Ophthalmologist 

Many children with hearing loss rely more heavily on their vision to communicate and learn about their world, however, children with hearing loss often have vision problems. An ophthalmologist is a medical doctor (MD will follow the person’s name) who diagnoses and treats eye diseases and can perform surgery. They also can prescribe eyeglasses or contact lenses for children. Some ophthalmologists specialize in working with people with low vision to help them maximize their use of sight, but most do not.

It’s also important to know that an ophthalmologist may or may not be a specialist in working with children.  Many ophthalmologists specialize in one aspect of eye diseases – retinal diseases, for example.  You’ll find in general that ophthalmologists vary considerably in their approach with children, especially those with multiple disabilities.  Examining and working with children often involves considerations different from those involved in working with adults.  A professional experienced in working with children knows how to communicate at their level, respond to a child’s emotions and behavior, and is attuned to the way in which children may indicate what they can, in fact, see.

The role of the ophthalmologist is to assess for the presence of syndromic visual loss associated with hearing loss, such as Usher Syndrome.  Evaluation for more common types of visual impairment including refractive error is essential for children who will likely be strong visual learners.  It is recommended that all children with hearing loss have a complete ophthalmologic examination on an annual basis.

Special consideration should be given to children with the following diagnoses:

  • Symptomatic congenital cytomegalovirus (CMV)
  • Down Syndrome (at 6 months and then annually)
  • Very low birth weight (until deemed unwarranted by the Ophthalmologist)
  • Usher Syndrome

Your observations of your child are important. When visiting a doctor’s office, it’s not unusual for parents and children to feel tense and anxious coming to an exam.  You can help everyone, including your doctor, by giving a clear, concise picture of how your child functions visually and what your observations and concerns might be.

For example:

  • What do you think your child can see?
  • What seems to attract his/her attention?
  • Can he/she control his/her head, or does it wobble, or tilt?
  • Is he/she sensitive to light or does he/she stare at it?
  • Does he/she rub or poke at his/her eyes?
  • Does he/she reach for toys – in front or toward one side or the other?

Providing this kind of information, based on your day-to-day observation of how your child behaves, will help your ophthalmologist evaluate your child.  Be sure to tell your doctor about any other health or disability conditions, allergies, and any medications that may have been prescribed by your pediatrician.  Also, if you have any additional medical or other relevant records, be sure to share them with your ophthalmologist.

 

line drawing of ophthalmologist

Questions to ask your ophthalmologist:

  1. What kind of vision loss does my child have?
  2. What caused my child’s vision loss? Was he/she born with it?
  3. What is the prognosis? Is my child’s vision loss stable? Will it get better? Will it get worse?
  4. Is there any treatment for the condition?
  5. Will eyeglasses or contact lenses help?
  6. Can you tell how much my child can see?
  7. What kind of lighting is best for my child?
  8. Are there any restrictions on my child’s activities?
(Adapted from Family Connect.  Working with Medical Professionals Toolkit. http://www.familyconnect.org/PDFs/Eye_Care_Professionals_English.pdf)