“When should my child visit you for their first eye exam?” This is a question that our doctors and staff often hear, and the answer may surprise you –Vista Eye Care, as well as the American Optometric Association, recommends that children receive their first eye exam at 6-12 months of age. The idea of early-life eye care is a relatively new one in the healthcare world, and it is unfortunately common that many children are not referred for their first eye exam until they are school-aged. Pediatric eye care can identity an early need for glasses, eye function issues, eye health issues, and ensure that the child’s eyes are in a good position to allow them to learn to their full potential.
Vision disorders are the fourth most common disability in the United States, and the most prevalent handicapping condition during childhood. In spite of the high prevalence of vision disorders in the younger population, studies show that only about 31% of children between the ages 6 and 16 years are likely to have had a comprehensive eye and vision examination within the past year, while below the age of 6, only about 14% are likely to have had an eye and vision examination. Uncorrected refractive error (nearsightedness, farsightedness, and astigmatism) can lead to amblyopia (also known as “lazy eye”) where the visual system is unable to develop properly because the images detected by the eyes are distorted or out of focus. How many infants need to wear glasses? Not very many, but those few that are prescribed glasses early in life greatly benefit because their visual system has the opportunity to develop normally.
How much reliance can be put on school screenings? These brief assessments sometimes performed at school are not a substitute for a complete eye and vision examination by an eye doctor. One concern about relying on school screenings is that the majority of school vision screenings test only visual acuity. Such testing is primarily aimed at detecting amblyopia and nearsightedness, and only high degrees of astigmatism and farsightedness. Although detection of such disorders is certainly a worthwhile objective, screening for visual acuity alone generally detects only about 30% of children who would fail an actual comprehensive eye and vision examination.
There is more to the sense of vision than just seeing clearly with a single eye. This means that even a patient that “sees 20/20” may have poor vision. Eye function is the eye’s ability to perform in the real-world, and in the case of children, the ability to perform in the classroom. The eyes’ ability to form a clear, binocular image, provide depth perception, focus properly, and move properly in tandem with the fellow eye are all crucial to learning and proper vision function. As an example of the prevalence of these conditions, eye turns have been identified in 3-4% of children. These conditions may interfere with school performance, causing a number of symptoms including eyestrain, blurred vision, double vision, loss of place, skipped lines, word movement on the page, inability to sustain attention when reading, and decreased reading comprehension over time. As with most visual problems, identifying these issues early in life will make them much more treatable, and get the child back on track with their visual development.
Ocular disease in children may not be detected at a pediatrician visit or school health screening. Dilation of the child’s pupils allows our optometrists to get a view of the retinas that let us rule out many ocular conditions. Many eye diseases that are traditionally associated with adult-age patients may be present in children from birth as a congenital abnormality. These conditions include cataracts and glaucoma. A thorough eye health exam is an important component of your child’s first eye exam.
According to the American Optometric Association, research indicates that early detection and intervention are particularly important in children because of the rapid development of the visual system in early childhood and its sensitivity to interference. Any barrier to the visual system’s proper function is a barrier to that child’s ability to learn. Amblyopia is a perfect example of a visual disease that if treated early on, will often allow that patient to develop normally. Putting off treatment results in dramatically lower visual ability later in life, and can seriously affect appearance, career choice, and overall quality of life. Vista Eye Care is a proud partner in the American Optometric Association’s InfantSEE program. We see patients 6-12 months of age at no charge in order to raise eye care awareness in that segment of the population. Please call us today at (303) 450-2020 to schedule your child’s first eye exam, or feel free to click the button below to schedule an examination online.
References:
Gerali P, Flom MC, Raab EL. Report of Children’s Screening Task Force. Schaumburg, IL: National Society to Prevent Blindness, 1990.
Poe GS. Eye care visits and use of eyeglasses or contact lenses. United States 1979 and 1980. Vital and health statistics. Series 10, No. 145, DHHS Publication (PHS) 84-1573, Hyattsville, MD: National Center for Health Statistics, 1984.
Blum HL, Peters HB, Bettman JW. Vision screening for elementary schools. The Orinda Study. Berkeley: University of California Press, 1959:36-55.
Ciner EB, Schmidt PP, Orel-Bixler D, et al. Vision screening of preschool children: Evaluating the past, looking toward the future. Optom Vis Sci. 1998; 75:571-84.
Scheiman M, Rouse MW. Optometric management of learning related vision disorders. St. Louis, MO: CV Mosby, 1994:321-
Duke-Elder S. System of ophthalmology, vol V. Ophthalmic optics and refraction. St. Louis, MO: CV Mosby, 1970:451- 86.
Daum KM. Accommodative dysfunction. Doc Ophthalmol 1983; 55:177-98.
Hennessey D, Iosue R, Rouse MW. Relation of symptoms to accommodative infacility of school aged children. Am J Optom Physiol Opt 1984; 61:177-83.
Haddad HM, Isaacs NS, Onghena K, Mazor A. The use of orthoptics in dyslexia. J Learn Disabil 1984; 17:142-4.
Sheedy JE, Saladin JJ. Association of symptoms with measures of oculomotor deficiencies. Am J Optom Physiol Opt 1987; 55:670-6.
Ludlam WM, Ludlam DE. Effects of prism-induced accommodative convergence stress on reading comprehension. J Am Optom Assoc 1988; 59:440-5.
Garzia RP, Nicholson SB, Gaines CS, et al. Effects of nearpoint visual stress on psycholinguistic processing in reading. J Am Optom Assoc 1989; 60:38-44.