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Questions and Answers

Q&A For Children’s Eye Care

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

The American Optometric Association and the American Public Health Association recommend that children have their first eye exam at 6 to 12 months of age.

Before Age 1:

Dr. Feucht and Dr. Saini will examine your child's eyes for disease, normal eye structure development, signs of amblyopia (lazy eye) and other vision disorders. Early detection and intervention can prevent vision problems that may have lifelong effects.

Age 3:

Dr. Feucht and Dr. Saini will check and assess visual acuity, eye health, eye movement, focusing and binocular vision (the ability for both eyes to work together as a team). Your child's eyes will again be checked for warning signs of amblyopia, which is most responsive to treatment if diagnosed by the age of 3.

Age 5:

At age 5, it's time to test your child's readiness for the visual demands of school. 80% of what children learn in school is presented visually.

After your child starts school, it is recommended that they get a "comprehensive eye health and vision exam" at Eyes on Worcester, at least once a year. Sending a child to school with an undetected vision problem may lead to severe learning difficulties. The risk of a child failing one grade is 3 times higher for children who have worse than 20/20 vision.

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

Conducting an eye exam on any non-verbal patient, regardless of age, is surprisingly easy. We use objective testing with various tools to figure out the refractive error, binocular function, and health of the eye.

An objective examination of refractive error can be completed several ways.  We can use a machine called an auto-refractor where the child looks at a computerized device and it tells you the refractive error or we can also use an instrument called a Retinoscope. This is a small handheld flashlight that directs a light into the eye. Based on the movement of the reflecting light, we can neutralize the power and figure out the prescription.

The same pretty much applies to the measurement of visual acuity, binocular function, and ocular health. We have several different tests and instruments that can objectively measure acuity, binocularity, and health without a verbal response.

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

At Eyes on Worcester, we like to refer to it as the "ABC's of Eye Problems in Children".

A – Appearance

  • Do the eyelids look red, swollen or crusty?
  • Does one eye turn in or out?
  • Are the eyes red and/or watery?

B – Behavior

  • Does your child rub his/her eyes a lot?
  • Is there squinting or excessive blinking?
  • Does he/she tilt their head or cover one eye?

C – Complaints

  • If you child says that he/she can't see or if there is pain, a problem is indicated.


Q: One of the greatest tasks of a school-aged child is learning to read. 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?

There are many visual skills beyond seeing clearly that team together to support academic success in school-aged children. Vision is more than just the ability to see clearly or having 20/20 eyesight. It is also the ability to understand and respond to what is seen. Basic visual skills include the ability to focus the eyes, use both eyes together as a team, and move them effectively. Other visual perceptual skills include:

  • Recognition: (The ability to tell the difference between letters like "E" and "F").
  • Comprehension: (To "picture" in our mind what is happening in a story we are reading).
  • Retention: (The ability recall details of what we read).

Every child needs to have the following vision skills for effective reading and learning:

  • Visual acuity or tablet, and up close for reading a book.
  • Eye Focusing — The ability to quickly and accurately maintain clear vision as the distance from objects change, such as when looking from the chalkboard to a paper on the desk and back. Eye focusing allows the child to easily maintain clear vision over time like when reading a book or writing a report.
  • Eye Tracking — The ability to keep the eyes on target when looking from one object to another, moving the eyes along a printed page, or following a moving object like a baseball.
  • Eye Teaming — The ability to coordinate and use both eyes together when moving the eyes along a printed page, and to be able to judge distances and see depth for class work and sports.
  • Eye-hand Coordination — The ability to use visual information to monitor and direct the hands when drawing a picture or trying to hit a ball.
  • Visual Perception

If any of these visual skills are lacking or not functioning properly, a child will have to work harder. This can lead to headaches, fatigue, and other eye-related problems. Parents and teachers need to be alert for symptoms that may indicate a child has a vision problem.

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?

There are many different behavioral characteristics that involve the visual system. Poor eye contact, staring at lights or spinning objects, looking askance, side viewing and general difficulties attending are often symptoms of visual dysfunction. Thus, any child or individual with a diagnosis of autism, PDD, learning disability, speech-language delay, sensory integration dysfunction, non-verbal learning disability or with psychological problems should most certainly undergo a thorough eye examination. The earlier children with any behavioral or social disorder undergo a visual examination and begin visual intervention, the faster the improvement. The longer lasting the gains and overall chances for success. 

