Kids & Eye Exams

Why are eye exams important for children?

Vision screenings at school and the pediatrician’s office do not check for visual dysfunction or ocular health problems. Children can often “pass” a vision screening even if they need glasses.
 

Because children do not know any different, it is very common that they will not realize their vision is blurry and won’t complain about problems seeing. Sometimes, vision problems start at a very young age, before children can articulate that they are unable to see well. Early eye exams allow us to evaluate their vision and offer appropriate treatments. We have methods for checking vision in young children, so they don’t need to know their letters or numbers. I have been able to perform full eye exams, and give prescriptions, for patients who are nonverbal.

How often should my child receive an eye exam?

The American Optometric Association (AOA) recommends that children receive their first eye exam at 6 months of age. After that, around 3 years, and again before starting school. Some children have risk factors that warrant more regular follow ups. According to the AOA, these risk factors are:

• Prematurity, low birth weight, oxygen at birth, grade III or IV intraventricular hemorrhage
• Family history of retinoblastoma, congenital cataracts, or metabolic or genetic disease
• Infection of mother during pregnancy (e.g., rubella, toxoplasmosis, venereal disease, herpes, cytomegalovirus, or AIDS)
• Difficult or assisted labor, which may be associated with fetal distress or low Apgar scores
• High refractive error
• Strabismus
• Anisometropia
• Known or suspected central nervous system dysfunction evidenced by developmental delay, cerebral palsy, dysmorphic features, seizures, or hydrocephalus

The myopia epidemic

Myopia, or nearsightedness, is increasing globally at alarming rates. As one’s nearsightedness increases, so does the risk of developing ocular health problems such as glaucoma, myopic macular degeneration, and retinal detachments. These conditions can cause vision loss. Visual clarity also starts to degrade as your prescription increases, and the lenses become thicker and less aesthetically pleasing.
 

Annual eye exams allow us to monitor a child’s myopic progression. If necessary, we can implement treatment methods, called myopia control, to slow down the progression.

Strabismus and amblyopia

Often referred to as a “lazy eye”, strabismus and amblyopia affect visual development in the brain. This can affect 3D vision, academics, and the ability to drive, among other concerns. This usually develops at very young ages and the brain will essentially shut down visual development in one or both eyes. Because this occurs so early in life, children will not know that their vision is impaired and will not complain of having trouble seeing. In these cases, it is imperative to treat children early in order to save vision and visual development. After the age of 9, it becomes increasingly more difficult to improve visual outcomes, though it is not impossible.

What are some signs that my child needs an eye exam?

It is important to know what is normal in children and what is not. Here are some things to watch out for:

• Squinting - though sometimes behavioral, squinting is a classic sign that a child needs a prescription.
• Eye turn - in children under 6 months of age, an eye that turns inward is normal. However, after 6 months old it is no longer normal and needs to be evaluated in order to ensure proper visual development. An eye that turns outward is never normal.
• Consistently closing an eye - this can indicate several different ocular health abnormalities that need to be evaluated to preserve normal visual development.
• Poor attention span / difficulty focusing - children are many times diagnosed with ADD or ADHD without a proper eye exam! If a child can’t see the board at school, or the homework in front of him, it only makes sense that he won’t be able to pay attention to his schoolwork. Children with poor grades should also have their eyes evaluated for the same reason.
• If parents have a high Rx - a child has an increased risk of developing a high prescription if one parent also has a high prescription. If both parents do, then the child has an even higher risk.

Early and regular evaluation is important to protect vision and ensure clarity! Because children, especially young children, may not complain about vision changes, it’s important they receive regular eye exams to ensure no visual or ocular health abnormalities develop as they grow.