Pediatric vision care includes a wide range of services, from the prescription and fitting of eyeglasses to strabismus surgery for what is commonly called ‘crossed-eyes’ to advanced retinal surgery for babies delivered prematurely. Pediatric eye care requires a combination of skills — the patience to work with patients who may not be able to communicate their problems, and the clinical and surgical skills honed from treating patients of similar age and/or with similar problems.
Since many pre-school and developmentally disabled children cannot read a Snellen eye chart, an eye doctor may use a cartoon video or project animal images onto a screen to register a child’s visual response. Toys also may be helpful during the exam, and a small toy to take home after the exam helps convince the child that a doctor’s office isn’t such a bad place to be.
We recommend that children’s eyes be screened (not a full exam) for eye disease and vision loss at the following intervals: before three months of age and at one year, three years and five years of age. These screenings are generally performed by pediatricians or family physicians, with referrals to eye doctors for full exams when necessary. However, if there is a family history of strabismus or amblyopia, a child should have a full eye exam before entering school or sooner if problems are noted.
Good vision is important for a successful education, and poor vision can negatively impact the development of a child’s personality and social skills. According to the Eye Care Council, over 20 percent of children entering kindergarten have undetected vision problems that can adversely affect their ability to learn.
Some common eye problems in children include amblyopia (lazy eye), strabismus (misaligned or crossed eyes), diplopia (double vision), color deficiency (color blindness), myopia (nearsightedness), hyperopia (farsightedness), and astigmatism (irregularly shaped cornea).
Warning signs of potential vision problems include: squinting, sitting very close to the television, covering one eye to read, inattentiveness, reversing letters or numbers, stumbling while going up steps, using a finger to keep place while reading, and behavior problems. The earlier a vision problem is detected, the more likely it can be successfully treated, so watch for warning signs and be sure that your child is being screened regularly.
The following topics are covered in this section on pediatric eye conditions: