Why worry about a child’s eyes?
Babies are able to see as soon as they are born. For vision to continue to develop properly, children need clear input from both eyes to the brain. If there is a problem that interferes with vision in either eye or both, the connections from the eye to the brain can become weak or not develop properly. Crossed or turned eyes or imbalance in the way each eye focuses can interfere with normal vision development.
When should I have my child’s eyes checked?
Children should have their vision checked by a pediatrician or family doctor, as part of regular well-child care. A doctor will refer your child to a specialist in ophthalmology if they see any sign of amblyopia, difficulty in measuring vision, if they suspect an abnormality of the alignment or structure of the eyes or if there is a family history of vision problems. Ophthalmologists can perform a complete eye exam on children of any age.
What does the examination include?
The eye examination includes measurement of vision, assessment of alignment and binocular visual function and evaluation of other factors that may affect eye alignment or function. If we need to dilate the pupils with eye drops, the effect may last six hours or more after the visit. During that time, sensitivity to bright light and some blurry vision may occur. This may affect driving and make reading difficult, so please plan accordingly.
How long will our visit last?
If you are having a complete eye examination, plan on spending about 90 minutes in the office. Most first visits require thorough examinations. Additional tests or extended consultation may make the visit longer.
What questions will the doctor ask?
Your child’s eye examination begins with the staff and doctor asking you if you’ve noticed any vision problems. Other question they may ask:
- Were there problems with the pregnancy or with your child’s birth?
- Are growth and development proceeding normally?
- Is there a history of eye problems in the family?
- Are there other medical problems?
- Is your child on any medications or have allergies?
- Has your child had surgery?
If your child has been treated with medications, glasses, or contact lenses, these should be brought to the eye examination. The names and addresses of other doctors who may be treating your child should be supplied so we can inform them of the findings.
What are common vision problems in childhood?
Four percent of children have eye problems that can diminish vision in one or both eyes. The three most common types of problems that occur are strabismus, amblyopia, and refractive errors (focusing problems).
Strabismus is the medical term for eyes that are out of alignment. One eye or the other is turned from its normal position so that both eyes cannot look at an object at the same time. After four months of age, all infants should have straight eyes, after that if one eye drifts in or out, up or down, a full explanation is important.
A crossed eye is known as esotropia. Exotropia refers to eyes that are turned out. Strabismus may be present all of the time or intermittently. Children with strabismus are usually unaware of the problem. Strabismus interferes with developing coordinated use of both eyes together.
Amblyopia, which is sometimes called “lazy eye,” refers to developing poor vision in one or both eyes. It occurs in infancy and early childhood during the sensitive period of visual development. The earlier amblyopia is detected, the easier it is to treat.
How do ophthalmologists examine a baby’s eyes?
Many parents are quite surprised to find that a complete eye exam can be performed on their baby. A skilled ophthalmologist can get a good idea of how well children can see based on the way they use their eyes to look at and follow attractive toys and lights.
No matter how vision is tested, it is important to check each eye separately. Two to 5 percent of children have 1 eye that does not see as well as the other.
For older children who can talk, but do not yet know their numbers or the alphabet, the doctor uses special charts that have common symbols such as birds, a circle, square or house or shape.
Some tests may require your child to point to a letter that matches one on a chart. Our staff show smaller and smaller items in order to get an idea of your child’s best visual ability.
Testing for binocular vision (the ability to use both eyes together) and depth perception can also be done early in childhood.
In some situations, evaluations may be made of your child’s vision based on brain wave measurements while he or she watches striped patterns or looks at black and white stripes on flash cards.
The doctor uses lights to see if the pupils are working properly. During this portion of the exam, the areas around the eyes, such as the eyelids and the tear ducts, are also examined.
A flashlight can also be used to see if your child’s eyes are straight or turned. This is important in infants because their wide nasal bridge may make their straight eyes look crossed. Sometimes, the doctor will cover one eye and then the other. If the eyes are not aligned properly, they will jump back and forth when looking at the light or a toy. Wedge-shaped pieces of clear plastic called prisms can be used to measure the amount of misalignment of the eyes.
Why are eye drops needed?
One of the less enjoyable but essential portions of an eye exam is dilating the pupils. This procedure not only allows the doctor to view the inside of the eye, but the dilating drops temporarily relax the child’s focusing power so that nearsightedness, farsightedness, or astigmatism can be measured. Some drops are given once, some are given more than once, and all take about 30 to 60 minutes to be fully effective. It may be necessary to have special drops or ointment put in at home and to return to complete the examination later.
What happens after the drops?
The doctor shines a beam of light into the eye and, by holding lenses in the path of this reflection, can detect nearsightedness, farsightedness, or astigmatism. From this part of the examination, we can determine if your child needs glasses.
How is the inside of the eye checked?
Once your child’s pupils are dilated, the doctor uses special instruments to get a good look at the structures inside the eye. The inside of the eye is where the retina is located, which is like film in a camera. The retina processes visual information into signals that are sent via the optic nerve to the brain. The optic nerve itself, as well as the blood vessels that supply the retina, can be seen in the back of the eye.
Will the doctor prescribe medication?
Following the examination, the doctor will discuss any necessary treatment. For your convenience, there is a pharmacy on the lobby level of the Physician’s Office Center adjacent of the Eye Institute. If you request, your prescriptions can be faxed to the pharmacy of your choice.
What if glasses are prescribed?
If the examination shows that glasses are needed, your doctor will discuss this and may give a prescription. An optician of your choice can fill your prescription. There is an optical shop in the lobby of the Eye Institute. The optical shop carries an excellent selection of glasses frames, even for infants and children.
What about insurance?
Be sure to bring all your insurance cards. If your plan requires authorization before you can have an eye examination, please call your insurance provider or primary care physician for an authorization number. If you haven’t done this before arriving, we may need to reschedule your appointment.
If you have further questions, please call 304-598-4820 before your visit.