Summer 2012

Child-Friendly Visual Center Make Exams More Effective

"The developmental ages between 0 and 6 are a sensitive period for vision. If the brain doesn't learn how to see then, there can be permanent damage, including blindness," says ophthalmologist Tina Rutar, M.D., director of the UCSF Visual Center for the Child.

Dr. Tina Rutar

Dr. Tina Rutar

These high stakes are compounded by the difficulty of performing a thorough exam on an infant or toddler. To address this, a specialty center like the UCSF Visual Center for the Child brings together expert, child-friendly ophthalmologists with a facility tailored to the needs of children and families.

"We are lucky to have this unique space," Rutar says.

Better Diagnosis, More Tailored Treatment

One thing such a center fosters is a more thorough exam. "When we examine young children in a nonthreatening way, we get information we might not get otherwise," Rutar says.

It begins in the waiting room. Amid the murals and toys that encourage children to climb down from the safety of their parents' laps, Rutar can begin checking for warning signs like a tilted head or squinting eyes.

UCSF Visual Center for the Child

Once in the exam room, a shy 3-year-old might refuse to talk, but the light-up, musical toys or the challenge of matching shapes can get the child visually engaged. Or a video might capture a child's attention long enough for Rutar to use a cordless, indirect ophthalmoscope to look at the retina and optic nerve.

In situations where a child is suspected of having a rare disease of the eye, physicians at the center have access to advanced imaging tools to complete their diagnosis.

UCSF Visual Center for the Child

The result is more precise, effective treatment, such as when a child needs surgery for outward drift of the eyes. "We need accurate measurements of the magnitude of drift, so we can tailor the procedure," Rutar says. When exams are less comprehensive — or conducted under trying conditions, such as when children have to be held down by force — the measurements are compromised.

When to Refer

Rutar notes that pediatricians do a good job with standard screening at appropriate age intervals, from checking the red reflex in newborns to a full assessment at age 3. Any failed vision screening exam in either eye is reason for a referral to an ophthalmologist.

Given the stakes described above for children between the developmental ages of 0 and 6, pediatricians should refer to a specialty clinic like the UCSF Visual Center for the Child for the following conditions:

  • Abnormal red reflex
  • Amblyopia
  • Blocked tear ducts in patients 12 months or older
  • Congenital cataracts and other congenital disorders of the eyes
  • Nystagmus in an infant
  • Retinopathy of prematurity (abnormal blood vessel development in the retina of the eye in a premature infant)
  • Strabismus
  • Trauma to the eyes

For more information, contact Dr. Tina Rutar at (415) 514-1502.

 

Summer 2012 Table of Contents

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