Doctor Patient Relations

Have These 3 Conversations with Parents to Grow Your Practice

Dr. Aworunse with her nephew. Dr. Aworunse says a few key conversations can change parents’ perspective for the better on the value of eyecare, and enable and OD to better care for young patients and grow their practice.

By Feyi Aworunse, OD, FAAO

August 17, 2022

Engaging parents about children’s vision and eye health can increase awareness about pediatric eye exams and create the opportunity to grow your patient base. This is especially true if your current patients do not realize that your scope of practice includes caring for children. Being in a practice that serves a primarily adult population, these conversations have been vital to increasing my pediatric patient base.

In my practice, we ask our patients about their families as part of the intake discussion. We ask if they have children, and if so, how many and their ages. In some instances, a parent or other family member will have a young child with them during the exam. This is also an opportunity to engage with the child during the visit and also ask the parent about any concerns they have about their child’s vision.

If these questions are not built into your current intake protocol, having posters or information available to patients may prompt a discussion about children’s vision and eye health and the importance of pediatric examinations.

Here are three essential conversations to have with parents to safeguard their children’s vision and eye health, and grow your practice.

The Importance of Comprehensive Eye Exams
This topic is the crux of the matter in children’s vision and eye health. Parents observe the rapid development of a child from birth to adolescence, yet vision and eye health are often overlooked. It has been widely reported that up to 80 percent of learning is visual. Furthermore, many ocular and visual conditions hinder proper development and are often missed during vision screenings. Knowing this, being proactive about making sure children have eye and vision issues identified and corrected, sets a solid foundation for success in and out of the classroom.

Conversation starter
“Have your children had their eyes examined before?”

● Parent responds: “My child gets their eyes/vision checked at the pediatrician’s office or school screening”
○ Emphasize the difference between vision screenings and comprehensive exams.
○ “Vision screenings provide limited information about your child’s vision and eye health and the pass/fail thresholds may give a false sense of normal development. A child who passes a vision screening can still have a vision problem relating to eye focusing, eye tracking and eye coordination.”
○ “A comprehensive exam performed by an optometrist evaluates the entire visual system and ocular health of the child. If we diagnose a problem, we are trained and equipped to properly manage these issues or refer the child for specialty care.”

  • Parent asks: “Are they old enough for an exam? When is a good age for my child to be seen for an exam?”
    ○ The American Optometric Association’s Evidence-Based Clinical Practice Guideline recommends the following exam interval:
    ■ “Infants should receive an in-person comprehensive eye and vision assessment between 6 and 12 months of age”
    ■ “Preschool age children should receive an in-person comprehensive eye and vision examination at least once between the ages of 3 and 5.”
    ■ “School-age children should receive an in-person comprehensive eye and vision examination annually.”
  • Parent responds: “My child sees child doesn’t complain about their eyes or vision.”
    ○ Doctor: “Your child may not be able to see well, even if you think they can. Children may not say outright, ‘I can’t see’ – because that is what’s ‘normal’ for them.”
  • Parent asks: “Is my child covered to receive an eye exam?”
    ○ Doctor: “Under the Affordable Care Act, pediatric vision care is considered one of the essential health benefits and is covered through eligible insurance plans. The eye exam and, in some cases, corrective lenses are covered.”

What’s at Stake for Children: Without early detection and treatment, uncorrected vision disorders can impair child development, interfere with learning, and even lead to permanent vision loss.

  • Provide information about: risk factors for children – history of family disease, complications at birth and impact on the child’s development. This can be discussed at the parent’s examination while discussing their personal health and family history. Family history is typically reported to include immediate family members, but children are often an afterthought. Remember that their family history can impact younger generations.
  • Parents who have a significant degree of refractive error (myopia, for example) tend to be concerned about the potential of their child having similar issues. By informing them of the options available to improve vision or slow the progression of myopia, they are more likely to follow through with an examination.

