Dr. Alex de Castro and the staff will do our very best to make sure your visit is as efficient as possible.

Every visit starts with taking a good history, checking the visual function, vision and eye alignment. New patients should expect to have a dilated eye exam as this is the best way to examine the internal structures of the eye and to best measure if there is any needed treatment for farsightedness, nearsightedness and/or astigmatism. Dilated requires drops to be placed into the eyes and about 20-40 minutes for the drops to take effect

Dilation drops allow the dilation of the pupils which can sometimes last as long as a day, however the blurriness and or light sensitivity from the drops usually lasts 2-6 hours.

If dilation is required, expect the visit to last at least 90 minutes. If dilation is not required, the visit should be less than an hour. However, we can never predict the complexity of patients, unexpected emergencies and other possible delays that can sometimes result in longer visits for our patients. Know that Dr. de Castro and the team will give each patient and their family the time, care and expertise that their individual circumstance require.

Dr. de Castro knows that some children and/or patients do not want their eyes dilated and that drops to the eyes can cause anxiety for others. Dilation of the pupils (the back circle in the center of the colored part of the eye) is an essential part of the examination to ensure the healthy internal structure of the eye and to adequately check patients for their need, if any, for glasses.

Without dilation, some eye diseases and abnormalities cannot be diagnosed or seen. Some unseen vision-threatening, and although rare, life-threatening conditions can only be diagnosed after dilation of the pupils.

Dilation is performed by placing one or more drops into the eyes. The drops relax the iris (colored part of the eye) muscle as well as the muscle that helps the eye focus, especially up close. Children have a large amount of focusing power in their young eyes and without relaxing this power with the drops, it will be difficult to accurately measure and prescribe glasses for them. The drops take about 20-40 mins to work on making the pupil large enough to see the internal structures and relax the focusing power of the eye.

Younger children have stronger focusing ability than older children and adults. Therefore, a longer acting drops is needed for the youngest of children. The blurriness from the drops usually wears off in 4-10 hours depending on the drops used and each patient’s response to the drop. The size of the pupil can sometimes last even longer than the blurriness, usually up to about a day, but rarely longer than that. Lighter colored eyes tend to stay dilated longer.

Children can go to school dilated but may have trouble with some light sensitivity or blurriness especially with things up close. We will provide tinted temporary glasses to block bright sun and bright lights. If the child is not bothered by the bright light, it is ok for them to forgo wearing the glasses, the lights and or sun will not cause damage to the eyes. The tinted glasses are for comfort. Some children will not feel comfortable playing sports after dilated but this is usually decided by the children and parents of the child.

This topic is quite complex but our office and team will work with you to help you understand. Vision insurance is designed to cover routine eye exams, glasses and sometimes contact lenses. Dr. de Castro is an expert in the medical and surgical ophthalmologic conditions of children and adults with strabismus (eye misalignment). Some children are referred for trouble seeing, failed vision screening and/or suspected vision problems. In most cases, the child will meet criteria to be covered under a medical diagnosis that is covered by medical insurance for the office visit. Some of these patients will only need glasses which may not be covered by medical insurance. Given the mission to identify and treat medical conditions, Dr. de Castro and Pediatric Eye Care do not participate in any vision plan insurance.

A refraction is the specialized testing done by Dr. de Castro to determine if a child has treatable refractive errors (nearsightedness or myopia, farsightedness or hyperopia, and astigmatism or a curvature of the cornea) that sometimes require correction with glasses or contacts.

A refraction can be done in a few different ways. In younger and pre-verbal children, Dr. de Castro will perform retinoscopy, using a light and lenses to determine the objective need for glasses of each eye. In older children and adults, Dr. de Castro may perform retinoscopy as well as the traditional “better one or better two” method to determine the need for glasses.

Similar to a refraction, the sensorimotor exam is a specialized test performed by Dr. de Castro in the assessment of patients vision and ocular alignment. Although adults with strabismus may cause double vision, children can adapt and not develop double vision or other vision related problems until later when it may be too late to address and treat the conditions.

Regardless of how a refraction is done, refractions are often not covered by medical insurance plans and therefore Pediatric Eye Care will charge for this specialized testing. The fee is charged regardless of whether a prescription of glasses is dispensed as refraction is a vital component of the care that Dr. de Castro gives. The sensorimotor exam is often covered by insurance however, dependent on the plan and deductible, the insured may be responsible for the fee. To assure a comprehensive evaluation of your child’s eyes, Dr. de Castro will perform these services as part of the comprehensive assessment of a new patient. If there are any questions, please do not hesitate to ask Dr. de Castro or his staff.