Healthy eyes and vision are a critical part of a child’s development. Their eyes should be examined regularly, as many vision problems and eye diseases can be detected and treated early. Although a standard Optometrist can examine and treat children, there are pediatric specialists that are educated and trained specifically for the needs of children. Regardless which specialist you visit, the routine eye exam for children should include:
- Newborns are typically checked for general eye health by a pediatrician or family physician while in the hospital nursery.
- Premature or high-risk newborns, those with a family history of eye problems, and those with obvious eye irregularities should be examined by an eye doctor as soon as possible.
- In the first year of life, all infants should be routinely screened for eye health during their standard checkups with their pediatrician.
- Around age 3, kids should undergo eye health screenings and visual tests that measure sharpness of vision with their doctors.
- Around age 5, kids should have their vision and eye alignment evaluated by their doctors. Those who fail either test should be examined by an eye doctor.
- After age 5, further routine screenings should be done at school or the doctor's office. Symptoms such as squinting, frequent headaches and even difficulty learning or reading at school may be indicators of a vision problem. In fact, teachers are encouraged to observe for these traits in students to assist in identifying a problem early.
- Children who wear prescription eyeglasses or contact lenses should have annual checkups to screen for vision changes.
- LASIK surgery is NOT a solution for children under the age of 18, because their eyes are still developing in size and strength.
Eye Problems in Children; How do you know?
From infant to school-age, children that exhibit one or more of the following symptoms may have a vision problem:
- Constant eye rubbing
- Extreme light sensitivity
- Difficulty following an object, such as a finger or flashlight
- 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
From age 5 and up, watch for other signs such as:
- Inability to see objects at a distance
- Inability to read the blackboard
- Difficulty following an object, such as a finger or flashlight
- Squinting
- Difficulty reading books
- Sitting too close to the TV
Watch your child for evidence of poor vision or crossed eyes. If you notice any eye problems, have your child examined immediately. Many vision problems in younger children can be treated successfully if caught early. Most problematic eye conditions in youth often can be reversed, so long as nerve damage has not occurred.
Common Eye Problems in Children
Several eye conditions can affect children and most can be detected during an eye examination:
- Amblyopia, also known as "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, because the brain will re-program itself to disregard signals from the impaired 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 eyeglasses also may 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 also can cause eyestrain and/or amblyopia. Nearsightedness is the most common refractive error; others include farsightedness and astigmatism:
- Nearsightedness is poor distance vision (also called myopia), which is usually treated with eyeglasses or contact lenses.
- Farsightedness is poor near vision (also called hyperopia), which is usually treated with eyeglasses or contact lenses.
- Astigmatism is imperfect curvature of the front surface of the eye, which is usually treated with eyeglasses if it causes blurred vision or discomfort.
Other eye conditions require immediate attention from an eye specialist (pediatric or otherwise), such as retinopathy of prematurity (a disease that affects the eyes of premature babies) and those associated with a family history, including:
- 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 before birth and 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 require children to have eye exams at an early age and regular screenings.
Be sure to talk to your doctor if your child is at risk for any of these conditions.
Eyeglasses and Contact Lenses for Children
Children of all ages can wear eyeglasses or contact lenses. If old enough, let your child play an active role in choosing his/her own glasses. The following are features to consider when buying eyeglasses for children:
- Shatterproof and impact resistant lenses - especially for children who participate in sport activities
- Scratch-resistant coating on the lenses
- Spring-loaded frames that are less likely to be bent or warped
- Silicone nose pads that prevent glasses from slipping
- Cable temples (ear pieces that wrap around the ear) - recommended in children under 4 years. Straps may also be recommended to hold the eyeglasses in place.
Your eye doctor can help you decide what type of vision correction is best for your child.
