Optometrist Moshe Roth’s Family Eye Care in Old Bridge, N.J., is largely a family practice; nearly 40 percent of his patients are children.
Moshe Roth, OD, is all about solving problems. And when it comes to kids and related issues of eye health, his motto is simple, but effective. “Solve little problems before they become big problems.”
Dr. Roth is not one to work up an exam, point parents toward the display of character frames and call it a day. His approach to dealing with kids is much more complex. “I’m part of a group that focuses on eye health—more specifically, how the eyes work together,” he explains. “The common assumption is that if the eyes work well individually, then vision is good. But how they work together is really the key.”
For Dr. Roth and other developmental ODs, it all comes down to how kids learn. If the eyes aren’t doing their job correctly, or to the best of their ability, then learning often suffers. “So much of how kids learn is done up close, not at the blackboard,” he says. “Reading, for example, requires about 20 different skills, including tracking, movement, identification (of letters), coordination... when we look at something up close, we have to focus the lens in the eye. It’s not the same as looking off in the distance and reading an eye chart. So, if we don’t test for these things, we won’t find the problems.”
To that point, Dr. Roth is an advocate of vision therapy, a program designed to correct visual-motor and/or perceptual- cognitive deficiencies related to eye alignment, eye teaming, eye focusing, eye movement and visual processing. “We can solve a lot of issues quickly and relatively simply if we find them early.”
For most parents—and even many practices—the idea of how visual health relates to developmental issues in children is not really top of mind. Schools typically offer vision screenings as early as pre-K and kindergarten, but most of these exams are administered by school nurses or the PTA. Pediatricians are often more diligent in their execution of eye exams—asking kids to read from an eye chart—but few, if any, of these professionals are versed in the language and execution of developmental eye health.
“If school screenings were adequate, lazy eye would have been wiped out by now,” says Dr. Roth. “But the problems aren’t being found and we aren’t getting to kids early enough. Parents often think vision is innate—but it’s not. It’s like a seed. You have to create the right environment for it to grow.”
Dr. Roth’s practice, Family Eye Care, in Old Bridge, N.J. is largely a family practice. Nearly 40 percent of his patients are children. Kids are given their first comprehensive eye exam as early as six months of age. Dr. Roth recommends parents take their children for their first exam by one year and follow up with exams at three and five years. “We need to do a better job of informing parents. School screenings often give parents and kids a false sense of security. We have to remember that very young children don’t have a point of reference— it would be unusual for them to tell their parents that they think something is wrong with their eyes.”
Through his practice, Dr. Roth has found that parents are receptive, but still naive. “Vision therapy has been around for 80 years or so, but it’s not widely known. I find I have to break it down in a way that parents can understand, and when I do that successfully, it’s like a light bulb goes on,” he says. “If the eyes don’t work together properly as a team then there can be a downward spiral of learning delays.” Dr. Roth is an advocate for educating, not just parents, but other medical professionals as well, on the benefits of comprehensive exams for children. “If we don’t get pediatricians on board, we’re not going to see a big change. Often very smart, very well-educated people don’t have the facts and don’t recognize the signs.”
As part of an ongoing effort to reach out to parents and the community, Dr. Roth submits regular articles to the local newspaper, publishes pamphlets for distribution in the dispensary and donates his time to speak to local PTAs and other parent groups. He will often use computer technology to survey the eye and share those images with parents and kids to better illustrate the importance of a good exam.
Frames for children run anywhere from $59 to $159, with the majority of those sold by Family Eye Care somewhere in the middle of that range. A complete sale of kid’s eyewear averages around $200, according to Dr. Roth. “Kids are often attracted to the designer names or the sport and character references, but parents are also looking for something functional. We make it a point to offer a lot of options—all of which need to be durable styles featuring spring hinges.”
And Dr. Roth is a firm believer in the importance of selecting frames to fit the activity. “Kids need to have safety eyewear, too. It doesn’t make any sense for them to wear the same pair of glasses in the classroom and in the gym. We need to educate parents about the right way to outfit these kids for sports. A hammer is a great tool, but sometimes you need a screwdriver or a wrench—that’s what I try to tell my patients. I try to put it in words they can relate to.”
For Dr. Roth, there are no shortcuts. It’s all about building a rapport with parents and kids and diligently following a plan for better eye health.
“I don’t have a large commercial practice. What I do is very specialized,” he says. “I like to offer alternatives, things that aren’t just run of the mill.”