Child & Teen Safety & Visual Hygiene
Each year thousands of children sustain eye damage, or even blindness, from accidents at home (toys, chemicals, household products, etc.) and accidents while engaged in sports or recreational activities. The majority of injuries could be prevented with the use of proper safety precautions, such as protective eyewear.

Conversation starter
“Does your child or teen play any sports? What are their favorite activities or hobbies?”

● For the child who plays sports, helps with outdoor chores, etc., highlight the importance of wearing protective eyewear to prevent injury and sunglasses for UV protection.
○ Instruct parents to ensure toys are age-appropriate; toys or objects with projectile or sharp components should be used with extreme caution and under adult supervision.

  • More than ever, digital devices are accessible to children to be used for school and play. Children and teens spend significant time looking at smartphones, tablets, video games and computers.
    ○ Discuss the importance of visual hygiene, including reading with good posture, using good lighting and taking frequent short breaks during reading or any other close-vision activity. These measures are considered helpful in preventing or reducing the progression of myopia, particularly in children.

What’s at stake for children related to this conversation?
● Prevent irreversible vision impairment in children due to injury
● The risk of eye injury is still prevalent into adulthood. Instilling these habits early increases the likelihood of continuing them over a lifetime.

Behavior & Academic Performance
Vision can impact a child’s behavior and performance. Observations about the child can give us insight into whether they have a visual challenge. Often, children won’t realize their difficulties until they reach school-age and are unable to keep up with their peers.

Conversation starter
● “How is your child doing in school? Do they have behavioral issues? Are they extremely shy/reserved or tend to act out?”

  • If the child is present with them, you may gain insight into this by observing their behavior.
  • Ask the parent if they observe excessive eye rubbing, head turns, difficulty concentrating, complaints about reading or aversion to completing certain tasks.

● Parent responds: “My child is doing well in school.”
○ As the doctor, inform the parent about ways to enhance performance or support continued success
○ Emphasize the importance of visual hygiene and the need for comprehensive exams.
○ Encourage the parent to ensure the child has the opportunity to voice any difficulties they may have, since children can mask or adapt to some underlying issues. Good behavior and performance do not qualify as normal vision or the absence of ocular disease.

  • Parent responds: “My child seems to be struggling or my child has behavioral issues.”
    ○ Discuss the need for evaluation by an eyecare provider to determine if there are issues such as uncorrected refractive error or binocular vision disorders.
    ○ If a problem is found and addressed, this may improve the child’s confidence, academic performance and behavior.

What’s at stake for children related to this conversation?
Many vision disorders may go undetected or may be misdiagnosed as a learning disability or behavioral problem. This can impact an individual beyond childhood, potentially affecting their social interactions, as well as educational and employment opportunities.

Practice growth opportunities: Additional Actions to Take
● Consider implementing and advertising clinical services and programs such as InfantSEE, myopia control, vision therapy, or building a referral network for such. Even if you do not choose to see pediatric patients or offer specialized services, it is still imperative that we educate parents on this important public health topic and be a trusted source of information.
○ InfantSEE is a public health program managed by the Optometry Cares – The AOA Foundation. It aims to ensure that eye and vision care is an integral part of infant care to improve a child’s quality of life. Through this program, AOA member optometrists provide a free, comprehensive eye and vision assessment for babies 6-12 months of age, regardless of family income or access to insurance.

  • Expand optical offerings to include children’s ophthalmic frames and sunglasses
  • If time is limited to discuss these topics in-office, consider creating informational material to have on display in your office, or feature this topic on social media or your practice website.

By proactively engaging with the parent about their children, they may be more likely to bring their child for an examination based on the interest you have shown in their child’s well-being. Parents and guardians serve as the advocate for the child, especially in health and wellness. It’s imperative to equip parents and caregivers with this information, so they can be empowered to act in the best interest of the child(ren).

Feyi Aworunse, OD, FAAO, practices at the Eye Clinic at Nashville General Hospital at Meharry. To contact her:



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