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Children’s Vision FAQ’s

When should children have their eyes examined?

The American Optometric Association (AOA) issued guidelines for how often children should go to an eye doctor for a comprehensive eye exam. According to these recommendations, infants should have their first ocular evaluation at 6 months of age. Routine eye exams should then follow at 3 years old and at 5-6 years old (prior to entering kindergarten or first grade). If they do not need vision correction, school-aged kids should have a complete eye assessment done every two years. Children who wear eyeglasses or contacts should have yearly examinations.

If my 5-year-old daughter passed a vision screening at school, does she still need an eye exam?

Yes, she should still have a complete eye exam.

Vision screenings in school are designed to identify gross vision problems. Yet a child can pass this screening and still have an eye condition that affects development, learning and performance in school. Studies have shown that up to 11 percent of kids who pass a school vision test actually have a vision difficulty that requires treatment.

In addition, a comprehensive eye evaluation by a qualified professional checks your child’s eye health, which is not included as a part of vision screening done in school.

What is vision therapy?

Vision therapy or training can be understood as a specialized form of physical therapy for the ocular system. Highly personalized, it involves a customized set of eye exercises that are intended to correct visual problems. Lazy-eye (amblyopia), focusing problems, trouble with eye alignment and movement, and specific visual-perceptual disorders are some of the conditions that may be treated with vision therapy.

Therapy sessions are generally held in an optometrist’s office, but most courses of treatment include daily exercises to be done at home.

Can learning disabilities be cured by vision therapy?

No. Yet children with learning problems often suffer from vision problems too. As the vision therapy corrects underlying ocular conditions, a child’s learning difficulty may be improved or resolved.

How can we get our active one year old son to keep his glasses on? He needs eyeglasses to correct farsightedness and a tendency towards crossed eyes. We’ve tried everything from elastic bands to tape, but he struggles, cries and pulls them off.

Most of the time a child’s resistance to wearing eyeglasses is settled through time and perseverance. Getting used to the feeling of wearing glasses can take some adaptation. It may help to put his glasses on immediately after he wakes up.

However, sometimes the child’s refusal to wear glasses is due to an incorrect prescription or uncomfortable frames. Recheck his prescription and make sure that his glasses fit well. Bring your child into the optometrist for a consultation.

Many frames for children come with an integrated elastic band to help keep the glasses sitting comfortably on your child’s head. Be sure to inquire about this option.

Our 3-year-old daughter was diagnosed with strabismus and amblyopia. What are the chances of a cure at her age?

The odds of a successful cure are very good if she receives proper treatment. Medical research has demonstrated that the visual system can develop stronger visual acuity at up to 8-10 years of age.

Constant strabismus often requires surgery to straighten and align the eyes, and then therapy for amblyopia (“lazy-eye”) follows in order to enhance the success of the surgery. Eye patching and vision therapy are generally implemented as a means to help both eyes team and function together. For more information, discuss treatment options with your Optometrist and a referral to see a pediatric ophthalmologist who specializes in strabismus surgery may be required.

My 10 year old daughter has been wearing eyeglasses since age 2 in order to correct farsightedness. We think her depth perception is weak. Can she be tested for this, and if there’s a problem – can it be treated?

A very simple, straightforward stereopsis test will determine if your daughter has normal depth perception. During this testing, she will put on 3-D glasses and be asked to look at a chart across the room or at a number of objects in a specialized book. If reduced stereopsis is diagnosed, she will be advised to undergo vision therapy.

Our 11-year-old son was first diagnosed with nearsightedness when he was 7 years of age. Since then, his vision has deteriorated every year. Is there any way to prevent this?

Recent studies suggest that myopia progression may be slowed or stopped in childhood. At present, there are four different types of treatment for myopia control: multifocal contact lenses, atropine eye drops, ortho-k and multifocal eyeglasses.

A professional eye doctor will conduct a comprehensive eye exam in order to determine your child’s candidacy for any of these potential treatments.

My son’s teacher thinks he has “convergence insufficiency” at 7 years of age. What is this, and what can be done about it?

When reading or engaging in other close-up tasks, our eyes need to be converged (pointed inwards) slightly. Convergence insufficiency (CI) refers to the eyes’ inability to do this easily and comfortably. Headaches, eyestrain, blurred vision, fatigue and reading problems may result.

Convergence insufficiency is a common learning-related vision problem that’s typically treated well with vision therapy and/or reading glasses.

According to the visual screening done at school, my 5 year old son has 20/40 vision in both eyes. Is this a reason for concern, or could his visual condition improve with time?

In general, 5 year old children can see 20/25 or better. Yet there are a number of possible reasons for his vision diagnosis. Visual acuity testing is highly subjective. Your child is asked to read small letters on a wall chart, and many kids simply give up – even though are able to read some of the smaller lines. Other children may claim that they can’t see the letters because they dream of wearing eyeglasses!

Keep in mind that vision screenings conducted at school are often compromised by many distractions. It’s wise to schedule a comprehensive eye exam with an eye doctor in order to confirm his prescription and rule out any eye health problems that may be affecting his visual acuity.

My daughter has severe farsightedness in one eye and was diagnosed with refractive amblyopia. She just received her glasses, and one lens is much thicker than the other. She is complaining that the glasses make her dizzy and she won’t wear them. Can anything be done about this?

When one eye needs much stronger vision correction than the other eye, contact lenses are sometimes preferable to eyeglasses. Unequal lens powers in glasses can cause an unequal magnification effect, so the eyes transmit images to the brain that are not the same size. The brain may not be able to blend these two images into a single one, which often causes dizziness and nausea. In addition, your child’s eyeglasses may be unattractive and causing her to not give them a real chance to adapt.

Contact lenses obviously grant a nicer appearance, and they don’t cause as many problematic variations in image magnification. Even young children can handle wearing contact lenses, and one-day disposables or continuous wear lenses (worn consistently for up to 30 days) are possible options.

With amblyopia, one eye doesn’t see as clearly as the other eye, even with the best contact lenses in position. Vision in her weak eye may not be drastically improved with contacts, and vision therapy will probably be needed too. Best to discuss all her options with her Eye Doctor.