Office Policies

Babies and young children will come to the doctor's attention early on if they have obvious problems such as strabismus, blocked tear ducts or eyelid lesions, absent red reflexes, prematurity or genetic disorders. If there is a strong family history of strabismus or amblyopia (blindness in one eye), early examinations before 18 months of age are recommended even if no abnormalities of the eyes are detected. Otherwise the recommendation by the American Academy of Ophthalmology and the American Academy of Pediatrics is that all children should be "screened" at three years of age. A reliably performed preschool screening test or the reading of an age appropriate eye chart at your pediatrician's office may be sufficient. It is critical that the eyes be tested separately. If there are any doubts about your child's response to the screening test or if your child fails vision screening for any reason, you should schedule an appointment with a pediatric ophthalmologist right away.

We do not charge for missed appointments. We understand that children get sick suddenly and that people change their minds about seeking care here. However, we request that you leave us a message as soon as you know you cannot keep the appointment even if it is the same day. We will gladly reschedule your appointment in a timely fashion when you call us.

Large pupils are necessary for the ophthalmologist to properly examine the retina which lines the inner eye. Dilating drops prevent the pupils from constricting when lights from the ophthalmic instruments are shined in the eyes. Another effect of the eye drops is to relax the eye's focusing muscle which is located behind the iris. This allows for a more accurate measurement (refraction) of your child's eye glasses prescription or to rule out the need for glasses. Note that this "defocusing" of the eyes for refraction is usually not necessary in adult patients.

The pupils can stay enlarged for up to two days, however, the norm is 24 hours. During this time your child may be light sensitive. Indoor activities, baseball caps or sunglasses may provide comfort. Blurred vision from the dilating drops generally lasts about eight hours. The extent of the blurred vision is variable depending on your child's type of eyesight. Please note that baseline vision returns more rapidly than pupil size. In other words, if your child's eyes are still dilated the next day, he or she is visually stable and can attend school.

There are two types of appointments: dilated examinations and rechecks. All new pediatric patients and those coming in for yearly follow-up will undergo a full examination with dilating eye drops. Dilated visits involve a waiting period for the eye drops to take effect, and the whole appointment will take at least two hours of your time. Best not to park in the one hour visitor slots! Recheck visits take less time because they do not involve the use of dilating drops. While dilating, patients can play or read in the waiting room. You may need to read to your child once the drops kick in. We have a variety of books and informational magazines such as "mental_floss" in the waiting room. On that note, we welcome the addition of used children's books to our collection if you're cleaning out your basement. Some families like to go for a walk or get a bite to eat in the neighborhood during the long wait. As in all medical offices, no food or beverage of any kind is permitted in our space. There are picnic tables outdoors in the parking lot perimeter if anyone needs a snack.

Dr. Hutcheon performs surgery at the Shady Grove Adventist Hospital (www.adventisthealthcare.com) and the Montgomery Surgery Center www.montgomerysurgery.com.

REFRACTION is the procedure by which your eye doctor determines the need for glasses as well as the actual prescription for these glasses. This is the back and forth, "better one or two," process you all know and joke about. Children are refracted after their eyes are dilated in order to relax up close focusing and obtain more accurate distance measurements. Very young and nonverbal children are also refracted, but the measurements are made objectively through dilated pupils without subjective responses.

The short answer is "not in this office." To explain, a refraction is a routine component of a yearly dilated eye examination even if your child is followed for eye disease. As such, routine refraction fees are covered only by Vision Plans, not medical insurance. We do not participate in or accept any Vision Plans which are indicated as a separate rider on your medical insurance card. The fee for this service is due on the date of the exam, and it is only charged on the days your child is dilated. Please note that because we do not accept Vision Plans, yearly comprehensive eye examinations for those without eye disease are the responsibility of the patient and must be paid on the day of the visit. In this case, there is no separate refraction fee. Please call the office for the current cost of a routine eye examination or refraction. We can provide you with a receipt to submit to your Vision Plan on your own.