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?

Some children with learning difficulties exhibit specific behaviors of hyperactivity and distractibility. These children are often labeled as having ADHD. However, an undetected or untreated vision problem may elicit the same signs and symptoms commonly attributed to ADHD. Due to similarities, some children may be mislabeled with ADHD when in fact they have an undetected vision problem.

It is estimated that 25% of school-aged children have an undiagnosed vision problem that could interfere with learning. Vision is more than just the ability to see clearly or having 20/20 eyesight, it is the ability to understand and to respond to what is seen.

Children with vision problems can be misdiagnosed with ADD/ADHD because of….

  1. -Skip and re-read lines.
  2. -Poor reading comprehension.
  3. -Take longer to do homework.
  4. -Show a short attention span for close work.

However, having a yearly eye exam can prevent a child from being misdiagnosed with a learning disorder. Fixing an undiagnosed vision disorder can solve most learning problems.

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

There is no official age rule for contact lenses. In fact, four million American children under the age of 18 wear contact lenses. Physically, a child's eyes can tolerate contact lenses at a very young age. Even some infants are fitted with contact lenses due to congenital cataracts or other eye conditions present at birth. Contacts can be a great tool. It is an effective treatment option in children for other vision disorders such as anisometropia (high prescription in one eye and a low prescription in the fellow eye).

A recent study that involved fitting children of ages 8-11, with daily disposable contact lenses, displayed that 90 percent of the kids had no trouble applying or removing the contacts without assistance from their parents.

If you are considering contact lenses for your child, take a look at how your child handles other responsibilities. Does he or she have good personal grooming habits, keep his or her bedroom and bathroom clean, and follow through with schoolwork and household chores?

If children need frequent reminders to keep things clean and follow good hygiene practices, they may not be ready for the responsibility of wearing and caring for contact lenses. If they handle such duties well, they might be excellent candidates for contacts.

A conversation whether contacts can and should be safely used with your child. 

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

We offer a large selection of children’s frames that are specifically designed to be flexible with the ability to withstand a reasonable amount of mechanical stress. However, some children will still manage to break, bend or damage their glasses. We often recommend having a backup pair of glasses for this reason.

Q: Is a school screening sufficient for my child?

NO! School vision screenings are only designed to alert the possibility of a visual problem. Screenings are a limited process that cannot be used to diagnose a visual disorder, but rather indicate a potential need for further evaluation. Vision screenings do not test for color deficiency, clear and sustainable near vision, eye teaming, focusing, tracking or even the health of the eye.

Studies show that 1 in 4 children who pass vision screenings actually have an undiagnosed vision problem. This may lead to poor recognition, comprehension, memory retention and ultimately learning potential.

Dr. Feucht and Dr. Saini strive to build a personalized relationship with each patient through excellent quality of care, patient education, and individualized service. They have developed a special interest in pediatric eye care and binocular vision disorders in children. In addition to comprehensive eye exams for all ages, Eyes on Worcester offers a wide variety of eyeglass frames, contacts lenses and medical services for the entire family.

Q: Any final thoughts or advice on Children, which relates to vision and learning?

Dr. Feucht and Dr. Saini stress the importance of early vision care to support your child's highest learning potential. Your child's vision, well-being, and happiness are very important to us. At Eyes on Worcester, we enjoy working with children of all ages and we are passionate about providing children and families with the care they deserve. We do not believe in the "one size fits all" mentality of vision care and work very hard to accommodate the needs of each individual child.

The earlier that vision problems are detected, the more responsive the visual system will be to treatment. Ensuring your child the best possible visual skills to learn and reach their full potential.

 

Schedule an eye exam at Eyes on Worcester today to make certain your child is learning to his or her full potential.

References:

  • Daily disposable contact lens wear in myopic children." Optometry and Vision Science. Vol. 81, No. 4 (April 2004); pp. 255-259
  • http://www.aoa.org/patients-and-public/good-vision-throughout-life/childrens-vision/school-aged-vision-6-to-18-years-of-age?sso=y

 

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