Eye Tests for Children

Posted on January 19, 2018

Eyes are the most important sense organ during our formative years, and play a critical role in children’s physical and cognitive development. As many as 25% of preschool children have a vision disorder five preschool-age children enrolled in Head Start have a vision disorder while 60% of children identified with learning disabilities have an associated vision related issue. Uncorrected vision problems can impair child’s social behavior, interfere with learning, and even lead to permanent vision loss. Over 80% of learning comes through input from the yes in the early years, it is therefore critical that any vision or eye related problem should be detected, and treated, as soon as possible.

Is A Routine Pediatrician Visit Not Enough?

Since it is not easy to evaluate the vision of young children, parents often are not aware of their vision disturbances, unless very severe. Also small children find it difficult to express their complaints, and their problems related to the eye are often ignored. It is therefore essential to get eye check-ups for young children as per the recommended schedule, since routine pediatrician visits do not involve a comprehensive eye examination.

Common Eye Problems

A vision check-up alone does not constitute an eye examination for children. Your ophthalmologist will screen for the common eye problems of childhood. These include:

  1. Refractive error:

    or the need for corrective spectacles is the most common childhood problem, and often goes undiagnosed unless the vision of the child is actively checked. Sometimes, the child may complain of headaches or eye pain, and sometimes the parents may notice that the child tends to rub his or her eyes very often, or watches television from very close. If prescribed, care must be taken to ensure that the child wears his or her glasses through the day.

  2. Amblyopia:

    or lazy eye is a term used to mean poor vision in an eye that has not developed normal vision (usually during early childhood). It occurs when visual acuity is much better in one eye than the other, and is potentially reversible till the age of eight. It is usually due to either an uncorrected refractive error, or a squint. Other disorders which deprive the child from having useful vision like cataract may also result in amblyopia. In case amblyopia is not treated in time, the vision loss becomes permanent and cannot be reversed in adults.

  3. Eye Allergy:

    Or spring catarrh often affects children. The eye appears red or pink due to inflammation of the conjunctiva. The child complains of itching and watering, and parents usually report an increased rubbing of eyes.

  4. Congenital Glaucoma:

    Glaucoma is a group of diseases characterized by damage to the optic nerve that often occurs when the eye pressure is too high. It usually affects the elderly but can affect children also. Infants with glaucoma classically present with a triad of symptoms: watering of eyes, clouding of the cornea and abnormal sensitivity and intolerance to light. This is a severe condition that requires immediate intervention, which is usually surgical.

  5. Congenital cataract:

    Some babies are born with cataract and may require an early surgical intervention so as to prevent the development of amblyopia. Others may have an opacity that does not increase with time or affect vision, and these cataracts may be observed over time. Parents may notice a white discoloration of the pupil. Any white reflex must be evaluated by an eye doctor on an urgent basis, because it can indicate a serious eye anomaly also.

  6. Retinopathy of prematurity (RoP):

    RoP is a disease that occurs more commonly in premature babies weighing 1250 grams or less that are born before 31 weeks of gestation. It is also known to be more common in infants who spend time in the neonatal ICU and have been administered oxygen. RoP is characterized by abnormal blood vessels in the retina, the layer of nerve tissue in the eye that enables us to see. This can result in a retinal detachment, and even blindness. The severity and stage of RoP decides its management which can range from simple observation to complex vitreoretinal surgeries. Children with RoP also may have a white pupillary reflex.

Recommended Schedule for Eye Examination:

The recommended schedule for eye examinations is not cast in stone, but is merely a broad guideline, to be followed for otherwise healthy infants in children. In case of any disease process your doctor will decide the frequency and timing of follow up, in consultation with your pediatrician.

  1. Newborns should be checked for general eye health by a pediatrician in the hospital nursery, and any abnormalities should be seen by an ophthalmologist.
  2. High-risk newborns (including premature infants and low birth weight babies), and those with obvious eye irregularities should be examined by an eye doctor at birth. This includes all preterm babies, and those with low birth weight as defined above.
  3. In the first year of life, all infants should be routinely screened for eye health during checkups with their pediatrician or family doctor.
  4. Many doctors recommend a check-up once every two years for children between one to five years also, in case the parents wear glasses (especially with high refractive error or astigmatism).
  5. Around age 5, kids should have their vision and eye alignment checked by an eye doctor.
  6. Children who wear prescription glasses must have annual checkups by an eye doctor to screen for vision changes.

Most eye doctors are happy to take care of children, but in case of a specific disease you may be asked to see a super specialist who may be an expert in taking care of children, or the particular disease that affects the child. As is true for almost every other disease, prevention is better than cure, and a timely intervention can ensure a happy and productive life for all our children.


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