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Q&A on Children’s Eye Care

Q: We hear a lot about “seeing your eye doctor regularly”.  In school aged children, ages 5 through 17, what does that regularly mean?

Yearly or more if a concern arises.  Unfortunately, parents often confuse having 20/20 eyesight with having “perfect vision.”  There are many other areas of vision that are equally, if not more important, to have examined on a yearly basis to make sure a child’s eyes can accomplish all the tasks required of the classroom.

 

Q: What about pre-schoolers?  Are there signs parents should look for that would indicate a trip the optometrist is necessary?

The AOA recommends an eye examination at the ages of 1, 3, and 5 if all findings are normal, and more often if there is a diagnosis that requires close monitoring.   Some concerning observations that can be looked for are:

·         Closing an eye when looking at something

·         Holding objects very close

·         Standing very close to a distant target in order to see it clearly

·         An eyeturn

·         Decreased depth perception

·         Overall clumsiness

·         Avoidance of near work / dislike of reading or coloring

·         Excessive eye rubbing

·         Unusual head turn or posture when reading or being read to.

 

Q: Because many children may be too young to read, how is an eye exam conducted if they cannot read a Snelling Chart?

We have the ability to measure visual acuity in newborns involving a teller acuity card. This card has a plain gray area, or a section with black and white lines.  This requires the infant or non-verbal child to choose between the two areas.  A normal response is observing the child looking at the target WITH the lines.  The lines can be made finer and finer until the child no longer demonstrates a preference.   At this point, an estimate of the child’s visual acuity can be determined.   We have number charts with common shapes on them for children that may not know their letters.  They can verbally communicate or communicate by matching to provide their response.

Q:  One of the greatest tasks of a school-aged child is learning to read and in older children, the amount of reading required.  What should parents be on the lookout for concerning their child’s reading and potential vision problems?

Reading is a difficult task for many children.  Common symptoms to watch out for include loss of place, poor comprehension, double or blurred vision, and fatigue while reading.  Some children may cover an eye while reading, lie their head down, demonstrate an unusual head posture or head tilt, while others may try to avoid the task at all cost.

 

Q: We often discuss vision problems as they relate to sitting in a classroom, but what about the playground or vision acuity’s effect on socialization and play?

Children with poor vision may have decreased depth perception or an overall clumsiness which can make sports and interaction difficult. Also a high uncorrected prescription could cause poor facial recognition, making it difficult to identify faces and objects.  Children with binocular vision disorders may have “normal” eyesight but still struggle with using monkey bars or other playground activities that require good depth perception.

 

Q: Today it seems that many children are very quickly diagnosed as learning disabled or dyslexic.  How does vision play into the problems and what are the differences?

There are many areas of visual perception which can contribute to areas of learning.  Difficulty with identifying direction on oneself or objects can relate to reversal of letters or numbers, difficulty with visual memory can relate to poor spelling, difficulty with visual closure can cause poor planning, and the list goes on.  All of these areas and more are evaluated in a special visual perceptual examination. Dyslexia is a condition which can only be diagnosed by a psycho-educational evaluation performed by a neuropsychologist, however many dyslexic individuals do have concurrent visual perceptual or sensory motor deficits.

 

Q: We have many choices today to correct our vision.  What do you recommend as the earliest age for contact lenses?

The appropriate age a child can start to wear contact lenses varies on a case by case basis; it is a big decision for the entire family.  The child has to be responsible, and willing to learn how to care for the lenses, while also being able to insert and remove them safely from their eyes. We have a wonderfully  trained staff who teaches the children how to insert, remove, and care for the lenses.  This process occasionally can take place over the course of a few visits, however once it is determined that the child is a candidate and the parents and child decide they are responsible enough, we work our hardest to fit all candidates.

 

Q: Kids can be hard on glasses.  Are there effective glasses for children today that last?

Matthew, Adam, and Amie have a large selection of frames in the dispensary, but in particular our flexible frames would be the most durable for daily wear, while our sports goggles are best for physical activities.

 

Q: Vision Therapy appears to be making a comeback and is being utilized by some students to address their vision problems.  Can you talk about vision therapy and when it is right for your child?

Vision therapy can be utilized for children with both sensory motor and/or visual-perceptual deficits. Sensory motor deficits include binocular (difficulties converging and diverging eyes), accommodative (difficulties keeping images clear), and ocular motor (difficulties tracking) deficits.  Whenever there is a diagnosis involving any of the above areas, vision therapy may be recommended.  We have both in office and home based therapy programs which we use individually or combined on a case by case basis.  Each patient is evaluated and a personalized plan is created based on their diagnosis and need.

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