Georgia Family Home

BACK

Check It Out
Children don’t have to be able to talk to have eye examinations. Most pediatric ophthalmologists use devices such as hand puppets to evaluate vision in young children. So when does your child need to have the first eye examination? The American Academy of Ophthalmology recommends the following:

  • Newborns should be checked for general eye health by a pediatrician or family physician in the hospital nursery.
    • u High-risk newborns (including premature infants, those with a family history of eye problems, and those with obvious eye irregularities should be examined by an ophthalmologist.
  • In the first year of life, all infants should be routinely screened for eye health during well-baby visits with their doctors.
  • Around the age of 3 1/2, children should undergo eye health screenings and visual acuity tests (or tests that measure sharpness of vision) with their doctors or optometrists.
  • Around the age of 5, children should have their vision and eye alignment evaluated. Children who fail either test should be examined by an ophthalmologist.
  • After age 5, further screening exams should be conducted at routine checks at school or at your child’s doctor’s office, or after the appearance of symptoms such as squinting or frequent headaches. (Many times, a teacher will realize the child isn’t seeing well in class.)
However, children who wear prescription glasses or contacts probably need annual checkups to screen for vision changes.

Signs that a young child may have vision problems include:

  • constant eye rubbing
  • extreme light sensitivity
  • poor focusing
  • poor visual tracking (following an object)
  • abnormal alignment or movement of the eyes (after 6 months of age)
  • chronic redness of the eyes
  • chronic tearing of the eyes
  • a white pupil instead of black
In school-age children, watch for other signs such as:
  • inability to see objects at a distance
  • inability to read the blackboard
  • squinting
  • difficulty reading
  • sitting too close to the TV
It’s also a good idea to watch your child for evidence of poor vision or crossed eyes. If you detect any evidence of eye conditions, your child should be examined immediately so that the problem doesn’t become permanent. If caught early, eye conditions can often be reversed.

Common Eye Problems
There are several eye conditions that may affect children. Most of them are detected by a vision screening using an acuity chart during the preschool years.

  • Amblyopia (lazy eye) is poor vision in an eye that appears to be normal. Two common causes are crossed eyes and a difference in the refractive error between the two eyes. If untreated, amblyopia can cause irreversible visual loss in the affected eye. (By then, the brain’s “programming” will ignore signals from that eye.) Amblyopia is best treated during the preschool years.
  • Strabismus is a misalignment of the eyes; they may turn in, out, up, or down. If the same eye is chronically misaligned, amblyopia may develop in that eye. With early detection, vision can be restored by patching the properly aligned eye, which forces the misaligned one to work. Surgery or specially designed glasses may also help the eyes to align.
  • Refractive errors mean that the shape of the eye doesn’t refract, or bend, light properly, so images appear blurred. Refractive errors may also cause eyestrain and/or amblyopia. The most common form of refractive error is nearsightedness; others include farsightedness and astigmatism.
  • Nearsightedness is poor distance vision (also called myopia), which is usually treated with glasses or contacts.
  • Farsightedness is poor near vision (also called hyperopia), which is usually treated with glasses or contacts.
  • Astigmatism is imperfect curvature of the front surface of the eye. It’s usually treated with glasses if it causes blurred vision or discomfort.
Other eye conditions require immediate attention, such as retinopathy of prematurity (a disease that usually affects premature infants who were on a ventilator for a long period of time after birth) and those associated with a family history, including the following:
  • Retinoblastoma is a malignant tumor that usually appears in the first 3 years of life. The affected eye may have visual loss and whiteness in the pupil.
  • Infantile cataracts can occur in newborns. A cataract is a gradual clouding of the eye’s lens.
  • Congenital glaucoma in infants is a rare condition that may be inherited. It is the result of incorrect or incomplete development of the eye drainage canals during the prenatal period. Congenital glaucoma can be treated with medication and surgery.
  • Genetic or metabolic diseases of the eye, such as inherited disorders that make a child more likely to develop retinoblastoma or cataracts, may make it necessary for a child to have an eye exam at an early age and regular screenings.
Be sure to talk to your child’s doctor if your child is at risk for any of these conditions.

Glasses and Contacts
Children of all ages—even babies—can wear glasses and contacts. Keep these tips in mind for a child who wears glasses:

  • Allow your child to pick his or her own frames.
  • Plastic frames are best for kids younger than 2.
  • If older children wear metal frames, make sure they have spring hinges, which are more durable.
  • If your child needs to wear thick lenses, consider plastic frames because these will hold thicker lenses better than metal ones.
  • An elastic strap attached to the glasses will help keep them in place for active toddlers.
  • Children with severe eye problems may need special lenses called high-index lenses that are thinner and lighter than plastic lenses.
  • Polycarbonate lenses are recommended for kids who play sports. Polycarbonate is a tough, transparent thermoplastic that’s used to make thin, light lenses. However, although they’re very impact-resistant, these lenses scratch more easily than plastic lenses.
Infants born with congenital cataracts may need to have their cataracts surgically removed during the first few weeks of life. Some children born with cataracts wear contact lenses at 6 months of age.

Around age 10, children may express a desire to get contact lenses for cosmetic purposes or convenience if they play sports. Allowing your child to wear contacts depends on his or her ability to insert and remove lenses properly, faithfully take them out as required, and clean them as recommended by the doctor. Soft lenses are easier to adapt to than hard lenses, but not all children are candidates for soft lenses. Talk to your child’s ophthalmologist about what type of contact lens is best for your child.