Baby’s First Exam
Although the physician examines babies at birth, it’s a good idea for an eye
doctor to observe how a 6-month-old baby focuses, and whether both eyes are used
together as a team. At this age, the doctor will also check to make sure there
are no diseases such as congenital cataracts
or other eye problems, and will determine whether nearsightedness,
farsightedness
, or astigmatism
is present. Although a baby can’t provide any "subjective" input at this age, the
doctor can conduct several tests that will provide input about the child’s
sight.
The First Comprehensive Exam
Barring any obvious eye problems or injuries, the next regular eye
examination for a child should be conducted between the ages of 3 and 4 when the
child can begin to give coherent answers to questions. The child’s eyes will be
tested using eye charts that contain pictures, numbers, or letters. At this
stage, the doctor measures a child’s
visual acuity
, checks
depth perception and color vision, examines the health of the eyes, and looks
for any signs of crosseye or other congenital disorders.
Another eye abnormality that eye specialists can detect
is
amblyopia, or lazy eye ,a condition in which sight does not develop normally in one eye. But unless the
eye is misaligned, it is possible that neither the child nor the parents
may be aware of the condition. If left untreated during early childhood,
amblyopia may not be treatable in later years. The amblyopic eye may develop a
permanent visual defect and/or depth perception may be lost.
Conditions, which are not urgent but require attention by an eye care
professional, occur when baby’s eyes seem to move continuously and when baby
does not look directly at a person.
The Preschool Exam
It is important for children to have an eye exam before starting school.
Vision screenings conducted through schools are not complete eye examinations. A
comprehensive children’s eye exam should check health of the eyes, visual
acuity, proper eye alignment and muscle function. It should also include a
refractive test to determine whether a child’s vision needs correction. A recent
study showed that only 14 percent of children entering school in the United
States had ever had an eye exam, even though early detection and treatment of
vision problems or eye disease is very important to the health and normal
development of a child.
School Age Exams
Youngsters with vision problems that make it difficult for them to see the
blackboard or up close (reading and writing) will undoubtedly have trouble with
their studies. And children with a vision problem may not know they have one —
they think everyone sees the way they do.
Children should have a complete eye examination every two years throughout
their school years. The eye doctor will check the health of their eyes and will
be on the alert for any underlying health problems, such as diabetes, that may
first be manifested in the eyes. The doctor also tests for any changes in
eyesight that may call for corrective lenses.
Preparation for the Exam
Eye appointments for young children or babies should be scheduled for times
when they are well rested — usually in the morning. Young children can be
prepared for the exam by telling them they’ll be looking at pictures and talking
to the doctor. Parents should take along a favorite toy or juice in case there
is waiting time or the child needs some familiar comfort.
An infant exam should be scheduled for the baby’s least fussy time — after he
or she has napped and been feed. And, because those quiet times between naps and
feedings often don’t last very long, it’s best not to spend time completing
required paperwork at the doctor’s office. Instead, paperwork should be prepared
and sent to the doctor’s office ahead of time or brought along to the
appointment.
The Examination
As soon as a child reaches school age, an eye doctor should perform a
pediatric eye exam, making allowances for a child's limited ability to read.
This exam will include an overall look at the appearance of the eye and
surrounding area, checking for signs such as squinting, drooping of eyelids,
facial muscles that do not appear to be working properly, and signs of
irritation such as redness or swelling. A check of pupil
function will also be
done at this point using a pen light to see if the pupil responds normally. In
addition, the eye care professional will perform the following checks:
If any of these initial tests indicate a potential problem, more extensive
testing may be done later in the exam.
To test
visual acuity in children who do not yet read and therefore cannot use the standard
Snellen Eye Chart of alphabet letters, the eye
care professional will use a chart in which the letter E is headed up, down,
left and right. The child can then point in the same direction as the prongs of
the E.
Special attention will also be paid to the detection
and treatment of congenital disorders such as
strabismus (cross-eye
),
amblyopia (lazy eye
) and
color vision deficiency.
If a child’s history indicates a possible developmental lag or a learning
problem, the eye doctor may administer a developmental visual perceptual
screening test to help diagnose and manage visual perceptual problems. These
tests can help assess developmental level, detect visual perceptual dysfunction
,
and enable early identification of children at risk for the development of
learning-related vision problems.
Visual Trouble Signs
Symptoms that require immediate attention from a physician are:
