Pediatrics

We offer a full range of pediatric eye care services, from basic eye exams for children to advanced treatment of eye problems. Children can suffer from a unique set of vision ailments, including strabismus (crossed eyes) and amblyopia (lazy eye). Although less common in younger patients, children also can develop glaucoma or be born with cataracts.

Whatever your child’s needs, our eye doctors have the training and experience needed to help. We have great respect for the patient/physician relationship and are well known for building a strong rapport with children and their parents. When you and your child schedule an appointment with the pediatric doctors at Concord Eye Center in New Hampshire you can rest assured you will have a safe and comfortable experience.

Routine Pediatric Eye Care

Pediatric eye exams usually begin with a referral from the child’s primary care doctor, either because of poor performance on a vision screening or because of an observed issue with the eye (eye turning in for example.)  The child’s pediatrician will send over notes about what they have observed, as well as information about the child’s general health.

Dr. Morse is our pediatric specialist, however many of our providers see children, either as part of their specialties (glaucoma for example) or for an emergency visit.  Our optometrists also work with children, mainly for routine eye exams and glasses and/or contact lenses.

A typical eye exam begins with one of our ophthalmic technicians.  The technician will verify your child’s health history, document any issues or concerns about your child’s eyes and perform a vision test.  The technician will then put some drops in your child’s eyes to dilate them.  Dilation causes the pupil to enlarge, allowing the doctor to examine the back portion of the eye. Generally, it takes about 30 minutes for the eyes to dilate.

Once the eyes are dilated, the child will return to the exam room, where they will be examined by the doctor.  S/he will use a retinascope, a handheld device used to determine refractive error (near or farsightedness). The doctor will also examine the eye, looking for areas of concern in the cornea, lens and retina.

If there is a suspicion of amblyopia or strabismus, the child will also meet with an orthoptist, a technician who will measure any deviation in the eye.

If glasses are needed, the opticians in the optical shop will work with you to choose the best type of glasses for your child.

Amblyopia

Amblyopia, commonly known as lazy eye, is an eye condition causing reduced vision in one eye. This means the vision or acuity (20/20) has not developed. It is estimated that 3% of children under six have some form of amblyopia. This relatively high incidence underscores the need for early detection programs such as vision screening in the primary care setting, in school, as well as by an ophthalmologist.

The development of a child’s visual system depends upon the ability to clearly focus light upon the retina within the eye. Sharply focused images permit the visual system to develop in a normal fashion.

Causes

This process of ocular development occurs during the early years of life. An interruption in this process, especially during the first three years of life, will have a long-lasting adverse effect on centers in the brain responsible for vision.

Anything that interferes with clear vision in either eye during the critical period (birth to 6 years of age) can cause amblyopia. The most common causes of amblyopia are:

  • Constant Strabismus (constant turn of one eye)
  • Anisometropia (different refractive errors or eye glass prescriptions in each eye)
  • Deprivation (child may be born with opacities or cataract in the cornea or lens)
  • Ametropia (very large refractive error or need for glasses)

Proper treatment to insure normal development of the vision system is essential. The principle for correcting amblyopia is directed towards helping the brain pay attention to the eye with deficient visual development. This may require sharpening the image that falls upon the retina with either eyeglasses or a contact lens when they are indicated.

Anatomic defects such as cataracts or corneal opacities usually need to be surgically corrected first. Once the light can be focused clearly on the retina, occlusion or patching of the dominant eye is necessary. Occlusion will force the brain to use the amblyopic eye and enable the vision to improve. The daily schedule and duration of occlusion will depend upon the age of the patient, how long the defect has been present, and the severity of the amblyopia. The earlier treatment is started by an Ophthalmologist, the more rapidly improvement will occur.

Strabismus

Strabismus is a visual defect in which the eyes are misaligned and point in different directions. One eye may appear straight, while the other eye turns inward, outward, upward, or downward. This misalignment may always be present or come and go. Sometimes the straight eye may turn while the misaligned eye straightens.

Strabismus is a common condition among children. About 4% of all children in the United States have strabismus. It can also occur later in life. The condition occurs equally in males and females. Strabismus may run in families.

Strabismus can be diagnosed during an eye exam. It is recommended that all children have their vision checked by their pediatrician, family doctor, or ophthalmologist (medical eye doctor) at or before their fourth birthday. If there is a family history of strabismus or amblyopia, an ophthalmologist can check vision even earlier than age three. The appearance of strabismus may improve as the child grows, however, the child will not outgrow true strabismus.

Treatment for strabismus works to:

  • Preserve vision
  • Straighten the eyes
  • Restore binocular (two-eyed) vision

Your ophthalmologist may prescribe eyeglasses to treat the condition. Other treatments may involve eye muscle exercises or surgery to correct the unbalanced eye muscles.

Through Our Patients Eyes

"I took my son to see Dr. Morse when he was about four and a half. My husband and I have no vision issues, so we were really in uncharted territory. Dr. Morse and the Concord Eye Center staff were so forthcoming and honest with information and that was so important for us. This was all new and we really needed all the support we could get. Dr. Morse has been really great – taking the time to explain everything to us. Cal was very nervous about having glasses but once he got them, he could see so much better that he forgot all his nerves and just took to them. We have just felt very comfortable with Dr. Morse and are grateful for the care she’s given our family."

Cal's Mom - Concord NH

"Dr. Wasserman knew when it was time for me to consider surgery and I liked that he didn’t rush it, that he was really looking for things to get to a point where surgery made sense. When he said it was time, that surgery could really help, we scheduled it. I felt comfortable with Dr. W and with the procedure – I knew I was in good hands and that I’d be fine. It all went very smoothly. My life has improved so much since the surgery – I love that I really don’t need my glasses all the time anymore – I don’t need them for driving or distance. I didn’t realize the cataracts were that bad – I am so happy it’s done!"

Barbara - Franklin NH

“I’ve been an eye surgeon in Concord for 22 years and have performed hundreds of surgeries for my patients. I can’t tell you how rewarding it is to hear them tell me how their sight has been enhanced and their quality of life improved. My favorite day of the week is my surgery day. My second is the next day when I get to hear the “wows” and see the smiles on patients’ faces. I think that’s what’s been my greatest pleasure in serving the people of Concord and the surrounding towns since 1994. If you have been noticing changes in your vision, I’m proud to recommend that you give us a call.”

Dr Erin Fogel – Concord Eye Center

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COVID-19What you should know before your next appointment

We're excited to see you again!

In an effort to keep you safe and comfortable we've made some changes to our normal process.

Please read about these changes before your next visit by visiting the update link below.  Additionally, in an effort to streamline the check-in process, please consider printing and completing your patient forms ahead of your appointment and bring them with you.

If you wish to visit our Optical Shops to purchase new frames and/or lenses, an appointment must be made ahead of time. You can make your appointment by calling us at 603.224.2020.

COVID-19 Update