Pediatric Eye Exams Open Parents’ Eyes
Written by Leslie J. Weil, M.D.
An estimated 10 million children age 10 and younger have vision problems. The earlier they're caught, the better. Not only do eye problems hinder learning, but some, such as lazy eye, can lead to blindness if not treated in the first few years of life.
Catching eye problems in preschoolers is a tough task for parents and general pediatricians. Those born with a disorder such as nearsightedness, focus problems or lazy eye have no way to know they're not seeing right, and it's easy to miss the subtle signs.
Many kids undergo "Vision Screening"--an eye chart test, with letters or symbols, to check distance vision--either before school or in early elementary grades. Often given by a nurse or pediatrician, screenings don't test if eyes focus and shift properly between distances, if eyes work together or are hooked up to the brain correctly to give realistic images. And most check only for nearsightedness when preschoolers more often are farsighted.
Some pediatricians do additional checks, such as seeing if a baby follows bright objects and if eyes are aligned. But there are no strict standards.
Infants and young children should have their eyes examined by their primary care provider at their regularly scheduled check-ups at the following intervals: newborn to 3 months, 6 months to 1 year and 3 to 4 years. They should be examined by the ophthalmologist at 3 to 4 years-old, before entering kindergarten and first grade. They should see an ophthalmologist earlier than age 3 if there is a family history of strabismus (misaligned eyes), amblyopia ("lazy eye"), blindness, or if there is any known medical condition that increases their chances of strabismus or amblyopia. No child is too young to have an eye examination.
Watch for signs of vision problems, including an eye that turns slightly in or out, squinting, closing one eye or turning the head when focusing, avoiding coloring or books, clumsiness or becoming easily frustrated during play or, for older children, study. Other symptoms to report to the pediatrician in order to obtain a referral to an ophthalmologist include a jiggle (nystagmus) in one or both eyes, unusual sensitivity to light, frequent rubbing of eyes, redness or discharge of eyes, tearing or a droopy lid.
