Vision problems affect one in 20 preschoolers and one in four school-age children. Since many vision problems begin at an early age, it is very important that children receive proper eyecare. Poor eyesight can affect learning ability, athletic performance, and self-esteem. Untreated eye conditions can worsen and lead to more serious problems, even blindness. Children should have a comprehensive eye exam by a licensed eye doctor at six months, three years of age, before first grade, and every two years thereafter, or as recommended. The doctor will determine if your child needs vision correction and check for common eye disorders. Be sure to tell the eye doctor about any changes in eye health issues in your family, as many of these can be inherited. Your paediatrician by now has probably tested your child’s eyesight to determine your child’s ability to focus, recognise colours and perceive depth or dimension. Common tests include:
- Alignment using toys that make noises. The paediatrician will cover and quickly uncover each eye to test for a dominant eye.
- Ability to fixate. Your paediatrician will move an object in front of your child’s eyes to see if the eyes can watch and follow the object.
- Coordination of eye muscles. The paediatrician will move a light or some interesting toys in a set pattern to test your child’s ability to see sharply and clearly at near and far distances.
- Pupil response to light. The paediatrician will shine a small light in your child’s eye and watch the pupil’s reaction. The pupil normally would get smaller very quickly in response to light.
- Eyelid health and function. The paediatrician will examine each eyelid to be sure it is functioning normally. This includes a check for drooping eyelid, inflammation, and any other indications that your child’s eyes need greater attention.
If your paediatrician sees anything amiss, you will be advised to make an appointment with a licensed eye doctor who will perform a thorough evaluation of your child’s eyes. Regardless, your child should see a licensed eye doctor by the time he reaches three even if there is no sign of trouble. It is a good idea to bring your child to a licensed eye doctor for their first comprehensive eye exam at six months old, but at least by three and again by age five. Even if there is no sign of trouble. A licensed eye doctor performs additional tests that the paediatrician does not. This is essential if there are any major vision issues that run in your family, as they may have been passed down. Your eye doctor will conduct some of the same tests you saw in your paediatrician’s office, but with some important additions:
- Vision correction. The eye doctor will use a few eye drops to help your child’s pupils dilate, creating a better window to the back of your child’s eyes. The dilation allows your doctor to check for nearsightedness, farsightedness and astigmatism. The drops take about 45 minutes to work, and will blur your child’s vision and cause a little light sensitivity for a few hours. Using a retinoscope, the doctor will move the light to see it reflected in the pupil. The shape of the reflection helps the doctor see if your child has any vision issues that require correction.
- The interior and back of the eye. After dilating your child’s eyes and dimming the lights, the doctor will use a special instrument called an ophthalmoscope to see through to the retina and optic nerve at the back of the eye. This is where clues to many eye diseases first show up.
- Tests for a specific issue. Be sure to discuss any other concerns you have about your child’s eyes such as crossed eyes or nystagmus, your doctor will do the appropriate tests and advise you on the action required.
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