status (how much true near/farsightedness and astigmatism they have). Why? Because young people have an amazing ability to accommodate / squint / overfocus. These can be good mechanisms out in the real world, but totally mess up an eye exam and determination of their eye’s power. Dilation takes that ability away briefly so we can get a true read of their refractive status. Furthermore, dilating the pupil makes it easier to see more of the retina in the back of the eye. It’s like trying to take a look inside a room where the door is just cracked ajar a little, versus taking a look in the same room when the door is wide open. We do NOT dilate on every visit, so not to worry, and we try to minimize how much we do it (putting eyedrops in children is no fun for us, either!). But, sometimes, particularly for NEW patient visits, recent eye trauma (eg baseball to the eye), annual return visits if it looks like there has been a big refractive change (or kid body-size change), or vision getting worse…these are all reasons that we will strongly consider dilating on your child’s visit. Most follow up appointments won’t require dilation, unless it has been over a year or two. Yes, we allow bargaining “can we do it next time?” if we are able to. We understand kids and parents have busy schedules, or you weren’t ready to have dilation today (though new patients should pretty much all expect to be dilated on the first visit). We aim to be very flexible, while trying to stay within the gold standard of good eye care, which has definite recommendations on when dilation should occur.
Most kids and adults stay dilated for approximately 2-4 hours, with lighter eyes (blue and green) usually staying dilated longer. Some rare kids are still dilated well into the day, but rest assured, the dilation effect WILL wear off. While each child is different and each parenting style is different, I have yet to ever run into a child who was happy they were “prepared” for the drops, or a situation that being told about the drops before they arrived made kids any more cooperative, as usually this approach makes the child apprehensive for the entire visit. But that is up to your discretion as the parent. Just like hospitals and IV’s, and driving and driver’s licenses, sometimes eye drops just have to happen. About 90 % of kids tolerate eye drops with minimal fuss. About 10 % go ballistic. Dr. Pav puts all his own eyedrops in each patient when warranted, and while he’s a pretty gentle guy, they still sting a little. Not gonna lie. We will all get through it together!
Taking an important school exam within a few hours of dilation is likely not a great plan for success, so we always give students an excuse for school saying they’ve been dilated. It's a good idea to plan ahead, though, to avoid appointment times during known midterms / finals / Virginia state assessments / SAT / ACT/ or tonight’s big game. You may want to bring a pair of sunglasses for your child to wear after dilation. If you are one of our adult strabismus patients, you might consider bringing someone to drive you home afterward (definitely bring sunglasses), though in adults we can usually use “less strong” dilating drops and most adults are able to drive home safely with only some mild blur. We will leave that up to your discretion.
Children & Vision
Many people are confused about the importance of eyeglasses for children. Learn the truths and myths here.
Kids Eye Doctors In Fredericksburg, VA
Pediatric Eye Doctors Opthalmology Stabismus Adult Kids Doctor Adult Eye Pedatric Pediatric Opthamology Eyedoctor eye doctor Eye Pediatric Ophthalmology Pediatric Eye Doctor Doctor Strabismus Strabismus Custom Website Design
