Pediatric Optometry
Questions and Answers

Why is an eye exam important before my child starts school?
A vision exam is a very important step in preparing children
for the first day of school. During the school years good
vision is essential in the ability to read to learn. Any vision
problems need to be detected and treated before they lead
to a learning problem. Once in school, children need a
comprehensive vision exam every year.

My child passed the school screening - is that sufficient?
Screenings can identify children with reduced visual acuity,
however, screenings do not test important visual skills,
including eye teaming (binocular vision). This can be
identified in a comprehensive eye examination.

At what age can a child have an eye exam?
The American Optometric Association recommends that a
child receive their first eye exam at 6 months of age. If
development is normal and no problems are found during
that exam, it is recommended that their next well child
exam be performed at three years of age and then before
starting school.

How does an optometrist check a child’s eyes when they
don’t know the alphabet?
While letters are preferred, there are many ways to assess a
child’s vision. We are able to accurately measure a child's
vision through naming or matching pictures. In very young
children that are not able to match pictures, we ensure that
a child is able to fixate and track an object equally with both
eyes and are able to reach and grab for age appropriate
objects. (These assessments can be performed from infancy
through early childhood).

How do you determine eye health and prescription in
young or non-verbal children?
There are many objective methods that can be done to
ensure that a child has healthy eyes and determine if there is
a need for glasses. A glasses prescription can be accurately
measured with a test called Retinoscopy, in which a mild
intensity light is used with various lenses to determine the
child’s prescription. This is how children with farsightedness
can be identified as often times they don’t have good
visual acuity despite a high prescription.
Various opthalmoscopes are used to examine the health of
children's eyes. These techniques can be preformed on
individuals ranging from infancy to adulthood.

Common Diagnosis

MYOPIA (NEARSIGHTEDNESS) A vision condition in which near objects are seen clearly, but distant objects do not come into proper focus. Nearsightedness occurs if your eyeball is too long or the cornea has too much curvature, so the light entering your eye is not focused.

HYPEROPIA (FARSIGHTEDNESS) A vision condition in which distant objects are usually seen clearly, but close ones do not come into proper focus. Farsightedness occurs if your eyeball is too short or the cornea has too little curvature, so light entering your eye is not focused correctly.

ASTIGMATISM A vision condition that occurs when the front surface of your eye, the cornea, is slightly irregular in shape. This irregular shape prevents light from focusing properly on the back of your eye, the retina. As a result, your vision may be blurred at all distances.

AMBLYOPIA (LAZY EYE) The loss or lack of development of central vision and is not correctable with lenses. It can result from a failure to use both eyes or a large difference in the degree of nearsightedness or farsightedness before age 6, and it does not affect side vision.

EYE COORDINATION The ability of both eyes to work together as a team. Each of your eyes sees a slightly different image and your brain, by a process called fusion, blends these two images into one three-dimensional picture. Good eye coordination keeps the eyes in proper alignment. Eye coordination is a skill that must be developed. Poor eye coordination results from a lack of adequate vision development or improperly developed eye muscle controls. Although rare, an injury or disease can cause poor eye coordination.

COLOR DEFICIENCY Your ability to distinguish some colors and shades is less than normal. It occurs when the color-sensitive cone cells in your eyes do not properly pick up or send the proper color signals to your brain. About eight percent of men and one percent of women are color deficient.

VISION LEARNING

• Up to 25% of all school age children have vision problems significant enough to impair academic performance
• Traditional testing for 20/20 visual acuity does not detect learning related vision problems
• Eighty percent of all learning is performed through vision.

CHILDREN’S VISION

A learning-related visual problem directly affects how we learn, read, or sustain close work. Visual problems in any of the following areas can have a significant impact on learning:

• Eye Tracking Skills - Eyes following a line of print.
• Eye Teaming Skills - Two eyes working together as synchronized team.
• Binocular Vision - Simultaneously blending the images from both eyes into one image.
• Accommodation - eye focusing

As vision and learning are intimately connected, a vision problem can be easily mistaken for a learning problem. Youngsters with visual problems can be misdiagnosed as having Learning Disabilities, ADHD, or Dyslexia. Children who have learning-related visual problems cannot sustain their close work at school, children who have ADHD also cannot sustain attention on their work. Same behaviors, different diagnosis.

SIGNS & SYMPTOMS
Vision problems can elicit a wide range of signs and symptoms. Some, like eyestrain or blurred vision, can usually be attributed directly to a visual dysfunction. Others, such as poor attention span at school, clumsiness in sports, or reduced productivity at work, may not immediately be recognized as possible signs of a vision problem.

Following is a listing of common signs or symptoms of vision problems that may indicate the need for a comprehensive vision exam:

Physical signs or symptoms

• Frequent headaches or eye strain
• Blurring of distance or near vision, particularly after reading or other close work
• Avoidance of close work or other visually demanding tasks
•  Poor judgment of depth
• Turning of an eye in or out, up or down
• Tendency to cover or close one eye, or favor the vision in one eye
• Double vision
• Poor hand-eye coordination
• Difficulty following a moving target
• Dizziness or motion sickness
• Performance problems
• Poor reading comprehension
• Difficulty copying from one place to another
• Loss of place, repetition, and/or omission of words while reading
• Difficulty changing focus from distance to near and back
• Poor posture when reading or writing
• Poor handwriting
• Can respond orally but can't get the same information down on paper
•  Letter and word reversals
• Difficulty judging sizes and shapes

If you or a member of your family experience any
of these signs or symptoms, a comprehensive
vision examination may discover undetected vision
problems.

If you have any concerns about your children's vision or eye health, please schedule an exam at any of our Family Eye Center locations.