Vision plays an important role in childhood development. There are a number of vision and eye problems that can be encountered in pediatrics, so a parent’s first question should be: “When should my child have his or her first eye exam?”
The pediatrician should examine your child’s eyes throughout the first year of life. If you or your doctor suspect any abnormality or if there is a family history of eye disease, your child should see a pediatric ophthalmologist — a medical and surgical doctor specializing in the eye care of children. All children should have a comprehensive eye exam by their 4th birthday if vision appears to be developing normally, and every two years thereafter.
What if a problem is suspected? Don’t panic. Early diagnosis and treatment of some of these common childhood eye diseases may mean better visual results for school-age children.
▪ Amblyopia (lazy eye) is a condition in which the visual function of one eye is underdeveloped while vision for the other eye is normal. Common treatments for amblyopia include glasses and patching the strong eye. The weak eye is strengthened because the child is forced to use it. With amblyopia, the earlier it is detected and treated the better the results have proven to be.
▪ Strabismus, or misaligned eyes, is commonly called “crossed eyes.” This is another common disorder that refers to eyes that are misaligned by turning in, out, up or down. It is noticeable when the child’s eyes point in different directions. Strabismus is more common among children, but is also present in some adults. Children will not outgrow true strabismus. Treatment of strabismus may include eye exercises, glasses, patching, eye drops or, occasionally, surgery.
▪ Ptosis is a condition in which the upper eyelid droops. If your child’s eyelid droops slightly or covers the pupil entirely, it can affect normal vision. This may be corrected with a surgical procedure.
▪ Pediatric glaucoma is a group of diseases in which eye pressure is too high, resulting in optic nerve damage. It is treated differently from adult glaucoma. Most young patients require surgery urgently and are referred to doctors who specialize in pediatric glaucoma surgery.
▪ While very rare, retinoblastoma is a form of cancer affecting the light-sensitive retinal cells that enable sight. You can tell if your child might have this uncommon cancer when looking at a photograph. If your child has “red eye,” it’s good. If the child’s eye appears to have white centers in flash photos, request a pediatric ophthalmic examination immediately.
Will my child need glasses?
Nearsightedness is the most common vision problem that requires children to wear glasses, often developing between age 6 and adolescence. With this condition, the child’s distance vision is impaired, making the blackboard or teacher at the front of the room seem blurry.
Farsightedness, which may cause headaches, blurred vision or crossing of the eyes, is most often associated with adults after the age of 40. However, farsightedness also occurs in children and causes difficulty seeing close objects or reading.
Nearsightedness and farsightedness can be corrected with eyeglasses. Your optometrist or ophthalmologist will write a prescription for your child specifying the lens power.
Eye safety for children
Parents should keep vision in mind when equipping their children for a successful year — both at school and at play. Select games and toys that are appropriate for their eyes. Supervise children when they are using pencils, scissors, forks and knives. Even common household items such as paper clips, rubber bands or wire hangers can cause serious eye injury. Childproof your home and keep all chemical sprays, household cleaners and detergents out of reach of small children.
Have children wear protective eyewear when participating in sports or other hazardous activities. Sports-related eye injuries range from abrasions of the cornea and bruises of the eyelids to internal eye injuries, such as retinal detachments and internal bleeding. Many of these injuries lead to vision loss and permanent blindness. Properly fitted protective eyewear can prevent 90 percent of sports eye injuries.
If you have teenagers who wear contact lenses, remind them to clean their lenses regularly and to follow their doctor’s recommendation about sleeping in their contact lenses. They should also keep their contact lens case clean and replace it regularly, at least every three months, as lens cases can be a source of contamination and infection.
It is extremely important to go to an ophthalmologist for diagnosis and treatment if you suspect your child is having problems with their eyes or vision. If an eye injury occurs, Bascom Palmer Eye Institute’s eye emergency room in Miami is open 24 hours a day, every day, to treat eye emergencies.
Ta Chen Peter Chang, M.D., is assistant professor of ophthalmology and pediatrics, Bascom Palmer Eye Institute at the University of Miami Miller School of Medicine. He specializes in pediatric ophthalmology and pediatric glaucoma. For more information, visit BascomPalmer.org or UHealthSystem.com/patients/pediatrics.