Back-to-School Eye Care

Challenges and expectations for pediatric optometrists.

By Nathan J. Bonilla-Warford, OD

The eye care profession comes with a wide range of clientele, and, as such, the respective busy season for each optometry practice tends to reflect its patient population. In switching back and forth between a family practice and one more geared toward pediatric care, I have gained perspective on the challenges of different patient types. When it comes to pediatric optometry, the back-to-school season is one of the busiest—if not the busiest—time of the year.


In my experience, the back-to-school rush comes in two waves. The first group tends to come in for scheduled appointments during the month leading up to school. These patients and their parents are usually just being proactive. Otherwise, they are likely to be motivated by a need for specialty services of some kind that requires a little more effort. The majority of these patients, however, present with no serious conditions and are easy to manage.

A lull in pediatric patients occurs during the first 2 weeks of school. I suspect this is chiefly because parents are more concerned with returning their children to a routine, and eye care is not at the front of their minds. After that lull, however, comes the second wave. Patients notice (or teachers notice, and thus notify parents) difficulties seeing the board or reading, and parents schedule an appointment. Patients in the first wave tend to present with issues (if they present with any pathology at all, that is) that may require long-term treatment; patients in the second group are largely examined and fitted for glasses.


With a practice based in Florida, we spend a lot of time on preventive education, especially regarding sunglasses. Another aspect of eye care that has become difficult to ignore is the increasing use of digital technology. It used to be that summers were spent outside, but, with the rise of smartphones, tablets, and video games, pediatric patients spend more time indoors exposed to the same screens that have caused adults so much trouble. This trend toward technology use could change the game regarding typical and expected childhood vision issues.


Despite having become safer and easier to manage, contact lenses have fallen out of favor among school-aged pediatric patients thanks to a number of factors. Whereas glasses were once considered unpopular, they have become trendy due to the availability of multiple styles made famous by celebrities and by the rise of geek chic style. With notable exceptions such as athletes and those with amblyopia, many pediatric patients are fine with getting glasses nowadays. Of course, there are still those who are dead-set against glasses, but they have become fewer.

One way or another, however, corrective lenses are a necessity for these patients. Contacts may be optional, but glasses are not. Fortunately, when it comes to prescribing contacts, the old age ranges have become increasingly younger. In my practice, parents are sometimes surprised by how early we recommend contact lenses, but, considering the improved safety of modern lenses and the body of research supporting compliance regardless of age,1 the decision to prescribe contact lenses ultimately comes down to the maturity and willingness of the patient.


Although there is expanding interest in pediatrics among optometry school students, some optometrists are wary of working with this age group. Young patients tend to be less predictable, to fidget, and to give less reliable information than their older counterparts. Much like adults, however, they respond positively to health care professionals who treat them well. If the optometrist puts in the effort and engages with them, their visits can be easy and fun. Plus, if parents appreciate the way your practice handles their child, you will likely end up seeing the rest of the family.

For pediatric eye care practices, the two waves of patients in the back-to-school rush can be hectic but beneficial overall. Fortunately, the internet seems to have made many patients and their parents more aware of potential eye-related issues. Regardless of which of the two back-to-school waves these patients stem from, each group contributes to the busiest time of the year for pediatric optometrists and can eventually become a cornerstone of the practice.

1. Walline JJ, Jones LA, Rah MJ, et al. Contact Lenses in Pediatrics (CLIP) Study: chair time and ocular health. Optom Vis Sci. 2007;84(9):896-902.

Nathan J. Bonilla-Warford, OD
• optometrist/owner at Bright Eye Vision in Tampa, Fla.
• financial disclosures: consultant, Marco Ophthalmic.