Our practice provides both comprehensive and specialty eye care services for patients of all ages, including the pediatric and geriatric population.
Our commitment to provide the best care possible includes routine use of diagnostic pharmaceuticals (pupil dilation), state of the art examination instrumentation, and allowing ample time (30 to 40 minutes) for thorough evaluation.
The Canadian Association of Optometrists recommends an initial comprehensive eye exam at the age of six months ... that's right, six months. At that time, your optometrist will objectively assess your child (no input required) for a high or unequal prescription, eye misalignment, or eye health abnormality that can interfere with normal visual development, a process that isn't complete until six or eight years of age. In fact, amblyopia, or "lazy eye", is the most common cause of preventable vision loss in young adults. It's likely that your child's pupils will be dilated with a kid-friendly, non-preserved drop, giving your optometrist the best opportunity to detect abnormalities. The importance of the infant eye exam is emphasized by its inclusion on the Region of Waterloo Well Baby Checklist.
Curious about what happens during an eye exam for an infant? Click here to see for yourself.
Assuming that your child's infant exam goes well, follow-up will usually be scheduled at around three years of age. By thisage, most kids are able to participate in the games that make this exam fun. Assessing prescription, eye coordination, depth perception, colour vision, and eye health all help ensure that your little one has the visual ability to be ready for school. As many as one in ten preschoolers can have an eye or vision problem significant enough to impact learning; however, signs or symptoms may be subtle, or more often than not, absent altogether.
JK and Kindergarten Exams
Around the age of five, your child can give even more subjective input, allowing your optometrist to fine-tune some of the earlier testing. Distance visual acuity, reading ability, and eye coordination are particularly important as school begins in earnest, and eye health assessment is essential for patients of all ages.
If you'd like to preview an exam of a 5-year old, please click here.
It's critical that parents recognize the difference between a vision screening and a comprehensive eye exam. Screenings, often performed by lay volunteers with the best of intentions, often miss kids with vision problems, giving parents a false sense of security, and delaying diagnosis and treatment. In Ontario, OHIP insures eye examinations until the age of 20, and the Eye See ... Eye Learn program covers the cost of eyeglasses for eligible children. There's no reason that your child should't see the optometrist early and often.
Click here to watch Dr. Karen MacDonald chat with Global News about the importance of routine eye care for children.
Visual Perceptual Assessment
Visual perception is the ability to make sense of what we see, and is particularly important in learning critical skills including reading, writing, drawing, and solving puzzles. Kids who are struggling in school may have excellent vision, but poor visual perception. Following a comprehensive exam to identify any refractive (prescription), eye coordination, or eye health concerns, your optometrist may recommend an assessment of sensory processing, visual memory, visual spatial relationships, and other visual perception skills. If necessary, remediation training may help your child learn more effectively. However, don't put the cart before the horse: VP testing should always follow, and never be considered without a full eye exam.
For some patients, glasses may be inconvenient, impractical, or simply unwanted.
Contact lenses are now available for the majority of prescriptions: near- and farsightedness, astigmatism, and yes, even for those who need reading glasses. Silicone hydrogel materials (on which Karen MacDonald authored the first published paper) have revolutionized lens wear, increasing permeability (oxygen transmission) while retaining moisture, allowing for excellent comfort and vision.
Specialty lenses, including rigid gas permeable scleral designs, are employed for patients with corneal irregularity due to injury, surgery, dystrophy or degeneration, or for those with extreme dry eye.
If you're interested, ask your optometrist if you're a candidate for contact lens wear: we recognize the importance of good comfort and sharp vision, and we'll work with you to find a lens that works for you.
Laser Vision Correction
We are very experienced in providing Laser Vision Correction assessment and co-management. While we commonly work with TLC at the University of Waterloo School of Optometry and Vision Science, we work for you, advocating on your behalf and doing our best to ensure that your surgical result meets your needs and expectations.
Imaging and Special Testing
Automated Visual Field (AVF) Testing: maps the peripheral (side) vision, and is a critical component of diagnosing and monitoring any neurologic defect or disease affecting the optic nerve, most commonly glaucoma. AVF analysis is an OHIP-insured service for patients 19 and under, 65 and over, and for adults with a medical condition (such as diabetes)qualifying them for OHIP coverage.
Digital Retinal Imaging: photography provides a high-resolution digital image that is of great value in diagnosing and monitoring diseases of the retina and optic nerve including diabetes, age-related macular degeneration (AMD; see above left), and glaucoma. Photography is not an OHIP-insured procedure for any patient of any age: we recommend baseline imaging for all adults, and thereafter as clinically indicated.
Fundus Autofluorescence: is a specialized photographic technique that identifies areas of distressed retinal tissue, helping in the care of patients with degenerative retinal disease, most commonly AMD (see above right).
Optical Coherence Tomography (OCT): provides a non-invasive and high-resolution cross-sectional image ... think of OCT as an optical ultrasound. It has become invaluable in the diagnosis and management of a number of retinal and optic nerve diseases including glaucoma, AMD (see above), diabetic retinopathy, and others. Like photography, OCT is not an OHIP-insured service for any patient of any age; as such, we recommend it only when clinically indicated.