Pediatric Eye Care

There are four visual issues that can affect the health and vision of our children. They are refractive error, such as myopia; strabismus; amblyopia, more commonly known as lazy eye; and lastly, significant ocular diseases.

SIGNIFICANT REFRACTIVE ERROR

Almost 15% of our children suffer from undiagnosed refractive problems such as excessive hyperopia, myopia, or significant astigmatism. Failure to identify these conditions at an early age can result in the development of amblyopia. Failure to detect these conditions can delay perceptual skills, reading abilities, create attention deficits and lead to the failure of the eyes to work together which, in turn, causes problems with depth perception. Fortunately, most of these conditions are easily treatable with glasses or contacts.

STRABISMUS

Strabismus, more commonly known as eye turn, affects about 3-4% of our children. It is an inability for the eyes to maintain alignment in the same direction simultaneously. When one or both eyes turn in or out, (esotropia and exotropia respectively,) symptoms such as headaches and blurred vision may occur. Hypertropia, also known as vertical misalignment, is much more difficult to pick up. It often manifests as blurred vision, headaches and changes in reading speed and comprehension. Children will often start using their fingers or another object to help guide them (or prevent them) from losing their place in line as they read. In addition to the obvious social implications and cosmetic concerns these children can encounter with eyes looking in opposite directions, they also risk amblyopia and loss of fine depth perception as well as frustrations with reading and often poor performance in a traditional school setting. The treatment for strabismus depends on the type and severity of the condition, but may include special prismatic glasses, surgery or vision therapy.

AMBLYOPIA

Amblyopia, the term used to describe a preventable reduction in vision acuity in one or both eyes, affects 2-8% of the overall population. It may be caused by strabismus, developmental ocular diseases such as cataracts or a significant difference in the prescription between the two eyes. It may lead to a permanent decrease in vision; if untreated, through pre-adolescence, and may have a significant impact by creating many occupational limitations. If caught early, the condition may be corrected through glasses, patching or vision therapy.

CHILDHOOD OCULAR DISEASE

Childhood ocular disease, though rare at about 0.5% of our children, has the most devastating effects. Childhood ocular diseases like retinopathy of prematurity, retinoblastoma (a 100% fatal cancer of the eye if not detected early in the disease), and toxoplasmosis (a fungal disease transferred from the mother to fetus through the placenta), can have effects much greater than just vision and ocular health. The treatments are variable depending on the condition, but early detection is the key.

SO WHY WORRY ABOUT THIS?

The reasons are numerous but the most obvious is that our children cannot always help themselves. Most of these vision conditions are painless and present since birth so they do not know that anything is wrong. They just think that how they see is the way that everyone sees. Worse yet, is that most of these vision disorders can result in serious learning problems and, at times, even behavioral issues. Think about how you would behave if you couldn't see what everyone else is seeing. Would you get frustrated?

EARLY TREATMENT = HOPE

The earlier a problem is detected the better the overall prognosis. We can prevent vision loss and decrease the negative impacts that vision loss will have on our kids for the rest of their lives. Mistakenly, most parents think that the vision screening our children have in kindergarten and again in fifth grade will detect these issues. Think about these facts:

Less than 15% of all preschoolers receive eye examinations from a qualified eye doctor.
Less than 22% of all pre-schoolers have an adequate vision screening consisting of visual acuity (amazingly only 30 states in our country require this), eye alignment (required by only 24 states) and refractive error (only 8 states require this).
There are no uniform criteria for screening failure across the country, state, county or school districts and this includes the area that we live in.
25% of 10 year olds have vision problems
After the age of 7 less than 20% of children with vision problems present in early childhood will ever recover functional vision similar to the other non-affected eye.

In summary, please make sure that your children have an eye exam by a qualified eye health professional, give them a chance at a life full of color, detail and possibility.

EYE SYMPTOMS CHECKLIST

Infants
Do they consistently turn their head to one side?
Do they consistently turn their head to one side when picking something up?
Do they seem startled if you approach from one side vs. the other?
Do they seem to consistently miss seeing something of interest?
Were there any complications during or immediately after birth?
Do their pupils look the same?
Do they have a family history of a lazy eye?

Pre-schoolers
Do they sit close to the TV because they say they cannot see it?
Do they complain of headaches?
Do they tilt their head to one shoulder or to one side consistently when watching TV or reading?
Do they have a shorter attention span than usual when doing near tasks?
Were they slower than expected in hitting their milestones?

School age children
Do they have attention issues?
Do they say they have headaches?
Do they complain of double vision or blurred vision at distance or near?
Do they have trouble seeing the board?
Have their reading comprehension scores started to drop?
Do they lose their place on the page or use their fingers to keep track of where they are on the page (after 2nd grade)?