Routine medical exams for kids’ vision include:
- Newborns should be checked for general eye health by a pediatrician or family physician in the hospital nursery.
- High-risk newborns (including premature infants), those with a family history of eye problems, and those with obvious eye irregularities should be examined by an optometrist.
- In the first year of life, all infants should be routinely screened for eye health.
- Around age 3½, kids should have eye health screenings and visual acuity tests (tests that measure sharpness of vision)
- Around age 5, kids should have their vision and eye alignment checked.
- After age 5, annual comprehensive eye exams should be done.
- Kids who wear prescription glasses or contacts should also have annual checkups.
SPOTTING EYE PROBLEMS
Signs that a child may have vision problems include:
- constant eye rubbing
- extreme light sensitivity
- poor focusing
- poor visual tracking (following an object)
- abnormal alignment or movement of the eyes (after 6 months of age)
- chronic redness of the eyes
- chronic tearing of the eyes
- a white pupil instead of black
In school-age children, other signs to watch for include:
- being unable to see objects at a distance
- having trouble reading the blackboard
- difficulty reading
- sitting too close to the TV
Watch your child for signs of poor vision or crossed eyes. If you notice any eye problems, have your child examined right away so that the problem doesn’t become permanent. If caught early, eye conditions often can be corrected.
COMMON EYE PROBLEMS
Several eye conditions can affect kids. Most are detected by a vision screening using an acuity chart during the preschool years, but a vision screening doesn’t pick up on all the problems there might be. For example, they might read the letter correctly, but this is how they see them:
- Amblyopia (“lazy eye”) is poor vision in an eye that may appear to be normal. Two common causes are crossed eyes and a difference in the refractive error between the two eyes. If untreated, amblyopia can cause irreversible visual loss in the affected eye. (By then, the brain’s “programming” will ignore signals from that eye.) Amblyopia is best treated as early as possible, ideally before a child is 8 years old.
- Strabismus is a misalignment of the eyes; they may turn in, out, up, or down. If the same eye is chronically misaligned, amblyopia may also develop in that eye. With early detection, vision can be restored by patching the properly aligned eye, which forces the misaligned one to work. Surgery or specially designed glasses also may help the eyes to align.
- Refractive errors mean that the shape of the eye doesn’t refract (bend) light properly, so images appear blurred. Refractive errors also can cause amblyopia. Nearsightedness is the most common refractive error in school-age children; others include farsightedness and astigmatism:
- Nearsightedness is poor distance vision (also called myopia), which is usually treated with glasses or contacts.
- Farsightedness (also called hyperopia), which is usually treated with glasses or contacts.
- Astigmatism is imperfect curvature of the front surface of the eye, which is usually treated with glasses if it causes blurred vision or discomfort.
OTHER EYE CONDITIONS
Other eye conditions need immediate attention, such as retinopathy of prematurity (a disease that affects the eyes of premature babies) and those associated with a family history, including:
- Retinoblastoma is a malignant tumor that usually appears in the first 3 years of life. The affected eye or eyes may have visual loss and whiteness in the pupil.
- Infantile cataracts can occur in newborns. A cataract is a clouding of the eye’s lens.
- Congenital glaucoma in infants is a rare condition that may be inherited. It is the result of high pressure in the eye from incorrect or incomplete development of the eye drainage canals before birth and can be treated with medication and surgery.
- Genetic or metabolic diseases of the eye, such as inherited disorders that make a child more likely to develop retinoblastoma or cataracts, may require kids to have eye exams at an early age and regular screenings.
GLASSES AND CONTACTS
Kids of all ages — even babies — can wear glasses and contacts.
Keep these tips in mind for kids who wear glasses:
- Let kids pick their own frames.
- Plastic frames are best for children younger than 2.
- If older kids wear metal frames, make sure they have spring hinges, which are more durable.
- An elastic strap attached to the glasses will help keep them in place for active toddlers.
- Kids with severe eye problems may need special lenses called high-index lenses, which are thinner and lighter than plastic lenses.
- Polycarbonate lenses are best for all kids, especially those who play sports. Polycarbonate is a tough, shatterproof, clear thermoplastic used to make thin, light lenses. However, although they’re very impact-resistant, these lenses scratch more easily than plastic lenses.
Babies born with congenital cataracts may need to have the cataracts surgically removed during the first few weeks of life. Some wear contact lenses after cataract surgery.
Around age 10, kids may want to get contact lenses for cosmetic reasons or if they play sports. To wear contacts, a child will need to know how to insert and remove lenses properly, take them out as required, and clean them as recommended by the doctor. Contact lens problems are almost always due to poor habits and bad hygiene.
THE DEVELOPMENT OF BABY’S VISION
The second Baby is born, his vision kicks in and his visual development begins. At birth, your baby’s eyes have the visual acuity of 20/400, but his rapidly developing vision will reach the adult level of 20/20 by the time he is 3-5 years old. That rapid growth is why his first months are so important to his visual development.
In the first week, Baby can only see objects about20 – 25 cm in front of her face. This is about the distance from his/her face to yours while feeding. Babies generally hold their gaze for only a few seconds.
Just after birth, your baby sees only in black and white, with shades of gray. As the months go by, your baby will slowly start to develop his color vision. Because of this, Baby loves to look at contrasting colors in bold geometric patterns. Your little one will develop his color vision around 4 months. (See resources below for some great print-outs to stimulate baby’s vision.)
Parents love to decorate nurseries in pretty pastels. In reality, these aren’t naturally stimulating colors for your baby’s vision. Black and white, along with primary colors, such as red, orange, yellow, and blue, are much more stimulating. This rule goes the same for toys.
By two weeks, Baby might start to recognize her caregivers’ faces. She will focus on your face for a few seconds as you smile and play with her. Just remember to stay within her field of vision: it’s still around 20 cm. This is where all of that up-close-and-personal time with your child pays off.
By week four, Baby might start to look at things to either side of her as they move back and forth across her midline. But she’ll do this by turning her entire head. She won’t be able to move only her eyes until she’s about 2-4 months old.
By 1 month, the following will happen:
- Moves eyes and head toward light sources.
- Tracks objects horizontally across midline (especially faces).
- Make eye contact and focuses on a caregiver.
2 to 3 months
- Tracks an object both vertically and circularly.
- Recognizes faces.
- Begins to move eyes independently from head.
- Exhibits increased light sensitivity.
- Studies hands or feet.
- Becomes easily distracted by interesting sights.
- Holds intense eye contact for longer periods of time.
3 to 6 months
- Watches and studies own hands and feet, as well as toys.
- Observes toys falling and rolling away.
- Shifts fixation across midline (moves gaze from left to right).
- Widens visual sphere of attention gradually.
- Focuses attention almost across the room.
- Likes looking at reflection.
- Moves eyes independently from head.
7 to 10 months
- Shows interest in pictures.
- Notices small bread crumbs. (Hopefully, this will be at his high chair and not on the floor!)
- Recognizes partially hidden objects.
- Hand-eye coordination improves as your baby learns to crawl.
11 to 12 months
- Looks through windows and recognizes people.
- Recognizes pictures.
- Plays hide and seek.
- Appears visually oriented at home.
- Shows sustained visual interest
For some interesting videos, links and print-outs, click here to visit our resource page. RESOURCES
Book an appointment with our Carina Janzen for your children from ages 3 months to ages 15 by phoning 012 998 7592/3