Children grow up quickly – their bodies develop at a rapid pace as they pass from infancy to adolescence. This is especially true of their eyes and their ability to see.
But sometimes a child’s vision doesn’t develop as it should, and problems may arise affecting eye health and visual ability. If not diagnosed and treated early, some of these problems could impair their future vision, as well as inhibit their intellectual, emotional and social development.
Hattiesburg Eye Clinic’s Pediatric Vision Team has the training and experience to evaluate your child’s eyes and vision, diagnose conditions and implement a treatment plan designed just for them. Using the latest diagnostic technology and treatment techniques, we’ll help make sure your child sees clearly.
Start Your Child On The Right Vision Track:
Your child’s vision begins to develop rapidly soon after they’re born. While at first they only focus on things at close range with high contrast colors (white, black or red), their vision quickly sharpens over their first year.
And it’s during their first year that problems could begin to show. So along with the American Optometric Association, we recommend you follow the following schedule for your child’s vision exams:
- First visit: 6 to 12 months;
- Second visit: 3 years of age;
- Third visit: Just before entering school;
- Subsequent visits: Every two years.
If your child has higher risk factors for vision impairment, like low birth weight or a family history of eye disease, or they’ve been diagnosed with a vision problem, they may need more frequent eye exams – such as once a year after starting school – and additional testing.
Screenings Are Great! But Your Child Still Needs A Full Eye Exam:
It’s quite common for children to undergo vision screenings at school or through other organizations. These screenings can do a lot of good –but they’re limited in their ability to diagnose eye and vision problems. Their main purpose is to raise a warning flag for an immediate vision need –which should then be followed up with a complete vision examination.
For optimum vision health, it’s important your child undergo a full exam that far exceeds the capabilities of a screening. An exam not only evaluates eye health, it also measures how effective the eyes and the entire ocular system is working, including eye teaming (coordinating together to produce binocular vision) and tracking, near vision, focusing and eye-hand coordination.
Screenings have their place – but you shouldn’t rely on them solely to diagnose your child’s full range of vision health.
Frequently Asked Questions:
The primary reason for pediatric eye exams is to rule out any eye disease or condition that could affect a child’s development. The two most common of such conditions are strabismus (crossed eye) and amblyopia (lazy eye). But we are also looking for refractive errors such as myopia (nearsightedness), hyperopia (farsightedness) and astigmatism (an abnormality in the shape of the cornea).
There are also conditions we may detect that represent a major threat to eye or general health. Of these we’re most concerned for a type of eye cancer called retinoblastoma that could otherwise go undetected during a routine check by a pediatrician. And although rare, we’re also on the lookout for congenital glaucoma, which is relatively simple to check for during an eye exam.
A pediatric eye exam can therefore help immensely with keeping your child’s development on track and alerting us to major eye-related health problems.
Our providers at Hattiesburg Eye Clinic, in conjunction with the American Optometric Association, recommend an initial eye exam for children at six months of age. Barring any findings that would indicate otherwise, we would then recommend seeing them again around three years of age.
After an initial visit at six months of age, we (along with the American Optometric Association) recommend subsequent visits at three years of age, followed by five years of age before the child begins kindergarten. We then recommend visits at intervals of one to two years, depending on any findings during the exam that may require treatment or further monitoring.
The different parts of the exam resemble those conducted for adults, but modified to match a child’s age or developmental stage. Depending on age and development, we will first ask the child to view an eye chart and read a series of letters, pictures or shapes. This will help us measure their visual acuity (clarity) and focus.
Typically, we will then dilate their eyes. This is so we can view structures in the eye such as the retina, optic nerve and lens through the use of magnification devices. Our goal with the exam is to detect any eye conditions requiring treatment and determining the prescription for their eyes to view normally.
During an eye exam we are primarily checking to see how the eyes function individually and together. These various functions include visual acuity (clarity), depth perception, color vision, eye alignment, eye teaming (or tracking), binocularity (ability for both eyes to work together) and refractive errors and their numerical prescription values.
