Get an Annual Pediatric Eye Exam for Your Kids in Hartsdale, NY
As a parent, you may wonder whether your pre-schooler has a vision problem or when a first eye exam should be scheduled.
Eye exams for children are extremely important. Experts say 5 to 10% of pre-schoolers and 25% of school-aged children have vision problems. Early identification of a child’s vision problem is crucial because, if left untreated, some childhood vision problems can cause permanent vision loss.
When should kids have their eyes examined?
According to the American Optometric Association (AOA), infants should have their first comprehensive eye exam at 6 months of age. Children then should receive additional eye exams at 3 years of age, and just before they enter kindergarten or the first grade at about age 5 or 6.
For school-aged children, Dr Schwartz recommends an eye exam every year even if a vision correction is not required. Children who need eyeglasses or contact lenses should be examined annually or more frequently depending on the child’s individual needs.
Early eye exams also are important because children need the following basic visual skills for learning:
- Near vision
- Distance vision
- Eye teaming (binocularity) skills
- Eye movement skills
- Focusing skills
- Peripheral awareness
- Eye/hand coordination
Eye testing for infants
It takes some time for a baby’s vision skills to develop. To assess whether your infant’s eyes are developing normally, Dr. Schwartz may use one or more of the following tests:
- Tests of pupil responses evaluate whether the eye’s pupil opens and closes properly in the presence or absence of light.
- “Fixate and follow” testing determines whether your baby can fixate on an object (such as a light) and follow it as it moves. Infants should be able to perform this task quite well by the time they are 3 months old.
- Preferential looking involves using cards that are blank on one side with stripes on the other side to attract the gaze of an infant to the stripes. In this way, vision capabilities can be assessed.
Eye testing for pre-school children
Pre-school children can have their eyes thoroughly tested even if they don’t yet know the alphabet or are too young or too shy to answer the doctor’s questions. Some common eye tests used specifically for young children include:
LEA Symbols for young children are similar to regular eye tests using charts with letters, except that special symbols in these tests include an apple, house, square and circle.
Retinoscopy is a test that involves shining a light into the eye to observing how it reflects from the retina (the light-sensitive inner lining of the back of the eye). This test helps eye doctors determine the child’s eyeglass prescription.
Random Dot Stereopsis uses dot patterns to determine how well the two eyes work as a team.
Eye and vision problems that affect children
Besides looking for nearsightedness, farsightedness and astigmatism (refractive errors), Dr. Schwartz will be examining your child’s eyes for signs of these eye and vision problems commonly found in young children:
- Amblyopia. Also commonly called “lazy eye,” this is decreased vision in one or both eyes despite the absence of any eye health problem or damage. Common causes of amblyopia include strabismus (see below) and a significant difference in the refractive errors of the two eyes. Treatment of amblyopia may include patching the dominant eye to strengthen the weaker eye.
- Strabismus. This is misalignment of the eyes, often caused by a congenital defect in the positioning or strength of muscles that are attached to the eye and which control eye positioning and movement. Left untreated, strabismus can cause amblyopia in the misaligned eye. Depending on its cause and severity, surgery may be required to treat strabismus.
- Convergence insufficiency. This is the inability to keep the eye comfortably aligned for reading and other near tasks. Convergence insufficiency can often be successfully treated with eyeglasses and prism lenses and/or with vision therapy, a specific program of eye exercises.
- Convergence Excess. Though less common than convergence insufficiency, it is also an inability to comfortably align the eyes at near. Reading glasses or prism glasses are the treatment of choice but vision therapy may also be helpful.
- Focusing problems. Children with focusing problems (also called accommodation problems) may have trouble changing focus from distance to near and back again (accommodative infacility) or have problems maintaining adequate focus for reading (accommodative insufficiency). These problems often can be successfully treated with vision therapy and reading glasses.
- Eye teaming problems. Many eye teaming (binocularity) problems are more subtle than strabismus. Deficiencies in eye teaming skills can cause problems with depth perception and coordination.
