2 things will happen tomorrow...

First - Syafiah

Syafiah will have her eye exam tomorrow morning. Her appointment card stated 'cyclo ra'.

Syafiah has her 1st eye screening at NICU as she was born premature. At first, it was just an ROP screening but her result turned out to be Stage II, Zone III on which she didn't have to undergo any treatment as her eyes will regressive from time to time. They did. Her retinal vascular maturity is complete. Now the problem is she sometimes focus on object, sometimes not.

What is a cycloplegic eye exam?

Answer :
A complete eye exam by an eye doctor has many components. It generally begins with the doctor talking to you to get a full history, which includes finding out the reason for your visit, learning about your overall health, getting a list of the medications you are taking (both oral and drops) and discussing any previous eye conditions or surgeries.

Then, the doctor usually measures your visual acuity, followed by an examination of your pupils, visual fields and eye movements. For people who report difficulty with their vision, a refraction is performed. A refraction is a test to determine the strength of glasses needed to optimize one's vision.

If the patient is under 16, the doctor may then repeat the refraction using "cycloplegic" drops to temporarily paralyze the ciliary muscles used to focus the eyes. This procedure, called a cycloplegic refraction, can be an important tool in helping eye doctors obtain accurate vision readings in frightened or squirming children. The results of the cycloplegic refraction are compared with the results from the initial refraction to arrive at the lens prescription needed to correct the patient's vision.

Read more on Glossary of Eye Terminology and here.

In medicine, particularly optometry and ophthalmology, refraction (also known as refractometry) is a clinical test in which a phoropter may used by an optometrist to determine the eye's refractive error and the best corrective lenses to be prescribed. A series of test lenses in graded optical powers or focal lengths are presented to determine which provide the sharpest, clearest vision.

In Illinois, USA, the state law requires eye exams for children enrolling for the first time in Illinois schools went into effect on January 1, 2008.

Quoted from the site:

There are four critical periods in the growth of a child’s vision: (1) preterm, (2) perinatal or infantile period, (3) preschool years, and (4) elementary.

Preterm infants are at risk of developing retinopathy of prematurity (ROP) and pediatricians are aware of the guidelines for referral to an ophthalmologist for ROP screening. Preterm babies with ROP should be screened by an ophthalmologist at regular intervals until retinal vascular maturity is complete. Laser treatment should be instituted when indicated. It is not safe to assume that babies born full term will not develop eye problems such as cataract, glaucoma, strabismus, and anterior segment dysgenesis. These are the conditions that should be looked for when screening healthy infants.

Preschoolers are likewise not safe from developing eye problems because it is during this stage that conditions such as strabismus, high error of refractions, anisometropia, and amblyopia start to manifest. Amblyopia treatment should be instituted right away.

Lastly, children in grade school or elementary should be screened for refractive errors like hyperopia, myopia, astigmatism, or any combination of these. Children are not small adults; they cannot verbalize what they feel (or see) most of the time. Parents only notice the change in behavior or head posture when the child is already symptomatic.

Dr. Wexler recommends the following guidelines for suggested eye exam schedules for children:

* At 6 months
* At 3 years
* At 5 years or just prior to entering Kindergarten
* Then, every 2 years

Unfortunately, there's no such program in Malaysia. Syafiah is lucky as she was born premature, so that we could check her eyes frequently. I just hope that the result will be on our sides, even though it is mean that she will have to wear spectacles in future! (all my nieces and nephews do! Genetic? *sigh*)

Dilating drops tu pun ada effeknya.. baca sini. Hish.. mana la pakcik Jingga ni... pakcik Jingga kan eye resident! Mungkin pakcik Jingga tak tahu cerita Syafiah dah pindah sini kot!


Second - Mastura

Mastura will have her trip to National Zoo tomorrow morning too. This trip is scheduled by her kinder. She has to be in school as early as always i.e. 7.30am and only will be back around 3.00 pm. We need to arrange for her transportation to return home as the pakcik usually fetch her home around 11.30am. She's excited! Talking about it non-stop.

I remember my kinder trip to Taiping Zoo, sitting on the stone crocs at the lake garden. Main gelongsor.. I still have the photos. When we returned, there's something happened to our coaster. There was not any flame but the water tank exploded. Luckily I was sitting at the back. My friends who were sitting in front got blistered by hot water. Terus singgah di klinik kesihatan nearby. Tapi tulah orang dulu.. mana reti nak saman² sekolah ni. Semua selamat. Awis, one of my friends in the photos is now resting in peace. He died young, around 24 due to an accident in his work place.

I hope she'll remember the trip the way I do!