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Expert Q&A:
How can I help my 2-year-old stay calm during an eye exam?

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Suzanne Dixon
Answered by Suzanne Dixon M.D., M.P.H.
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"There is nothing so amazing as the development of a child," says Suzanne Dixon, M.D., a behavioral and developmental pediatrician who was one of the founding members of the Pampers Parenting Network. "Every day is a new adventure when you have a child around you. I never get tired of learning from the children who have been a part of my life, professionally and personally."Suzanne Dixon, M.D., M.P.H., was born and raised in Minnesota and graduated from the University of Minnesota, School of Medicine. She did her pediatric training at Massachusetts General Hospital in Boston and then completed a fellowship in Child Development at Boston's Children's Hospital. Dr. Dixon joined the faculty at the University of California, San Diego, and did patient care, teaching, and research for 20 years. She ran a large newborn service, performed research in early child development, and was involved in many community outreach activities in maternal child health. Throughout her entire professional life she has maintained an interest in cross-cultural activities, living and working in many parts of the world, including Mexico, India, Kenya, Indonesia, and several countries from the former U.S.S.R. Dr. Dixon is the author of numerous research articles, review articles, and textbook chapters in pediatrics, child and family development, and public health. Her textbook, written with Dr. Martin Stein, Encounters With Children: Pediatric Behavior and Development, has become a classic in child health education and is in its fourth edition. She is Editor in Chief of the Journal of Developmental and Behavioral Pediatrics, an international journal of high standing in the professional world. She also has served as an associate editor for Infant Mental Health and currently reviews for several major pediatric journals. Dr. Dixon is a fellow of the American Academy of Pediatrics and served in national positions in that organization. She is a member of the Society for Pediatric Research, the Society for Research in Child Development, the American Public Health Association, and the Executive Council of the Society for Developmental and Behavioral Pediatrics. She serves as consultant to several national and international organizations and has received an award from Healthy Mothers, Healthy Babies.Dr. Dixon continues to lecture and consult worldwide on aspects of maternal, child, and family health. She practices behavioral and developmental pediatrics in Montana and works with local advocacy groups on education and women''s health. Dr. Dixon has been married for over 30 years and has three sons. She and her husband travel frequently, are outdoor enthusiasts, and enjoy being amateur anthropologists.
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Question


My 2-year-old son has what is called a corneal dermoid. He goes to an eye specialist every six months for an eye exam and has his eyes dilated, etc. His doctor recommends having the dermoid removed before he gets old enough to be in school. The dermoid does bother his eye, and he rubs it from time to time. We had decided to go ahead and have it removed now while he is still young. The problem is my son will not sit still -- he screams and kicks during the exam and the vision test. What can I do to help him get over this reaction? The vision test did not turn out because he would not leave the electrodes in place.

Answer


Most 2-year-olds are pretty upset by examinations and procedures, particularly those involving areas around the face. Your child also has memories of struggles with these procedures in the past. Although his behavior will get better with time as he matures, a mild sedative might help him get through it for now. Checking his vision is important, so it might be worth it to try this. Discuss this with his primary care physician, who could in turn work with the ophthalmologist to help things go more smoothly. Placing the electrodes on before going into the exam room, your staying with him and holding him, and the use of puppets are all techniques that can help. Offices that see young children regularly usually have a whole bag of tricks to get these things done. Be sure that the specialist is experienced with young children. Your child doesn't sound at all unusual for the age.
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