Pediatric Eye Care
Baby’s First Exam
First, your baby’s pediatrician examined your baby’s eyes at birth. At Shah Eye Center we recommend that our optometrist or ophthalmologist observe how a 6-month-old baby focuses and whether both eyes are used together. During the exam, your Shah Eye Center doctor will also check to make sure there are no diseases such as congenital cataracts and will determine whether nearsightedness, farsightedness or astigmatism is present. Although a baby can’t provide any "subjective" input at this age, the doctor can conduct several tests that will provide input about the child’s sight.
Conditions, which are not urgent but require attention by an eye care professional, occur when a baby’s eyes seem to move continuously and when a baby does not look directly at a person or an object.
The First Comprehensive Exam occurs usually between age 3 and 4.
The next regular eye examination for your child should be between the ages of 3 and 4. This is when your child begins to give coherent answers to questions. The exception is any obvious eye problems or injuries.
Your infants exam should be scheduled when your baby is the least fussy — after he or she has napped and been feed. And, because those quiet times between naps and feedings often don’t last very long, it’s best not to spend time completing required paperwork at the doctor’s office. Instead, paperwork should be prepared and sent to the doctor’s office ahead of time or brought to the appointment.
Your child’s eyes will be tested using eye charts that contain pictures, numbers or letters. At this stage of your child’s development, Shah Eye Center measures a child’s visual acuity, depth perception, color vision, examines the health of the eyes and looks for any signs of cross-eye or other congenital disorders.
Another eye abnormality that eye specialists can detect early on is amblyopia or "lazy eye." This a condition in which sight does not develop normally in one eye. Unless the eye is misaligned, it is possible that neither the child nor the parents may be aware of the condition. If left untreated during early childhood, amblyopia may not be treatable in later years. The amblyopic eye may develop a permanent visual defect and/or depth perception may be lost.
The Preschool Exam
It is important for your child to have an eye exam when starting school and every two years if there are no problems detected. Vision screenings conducted through schools are not complete eye examinations, although Shah Eye Center fully encourages that vision screenings.
The National Commission of Vision and Health reports:
- 25% of children aged 5-17 have a vision problem1
- 79% have not visited an eye care provider in the past year1
- 35% have never seen an eye care professional3
- 40% who fail initial vision screening do not receive the appropriate follow up care.4,5
Kleinstein, RN et al. Refractive error and ethnicity in children. Arch Ophthalmol 2003; 121:1141-1147.
Centers for Disease Control and Prevention. Visual impairment and use of eye-care services and protective eyewear among children – United States, 2002. MMWR 2005; 54:425-429.
The Vision Care Institute. Americans’ Attitudes and Perceptions about Vision Care. Conducted by Harris Interactive on behalf of The Vision Care InstituteTM of Johnson & Johnson Vision Care, Inc., 2006.
Donohue SP, Johnson TM, Leonard-Martin TC. Screening for amblyogenic factors using a volunteer lay network and the MTI photoscreener. Ophthalmol 2000;107:1637–44.
Preslan MW and Novak A. Baltimore vision screening project. Phase 2. Ophthalmol 1998;105(1):151–153.
Eye appointments for young children should be scheduled for times when they are well rested — usually in the morning. Young children can be prepared for the exam by telling them they’ll be looking at pictures and will telling the doctor what they see. Parents should take along a favorite toy or juice in case there is wait time or your child needs something familiar in their surroundings. Shah Eye Center has a well-equipped playroom for children and encourages our young parents and young patients to take advantage of this area.
School Aged Children Eye Exam
As soon as a child reaches school age, your Shah Eye Center eye doctor should perform a pediatric eye exam, making allowances for a child's limited ability to read. This exam will include: an overall look at the appearance of the eye and surrounding area, checking for signs such as squinting, drooping of eyelids, facial muscles that do not appear to be working properly, and signs of irritation such as redness or swelling. A check of pupil function will also be done at this time using a penlight to see if the pupil responds normally. In addition, Shah Eye Center care professional will perform the following checks:
- Eye alignment
- Near convergence - point at which both eyes together can see a single image
- Near point of accommodation - closest point at which an image is seen clearly
- Stereopsis - ability to see three dimensionally
- Color vision
- Confrontation fields - a test of peripheral (side) vision
If any of these initial tests indicate a potential problem, more extensive testing may be required.
Pediatric Glaucoma (also referred to as Childhood Glaucoma, Infantile Glaucoma or Congenital Glaucoma) is a relatively rare disease, as most patients with Glaucoma are adults. However, Pediatric Glaucoma can lead to loss of vision and blindness in a young child and will profoundly affect the child’s life, if not diagnosed promptly and treated appropriately. Pediatric Glaucoma can include a number of different diagnoses. Primary Congenital Glaucoma occurs in the first three years of life (usually within the first 6 months of life) without associated ocular or systemic abnormalities. Your baby’s pediatrician will examine your infant’s eyes at birth. Then you should have your child’s eye examined beginning at six months and then as prescribed by your Shah Eye Center doctor.
Pediatric Cataracts in newborns and children are rare, but it does exist and it requires specialized care. A newborn with Cataracts is commonly termed ‘Congenital Cataract.’ Cataracts in newborns can affect one or both eyes and is not necessarily hereditary. Occasionally, congenital cataracts may be a manifestation of more significant eye disease or systemic metabolic disorders. The newborn’s vision can be minimally to severely affected. As we said, Cataracts are rare in children. Having your baby’s eyes examined at Shah Eye Center could save your child’s vision.