Scheduling your child’s eye exam
Your family doctor or pediatrician likely will be the first medical professional to examine your child’s eyes. If eye problems are suspected during routine physical examinations, a referral might be made for further evaluation. Dr Schwartz have specific equipment and training to help with early detect and diagnosis of potential vision problems.
When scheduling an eye exam, choose a time when your child is usually alert and happy. Specifics of how eye exams are conducted depend on your child’s age, but an exam generally will involve a case history, vision testing, determination of whether eyeglasses are needed, testing of eye alignment, an eye health examination and a consultation with you regarding the findings.
After you’ve made the appointment, you may be sent a case history form by mail, or you may be given one when you check in at the doctor’s office. The case history form will ask about your child’s birth history (also called perinatal history), such as birth weight and whether or not the child was full-term. Your eye doctor also may ask whether complications occurred during the pregnancy or delivery. The form will also inquire about your child’s medical history, including current medications and past or present allergies.
Be sure to tell Dr. Schwartz if your child has a history of prematurity, has delayed motor development, engages in frequent eye rubbing, blinks excessively, fails to maintain eye contact, cannot seem to maintain a gaze (fixation) while looking at objects, has poor eye tracking skills or has failed a pediatrician or pre-school vision screening.
Dr. Schwartz will also want to know about previous ocular diagnoses and treatments involving your child, such as possible surgeries and glasses or contact lens wear. Be sure you inform your eye doctor if there is a family history of eye problems requiring vision correction, such as nearsightedness or farsightedness, misaligned eyes (strabismus) or amblyopia (“lazy eye“).
Vision and learning
Did you know that 80% of everything a child learns, understands, and remembers is acquired through his or her visual system? Vision is very important in the learning process. What’s worse is that one in four children have undiagnosed vision problems that affect their learning. Sometimes the problem is misdiagnosed as ADD (attention deficit disorder), ADHD (attention deficit hyperactivity disorder), or dyslexia.
It is important that children receive comprehensive visual exams starting as early in life as possible. Vision screenings at school are not sufficient as a basis for diagnosing vision problems. A comprehensive exam may find a visual problem missed during screenings, and Dr. Schwartz can recommend treatment.
Your child may suffer from a visual problem if they exhibit any of the following characteristics:
- struggles with reading
- grows tired or frustrated with reading
- can’t sit still or stay at a task for any length of time
- reverses words, numbers, or letters
- has difficulty remembering the spelling of words
- frequently loses their place, skips words, or skips lines of text while reading
- has poor reading comprehension
- has shown no improvement from medication or tutoring
Children suffering from uncorrected vision problems may face many barriers in life – socially, academically, and athletically. Make sure your child’s vision is developing well.
A child's comprehensive eye examination
A child’s comprehensive eye examination should include the testing of the following visual skills which are aspects of normal, healthy vision:
- Acuity-Distance: visual acuity (sharpness, clearness) at 20 feet distance.
- Acuity-Near: visual acuity for short distance (specifically, reading distance).
- Focusing Skills: the ability of the eyes to maintain clear vision at varying distances.
- Eye Tracking and Fixation Skills: the ability of the eyes to look at and accurately follow an object; this includes the ability to move the eyes across a sheet of paper while reading, etc.
- Binocular fusion: the ability to use both eyes together at the same time.
- Stereopis: binocular depth perception.
- Convergence and Eye Teaming Skills: the ability of the eyes to aim, move and work as a coordinated team.
- Hyperopia: a refractive condition that makes it difficult to focus, especially at near viewing distances.
- Color Vision: the ability to differentiate colors.
- Reversal Frequency: confusing letters or words (b, d; p, q: saw, was; etc.)
- Visual Memory: the ability to store and retrieve visual information.
- Visual Form Discrimination: the ability to determine if two shapes, colors, sizes, positions, or distances are the same or different.
- Visual Motor Integration: the ability to combine visual input with other sensory input (hand and body movements, balance, hearing, etc.); the ability to transform images from a vertical to a horizontal plane (such as from the blackboard to the desk surface).
Be sure to schedule a complete eye exam for your child prior to the start of school. Learn more: