Aside from food, shelter and love, a well-functioning visual system is extremely important for proper cognitive development of a child. It has been found over 80% of their world is absorbed visually. In fact, the brain is constantly growing new neurons, interconnecting neurons and then pruning neurons at an incredible pace during what is called the “critical development phase” lasting approximately until 10 years of age. A poorly functioning visual system, including an eye or eyes which sees the world blurry, double or not at all will have permanent effects on the child for the rest of their life. Eyes which do not work well together for form three dimensional images in the brain can lead to permanent issues not correctable later in life. Once a child is past this critical development period, few things can be done to bring reverse damage done. Visual therapy and even surgery may be of some benefit, however most gains are hard-fought for and rarely approach ‘normal levels’ had that child’s visual system been fully functioning earlier in life.
The American Optometric Association (AOA) encourages parents to include a trip to the optometrist in the list of well-baby check-ups. Exams at six to 12 months of age can determine healthy development of vision. Early detection of eye conditions is the best way to ensure your child has healthy vision for successful development, now and in the future. Pediatricians perform screening eye exams on newborns to check for infections or structural problems with the eyes: malformed eyelids, cataracts, glaucoma or other abnormalities. However, few pediatricians have the training or knowledge to accurately diagnose many diseases of the eye and visual system.
When should my child have their first eye exam?
While the AOA recommends that children be checked at six months of age, your pediatrician will help you determine an appropriate time for your child’s first visit. It is a good recommendation to have an additional eye exam at three years of age and then again at around five or six by an optometrist or ophthalmologist, which is usually around the time formal grade school begins.
Why does my child need an eye exam?
Even the most astute parents have a hard time judging how good their own child’s vision seems to be. Having an eye exam is much more involved than reading the letters of the eye chart, and babies don’t communicate much at all except when they are hungry and tired. A trained optometrist or ophthalmologist can evaluate your child’s vision sometimes without your child saying a word. Infants and young children need eye exams because those with large problems that may go undetected can be addressed before they turn into something that cannot be fixed.
A child’s neural system is complex, and still developing until 7-8 years of age. Problems that can be addressed before the age of 7 or 8 can save a lifetime of vision, social or employment problems.
What should be expected during the exam?
An infant eye examination is similar to that performed on adults. However, it is simplified a bit. There are three goals that the doctor will try to achieve during an infant’s eye exam:
- Rule out significant amounts of farsightedness, nearsightedness or astigmatism
- Rule eye muscle and binocular problems such as strabismus
- Rule out eye disease including the presence of congenital cataracts, retinal disorders and tumors
I will evaluate your child’s medical history, vision, eye motility and surrounding structures. I will observe how your child focuses and whether or not both eyes are working together. It is common for babies to not obtain full time binocularity (both eyes working together) until 4-6 months of age. Occasionally, you may see one eye go out or both eyes crossing. It should be brief and not often. I will asses this carefully to make sure both eyes fall within normal ranges.
Although a baby can’t provide any “subjective” input at this age, we can perform several tests that will provide information about the child’s sight.
- Assesses the baby’s vision: Does the eyes react to light shone in the eyes? Will the baby look at a face or follow a moving toy? Other, more sophisticated vision tests may be used if needed.
- I can temporarily dilate the pupils with dilating drops. The eye doctor will use an instrument to test the baby’s eyes for refractive error, such as nearsightedness, farsightedness or astigmatism without the infant or child saying a word. Most babies are slightly farsighted at birth. This usually goes away by 3-5 years of age. However, a baby can wear glasses if needed. Special eyeglasses are designed to fit very small faces.
- I will use various instruments including and ophthalmoscope to look inside your baby’s eyes.
Preparing for the exam
Many parents ask how they should go about preparing a toddler or young child for their first eye exam. The truth is, some parents often have more apprehension than their child. Following are a few tips for reducing anxiety for both parents and children.
- Show and Tell: Talk to your child about eyes and vision in general. Check your local library for children’s books about the eyes. Try playing “I Spy” or other fun games that deal with the eyes. Help your child draw an eye chart on a large poster board for playing eye doctor…take turns being the patient. Practice putting eye drops into your child’s eyes, and your eyes as well, using a small bottle of artificial tears. When eye drops are instilled into his or her eyes at the doctor’s office, it won’t be a total surprise. These ideas will get children to think about their eyes and how they use them. Some may even give you an idea of how your child may react in the exam room.
- Take a Test Drive: If you already have an eye doctor you are comfortable with, schedule a “fun visit” to introduce your child. Most optometric offices are willing to schedule an appointment for your child to tour the office without actually having an eye exam. We would be happy to allow your child to see the exam room, and possibly handle a few of the eye exam tools. We wish to reinforce the positive experience by allowing your child to pick one prize for each visit to our office. (Your child may beg to go back!) If you do not already have your own eye doctor, schedule an exam for yourself to make sure you are comfortable with the doctor and office staff.
- Relax: If you are apprehensive about your child’s eye exam, your child will be too. Some parents tend to worry that their child may unintentionally give an incorrect responses and wind up getting glasses when they don’t really need them. Pediatric vision is an advanced science and optometric physicians are well-trained in dealing with young children. Although examining a child’s eyes and vision is sometimes a trying process, there are objective ways of determining whether or not a child needs corrective eyewear. Often, very little input is needed from the child.
If your child is struggling at school, an undetected vision problem may be to blame. A child who is unable to see the blackboard clearly or has a hard time focusing on the work at his desk will soon become frustrated. Many children’s vision problems go undetected during school vision screenings, so parents and teachers should watch for the following signs that may signal vision problems. If you notice any of these signs in your child, schedule an appointment for a full eye exam. I can easily determine if your child is nearsighted, farsighted or emmetropic (no vision problem). Most vision problems are easily corrected, often with contact lenses if your son or daughter is mature enough to handle and care for the lenses.
Common Symptoms for visual disorders:
Squinting is much like looking through a pinhole. Peeking through a small opening reduces the size of the blurred image on the back of the retina. This temporarily improves vision and could be a sign of your child compensating for poor vision.
- Tilting their head
Tilting the head can be a sign of an eye muscle imbalance or strabismus. A child may have double vision when looking down or in a certain direction. Tilting the head may minimize the double vision to a more manageable level.
- Sitting too close to the television
Sitting very close to the television or lowering the head while reading is often a sign of nearsightedness. Nearsighted people generally have clear vision at a close range and poor vision at a distance. Moving closer to an object brings the object to their clear focal point and makes the image larger.
- Losing place while reading
Skipping lines or losing your place while reading can be a sign of a vision problem. Often, astigmatism or an eye muscle problem such as strabismus is to blame.
- Covering one eye to read or watch television
A child who covers one eye to read is simply shutting the eye with the poorer vision off so that it does not interfere with their vision. An uncorrected vision problem in one eye can increase a child’s risk of developing amblyopia. Covering one eye can also be a sign of double vision caused by strabismus or a more serious medical problem, such as a cataract.
School screenings are not enough. Schedule your child an eye exam at Alpine EyeCare Center.
- Excessive tearing
Children often have lag ophthalmus, a condition which causes the eyes to dry out at night because the eyelids do not completely close while sleeping. This can cause excessive tearing during the day that interferes with good vision.
- Rubbing eyes
Rubbing the eyes is a sign of eye fatigue and can be a sign of all types of vision problems. Medical conditions such as allergic conjunctivitis can also cause vision problems.
- Finger pointing while reading
Finger pointing while reading is not always a bad sign. It is often seen in a child learning to read independently. However, it can be sign of an uncorrected vision problem such as amblyopia. Amblyopic eyes exhibit a crowding phenomenon. When letters or words appear very close to other letters or words, it makes them difficult to recognize.
- Light sensitivity
Children with exotropia, a type of strabismus, occasionally squint one eye when exposed to bright sunlight. This may be interpreted as light sensitivity.
- Frequent headaches
Uncorrected farsighted children often have frontal headaches or brow aches. This is a result of the child attempting to compensate by exerting extra effort to clear their blurry vision.
Make it your priority to bring your child (or children) into Alpine Eyecare Center.
We love kids and I personally would love to meet yours!