Children’s Eye Exams

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When should you have your child's eyes checked?:
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Many people ask us to discuss children's eye exams with them. Ask Wendy Marsh-Tootle, O.D., of the University of Alabama, Birmingham (UAB), and she'll tell you it's never too early for an eye exam -- especially if you suspect that your child has an eye or vision problem.

"Eye doctors can conduct an eye exam long before a child can talk, so get your baby's eyes checked early if you suspect an eye or vision problem," says Dr. Marsh-Tootle, an associate professor and director of pediatric services for UAB's School of Optometry.

Ideally, all children should have their eyes examined by an eye doctor at least by the time they enter school. In fact, the American Optometric Association suggests that children should have their first regular eye exam at 6 months. Follow-up exams should occur at age 3 and again just prior to starting school. If a problem is found, more frequent care may be necessary.

For young children without obvious signs of an eye or vision problem, Dr. Marsh-Tootle says eye doctors rely on pediatricians to screen for some important problems at key ages. "A baby's visual system is very immature at birth and develops very rapidly, so newborn screenings by the pediatrician are very important," she points out. "For example, rare problems such as cataracts must be treated within the first few weeks of life or normal vision will never develop."

So what's a parent to do? Keep a watchful eye, so to speak, on your child's eyesight from infancy through adolescence.

"After the first few weeks of life, your baby should seem to look at you," Dr. Marsh-Tootle says. "After a few months, he or she should use the eyes together more and more. If your baby does not appear to use his or her eyes together normally by the sixth month, get a checkup from an eye doctor."

Once children reach preschool age, it's important to have them checked for "lazy eye," as well as for risk factors including high refractive error or strabismus. Treatment of these conditions before the child enters school is easier on everyone.

Finally, once your child starts school, be sure to have his or her eyes checked for focusing problems and for nearsightedness. "Both are common conditions that develop during school years, so it's a good idea to get a checkup periodically, particularly if your child is struggling with school work," says Dr. Marsh-Tootle. "Most eye problems are easily treated once the problem is diagnosed."

According to Wendy Marsh-Tootle, O.D., infants should visit an eye doctor if they have:

  • Poor focus on objects after 3 months of age.
  • Eyes that are not straight.
  • An eyelid that is droopy.
  • A family history of serious eye problems.
  • A watery eye with overflow tearing.

Children should have an eye examination if they:

  • Have a red eye with or without discharge.
  • Squint their eyes to read or see small objects.
  • Complain of blurred distant vision.
  • Blink their eyes excessively.
  • Complain of headaches or double vision.

Polycarbonate Lenses: Premium on Safety

While the visual needs of children haven't changed much over the years, their eyewear options certainly have. Products that suit the unique needs of kids have never been more bountiful.

Ask any optical dispenser what lens material children should receive and the reply will most likely be polycarbonate. This is largely due to polycarbonate's inherent safety characteristics. Polycarbonate is virtually unbreakable and can pass the drop-ball test even at a 1.0mm center thickness. For active people, and children usually are, it's important to keep the minimum thickness to a safer 2.0mm.

According to the Polycarbonate Lens Council, close to 50% of all children's eyewear is still ordered using conventional lenses. While this statistic is better than it was several years ago, it shows that not all ophthalmic professionals nor the industry as a whole have embraced polycarbonate usage as a standard for children. Today's polycarbonate lens material is much improved over what it was in the past, and providers need to reconsider offering this product to their patients?especially children.

In most cases, impact resistance is the most important lens characteristic for a child. Compared to other lens materials, polycarbonate provides 4 to 5 times more impact resistance to breakage thus making it an excellent choice for kids.

Polycarbonate lenses are also lightweight and resist scratching, two more important considerations for kids. Most children will be rougher on their eyewear than the average adult, yet parents expect a reasonable lifespan for the lenses. Today's polycarbonate lenses also have improved lens coatings rivaling the surface coatings found on most other lenses.

Finally, a distinct benefit of polycarbonate lenses is their UV protection. Many people aren't aware of the inherent dangers of long-term exposure to ultra-violet light in terms of ocular health. While some lenses provide natural ultra-violet absorption, some have little. Polycarbonate lenses in their natural form (no additional coatings or dye) offer 98-99% ultra-violet light protection to the eye.


Pre-School Vision

From ages 3 to 6, your child will be fine-tuning the vision already developed during the infant and toddler years. Older preschoolers are learning how to use sports equipment and working on the fine motor skills needed to write their names.

Warning Signs:
Watch for the warning signs of visual problems, such as:

  • Loses their place while reading
  • Avoids close work
  • Holds reading material closer than normal
  • Tends to rub their eyes
  • Has headaches
  • Turns or tilts head to use one eye only
  • Makes frequent reversals when reading or writing
  • Uses finger to maintain place when reading
  • Omits or confuses small words when reading
  • Consistently performs below potential

Farsightedness and strabismus are common problems with this age group. However, some problems might not have a sign; only an eye doctor can tell.

If your child exhibits no symptoms of a visual problem, he should have an eye exam by the age of 3. Having a complete eye exam even before the child enters school allows enough time to catch and correct any problems while the visual system is still flexible.

If your pre-schooler needs glasses, make sure your child understands why. Explain that he/she needs glasses to see clearly, and give specific examples of the benefits, such as that he'll be able to see the words in his books better or will be able to play catch with his brother because he can now see the ball.

School Days:
School-age children should receive an eye exam before entering kindergarten and regularly after that if they have no visual problems. If your child requires glasses or contact lenses for refractive errors, schedule visits every 12 months.

A vision screening performed by your pediatrician or the school nurse is not a complete eye exam. These screenings are designed to alert parents to the possibility of a visual problem and do not take the place of a visit to the eye doctor. Studies even show that these screenings miss sight-threatening eye conditions.

If a visual dysfunction is part of your child's learning difficulty, special lenses or vision therapy may help. Should your child's visual function not be an issue, ask your eye doctor for referrals to the appropriate specialists. Visit your family doctor or pediatrician as well for more information on diagnosing your child.


Sunglasses for Kids

Sunglasses_Child3While adults often take sunwear very seriously for themselves, they sometimes don't think about protecting the kids. Children's sunglasses are frequently an impulse purchase from the toy store, with little thought for durability or protection. Yet young eyes need the same UV shielding as adult eyes. We know that long-term exposure to UV light contributes to premature cataract formation and macular degeneration, both good reasons to start sunglass wear early in life.

Monkey See, Monkey Do:
Kids like products that mimic what mom and dad wear, and there is no reason to compromise on performance when it comes to kids' sunwear?it just needs to come in smaller sizes. There are several lines of kid's sunglasses that offer smaller versions of adult performance sunwear. Check with your eye doctor to determine what's best for your children.

What to Look for in Kids' Sunwear
Children's sunglasses should offer full protection from ultra-violet rays up to 400nm.

  • Lenses should be polycarbonate for safety and durability.
  • Scratch resistance is a must.
  • Spring hinges are a major plus.
  • Nylon frames give superior durability.
  • Saddle bridges are more comfortable for small noses.
  • Retainers help prevent loss and damage.
  • Frame materials should hold adjustment.
  • Replacement parts should be available.
  • Kids are keen on styles that mimic adult sunglasses.
  • Children like product tie-ins with cartoon characters, etc.