We’ll also look for signs of ocular allergies or side effects from certain medications that often manifest as dry eye. Other common issues an exam may reveal include epiphora (excessive tearing, common in infants with blocked tear ducts), Blepharitis (a bacterial infection on the eyelids), styes or conjunctivitis (pink eye). We’ll also check for eye conditions like retinoblastoma (a type of eye cancer), congenital glaucoma, or congenital cataracts.
It’s also possible during an eye exam to detect signs of a general, systemic condition. These can include diabetes or juvenile rheumatoid arthritis.
We use eye dilation, usually achieved with a series of eye drops that may slightly sting for a few seconds, for two primary reasons. First, we need to enlarge the pupil so that we have a clear, unaffected view of structures in the back of the eye such as the retina and optic nerve.
Our second reason is important in examining children: we want to relax the child’s accommodation to focus, which occurs naturally as they move the eye from one distance to another. Because this ability is strong and less controllable in children, dilation helps us achieve an accurate read of their needed prescription.
Relaxing accommodation is important, especially in children who are pre-verbal or otherwise unable to communicate effectively, so that we can test light reflexes necessary to obtain an accurate prescription. Additionally, some accommodative disorders are better evaluated when the eyes are dilated.
Dilation is a standard part of a pediatric eye exam unless there is some medical contraindication or a strong aversion by either the child or the parent. Follow up exams sometimes require dilation depending on the condition, but not always.
Your child may need glasses if they fall outside of normative ranges for visual acuity (clarity). Because each eye can have a different prescription (the numerical measure to achieve normal vision), without corrective glasses the risks are high for developing amblyopia (lazy eye), especially if the child has a family history with the condition. Mainly, though, children should wear glasses if their lack of visual acuity could potentially affect their development.
What type of glasses and how they’re worn can vary widely: some children may require wearing them full time, while others only for certain tasks like reading or using a computer. Occasionally, a child may need bifocals or undergo other forms of vision training or therapy like eye patching or drops to help strengthen the weaker eye. And, sunglasses are always recommended in children to limit ultraviolet light exposure.
Absolutely – screenings are great and often catch a major eye problem. It’s more likely, though, that a screening in a pediatrician’s office using specialized equipment can detect more eye problems than a school screening – but not all.
A school screening, on the other hand, checks mainly for how well your child can see at far distance. A child may still have an eye condition or disease that can be missed with such a screening. It’s common for a child to pass a school screening and still have a major eye condition.
In addition, a number of pediatric vision problems involve focusing up close for reading, something not measured with a school screening. A full eye exam can detect these problems as well as evaluate the health of the eye. Children may also have underlying vision issues that could contribute unknowingly to behavioral or developmental challenges.
Children can also be uncooperative about their eyesight. A trained professional in pediatric eye examination, knowing the right questions to ask, can often retrieve information from them.
Your child may need their eyes examined if they’re complaining about an inability to see the school blackboard clearly, they tend to hold items like books too close to view them, they exhibit itching, burning or tearing eyes, have unusual eye movements or they complain about sensitivity to light. You should also be concerned about their vision if they’re having trouble with reading comprehension at school or tell you the words tend to “jump around” on the page. Frequent headaches may also be a sign of vision problems.
With that said some eye conditions may not present early symptoms at all, or may not be apparent to them. Concerning the latter, they grow accustomed to any condition they’re born with – they have no frame of reference that anything about their vision is abnormal.
All of these are reasons why we recommend eye exams at various age intervals, especially before a child starts kindergarten at age 4 or 5.
If your child has a family history of eye conditions like amblyopia (lazy eye) or refractive problems, it’s wise to have their eyes checked for any possible inherited problems. For example, if either of the parents have a strong glasses prescription, there’s a higher likelihood of similar problems with the child.
Your child may also be having issues like allergies or headaches that although not seemingly related to their vision could be an indication of eye problems. And it would be a good idea to have a child suspected of attention-deficit/hyperactivity disorder (ADHD), especially before going on medication, to have their eyes examined to see if vision problems are contributing to any physical, emotional or behavioral issues affecting their development.