We’ve all seen those videos where the baby is sitting in her mother’s lap as the optician wraps the hot pink frame strap around her head. The baby usually takes a moment, looks deliberately at her mother, and then erupts in a huge gummy smile. These are the some of the heart-warming moments optometrists remember throughout their careers!
What is InfantSEE?
InfantSEE aims to detect potential vision problems early by providing a one-time, no-cost eye and vision assessment to infants between the ages of six and twelve months (1). This public health program is supported through the American Optometric Association Foundation’s Optometry Cares® program and volunteer optometrists.
Why should I participate?
“Why wasn’t this caught earlier?” These are the words we all hate hearing from our exam chairs, especially if dealing with a preventable form of vision loss. You don’t have to be a pediatric optometrist to do an infant exam. (Really!) Infant eye exams provide an opportunity to detect sight-threatening refractive error, binocular vision disorders, and ocular health concerns early. They also build an understanding of the importance of comprehensive eyecare throughout childhood and beyond.
How can I start?
Become a member of the American Optometric Association. Of course you can still examine infants if you aren’t an AOA member, but professional membership gives you access to official participation in the InfantSEE program.
Sign up to become an InfantSEE provider. You will be asked to sign off on the program requirements. Current students can also pledge their intent to become a provider upon graduation. Once successfully registered, your name and practice information will be provided to parents searching for local providers.
Talk to your patients about their children’s eye care. When a parent mentions that they have a baby, I always ask if he has had a comprehensive eye exam. If not, I will make sure to give InfantSEE informational material. Free promotional material is available by request through the InfantSEE Provider Toolkit. This will help market yourself as an InfantSEE provider to your existing patients and the community. You can request educational leaflets in English and Spanish, posters, and business cards. Infant vision simulator cards are also available and fun to use as demonstrations in the waiting or exam room!
What do I actually do for an infant exam?
InfantSEE specifies five assessment objectives – ocular motility, binocular function, refraction, looking behavior, ocular health. The provided guideline lists rough criteria for classification as a problem, concern, or no concern (1, 2).
After each exam, InfantSEE requires that you submit your assessment results. While patient identifying information is kept anonymous, your encounters will be logged under your account.
Tips for examining infants
Try to schedule infant exams during a time of day when the infant will be alert and content – not during naptime, feeding time, or at the end of the day.
Minimize wait time by having parents fill out paperwork beforehand. InfantSEE provides an optional template questionnaire you can use to obtain a more targeted history.
Gather an assortment of colorful, bright, and noisy toys to keep close at hand during the exam. Infants can become bored quickly, so be prepared to switch toys rapidly and frequently. Consider starting with smaller, less impressive toys and working your way up towards the louder toys with spinning lights.
Most objective testing can be completed with loose prisms, a retinoscope, loose lenses or retinoscopy bars, a penlight, acuity grating cards (Teller Cards, Lea Paddles), and a BIO or ophthalmoscope.
Check to see if your electronic visual acuity chart has video capabilities that can be used as a distance fixation tool. If not, consider placing an automated toy, family member, or staff technician at the end of the room to grab the baby’s attention.
Don’t be afraid to act silly and have fun! While singing “Old McDonald” and making animal sounds may not be appropriate with your older patients, your enthusiastic demonstration will likely prove irresistible for your infant patient. As the baby fixates on your face, you may have just enough time to complete your near testing.
Parents are amazed what you can learn by interacting with their child! Explaining what you are looking for as you move through the exam will allow the parents to differentiate your examination from a basic pediatric screening.
Send a follow-up report to the infant’s pediatrician. This can become an excellent educational opportunity and referral source.
Try to have fun and not get caught up in any one aspect of the examination. Keep moving and stay calm!
Success in examining an infant revolves around flexibility
Optometrists have the opportunity to cultivate a lifetime of healthy vision for our patients starting in infancy. Enjoy the chance to act silly and have fun while saving some vision! Share your experience in the comments below!
- InfantSEE: A Public Health Program For Infants. Helping Infants to Establish a Lifetime of Healthy Vision. Accessed January 2018.
- Optometric Clinical Practice Guideline: Pediatric Eye And Vision Examination. Published March 2002.Accessed January 2018.