Start Early
Start your child’s eye-health program early. Even when your baby is six-months old, eye doctors can observe how your baby focuses and whether both eyes are used in coordination with each other. Many hospitals include routine infant eye exams shortly after birth. Doctors check toddlers for unusual diseases, such as cataracts and other eye problems, and can determine whether nearsightedness, farsightedness, or astigmatism are present even without the child’s subjective input.
Your Child’s First Comprehensive Exam
If your child has no obvious eye problems or injuries, the next regular eye examination should be conducted between the ages of 3 and 6, when children are able to respond to questions. Pediatric eye exams use charts that contain pictures, numbers, or letters children understand. If necessary, they are asked to point the direction they see a chart object pointing. Doctors check for visual acuity (clear focus), depth perception, and color vision. They also check general eye health and screen for crosseye, “lazy eye,” or other congenital disorders.
Lazy eye -- or amblyopia -- is a condition in which sight does not develop normally in one eye. It is possible for the child and parents to be unaware of the condition if the eye is aligned. If untreated, lazy eye may develop a permanent visual defect and the child could lose depth perception. Doctors also look for other conditions, such as whether eyes move continuously and the child does not look directly at a person.
Preschool Check-Up
All children should have an eye exam before starting school. School vision screenings are not complete eye examinations. A comprehensive eye exam checks eye health, visual acuity, proper eye alignment, and muscle function. Your child’s exam should also include a refractive test to determine whether eyes need correction. In a recent study, only 15 percent of U.S. children entering school had an eye exam. Early detection and treatment of vision problems or eye disease is very important to your child’s health and normal development.
Schedule Regular Exams
Children should have complete eye examinations every two years throughout their school years. Youngsters with undetected vision problems typically have trouble with studies because they have difficulty seeing the blackboard or reading and writing. Children usually don’t even know they have vision problems because they think everyone sees the same way they do.
Another benefit from regular eye exams is doctors not only check eye health but also are on the alert for any other health problems that often first show up in the eyes, such as diabetes and high blood pressure.
Eye Exam Preparation
Schedule infant or young children’s appointments in the morning when they are rested. Prepare your children for the exam by telling them they will be looking at pictures and talking to the doctor about how they see. Bring along a favorite toy or juice to preoccupy the child and provide familiar comfort.
Infant exams should be scheduled for the baby’s least fussy time, usually after regular meal and nap times. Any paperwork the doctor needs may be filled out ahead of time and sent or brought along to the appointment so you can attend to your child in an unfamiliar environment.
The Examination
Pediatric eye exams include an overall look at eye appearance and check for signs such as squinting, eyelid drooping, problems with facial muscles, and redness and swelling that might indicate irritations. Doctors check pupil function using a pen light to see if pupils respond normally.
Other checks include eye focusing abilities, three-dimensional vision, color vision, peripheral vision, and other checks and screenings.
What To Look For
Trouble signs and symptoms parents should be aware of that require immediate attention include:
- A white pupil
- Sudden swelling or drooping of an eye lid accompanied by a red eye
- Enlarged cornea in one or both eyes
Other conditions which are not urgent but should be checked by a doctor include:
- One or both eyes turning in or out
- Tearing, redness, or discharge that lasts for several days
- One pupil appearing larger than another
In children aged 2 to 6 years, signs of potential vision problems that would warrant an eye exam might include your child:
- Covering one eye when looking at a book or object
- Suffering from headaches
- Asking to sit closer to the blackboard at school
- Sitting very close to the television
- Rubbing or squinting eye excessively
- Not wanting to look at books
Children’s Eyeglasses
Fitting children with eyeglasses requires special considerations. Frames selected for children should be especially designed for them, not just a pair of small-adult eyeglasses. Lenses should be made of polycarbonate material to protect active children from lens shattering.
Eyeglass lenses help focus light clearly on the back of the eye. The lens curvature helps correct various kinds of eye weaknesses. Nearsighted children see close objects clearly but not those far away. This is called myopia. Farsighted children see things far away more clearly than things close up. This is called hyperopia. Adults often develop farsightedness because the aging process limits the eye’s ability to focus. Children normally are farsighted, which can lead to eye strain and even lead to eyes crossing. Astigmatism is a condition where the eye is not completely round, causing distortion of the optical image coming into the eye. This can be corrected with eyeglass prescriptions.
Children’s Sunglasses
Some health officials estimate 70 percent of a person’s lifetime sun exposure occurs under the age of 18. Children’s eyes are most susceptible to ultraviolet exposure because their eye lenses are clearer than adults’ are. Ultraviolet light has been linked to cataract formation, macular degeneration, intraocular tumors, eyelid skin cancer, and pterygium ¾ an abnormal growth on the eye surface. Ultraviolet-light and sun-exposure damage is cumulative over a person’s life.
Decreasing the amount of sun exposure in childhood is essential, and sunglasses help do that. Children who cannot tolerate sunglasses should wear wide-brimmed hats to help protect against ultraviolet light. Sunglasses serve two major functions. By decreasing the amount of sunlight reaching your children’s eyes, they offer comfort and they protect eyes and surrounding structures from ultraviolet light.
Purchase sunglasses with complete ultraviolet blockage. Do not be misguided by higher-priced sunglasses that may represent fashion trends or durability but not ultraviolet light protection. Ensure sunglasses fit properly because ultraviolet light protection is minimized or lost with poorly fitted glasses..
Crossed Eyes
Crossed eyes -- or esotripia -- is a condition wherein one eye may look straight ahead and the other toward the nose. Many children have intermittent eye crossing during the first three to four months of life. However, if children continue to experience persistent crossed eyes past that age it should be considered a serious condition. The brain begins to ignore the turned eye and may eventually suppress its imaging. If not treated, the condition can lead to permanent functional blindness.
Teens and adults may experience esotropia as a result of systemic disorders, such as high blood pressure, diabetes, strokes, or other brain injuries. These health problems affect nerves that communicate between the brain and the eye or the eye muscles themselves. Double vision is usually the first symptom. promptly see a physician if this occurs.
Treating eye misalignments usually involves correcting refractive errorS with glasses. Depending on the condition’s seriousness, eye patches or other devices are applied to force use of the turned eye. If these basic interventions don’t work, surgical adjustment of the eye muscles may be required.
Lazy Eye
Lazy eye is a common term to describe two different eye conditions: amblyopia and strabismus. In amblyopia, eyes have poor vision without any obvious injury or eyeball disease. Strabismus is a misalignment of the eyes.
Amblyopia is treated with an eye patch or blurring drops to force use the affected eye to strengthen it. Early diagnosis is important because treatment is easier and more successful the younger the child is. Although more difficult to treat after the child is 7 or 8, persistent treatment may improve vision. Untreated amblyopia, though, can result in a permanent vision decrease and even functional blindness.
Strabismus is also a serious condition. The misaligned eyes often lead to amblyopia. Strabismus in early childhood is generally a benign condition that can be treated with glasses. Sometimes surgical intervention is required to align the eyes.
Adults whose eyes become misaligned may be suffering from other serious underlying problems and must be evaluated by a doctor promptly.
Reading and Learning Disabilities
Most learning disabilities involve difficulties processing information by the brain and not eye or vision problems. Many reading difficulties relate to reading skills. However, any child being evaluated for a reading disability should have a complete eye examination and evaluation to determine if eye problems are contributing to learning problems.
A comprehensive eye exam can identify and lead to treatment of vision problems to help ensure learning success. However, local school districts have specialists and resources to screen children for learning disabilities and provide treatment or other programs for them.