Early Detection By A Physician Is The Key
To Good Vision In Infants And Children

Early detection of vision problems in infants and children is just as important as early detection of dental and hearing problems, according to the American Association of Pediatric Ophthalmology and Strabismus (AAPOS). Many states require newborn hearing tests before leaving the hospital, and a number of parents take their children to the dentist at an early age, but an early visit to the eye doctor is often disregarded. An infant or toddler may appear to see normally during day-to-day activities, but may have extremely poor vision in one or both eyes. Parents or other care givers may not even notice a problem.

Every parent should have their child's eyes checked by a trained professional immediately following birth and at regular intervals throughout childhood. Newborns should have their eyes inspected by a primary care doctor before leaving the hospital nursery. The primary care doctor will look for obvious structural abnormalities of the eyes and the presence of a healthy "red reflex," an orange reflection present in healthy eyes. If abnormalities are detected, the infant should be referred to a pediatric ophthalmologist.

A pediatric ophthalmologist is an Eye MD (eye physician and surgeon) who specializes in children. A pediatric ophthalmologist graduated from medical school and completed a three or four-year approved ophthalmology residency program in all aspects of eye disease. In addition, this type of physician received further training in an approved fellowship program dedicated to the study of eye diseases and disorders of children's eyes such as hyperopia, myopia, astigmatism, strabismus and amblyopia. Pediatric ophthalmologists who are members of AAPOS have demonstrated high qualifications in the proper treatment and care of children's eyes.

It is vital for infants and children to be checked for amblyopia (the most frequent cause of visual loss in all people prior to age 50). Children with amblyopia cannot see well out of one or even both eyes, and glasses alone will often not enable them to see better. Diminished vision in one eye always leads to a deficiency in stereovision (the ability to see three-dimensionally). Children without stereovision have a higher risk of injury to the normal eye and a higher risk of developing strabismus (an eye that wanders in, out, up or down) that can lead to even worse three-dimensional vision and social problems. As a result, an afflicted child will often receive embarrassing questions such as, "Who are you looking at?"

According to the AAPOS, if a child has a family history of either glasses at a young age, strabismus (crossed eyes), or amblyopia (lazy eye), then the child should undergo a complete eye exam between age six to twelve months. As a general rule, children without a family history of eye problems should have their eyes examined by age four, even if they are unable to read an eye chart. A pediatric ophthalmologist has many ways of assessing vision even in children who are not verbal. In some cases, amblyopia must be detected and treated even earlier than age three to preserve both good vision and three-dimensional vision (stereovision).

Parents often wonder if their child who is not yet able to read will be able to have their eyes examined. There are a variety of techniques used to screen young children for eye problems like amblyopia, strabismus or an early need for glasses. While testing vision with an eye chart is the best method, it requires an older and cooperative child. Some primary care doctors use technologically advanced screening devices, such as a photoscreener, to detect children at risk for eye problems. While these devices have been used for several years, there is still controversy about their performance and accuracy; however, experts anticipate that future refinement of these devices will allow vision screening to more reliably determine the right children to refer to a pediatric ophthalmologist for further diagnosis and treatment.

Since not all communities have organized vision-screening programs for young children, parents have a responsibility to have their child's vision checked early. An eye exam for young children is an excellent investment to be certain that vision is developing normally. The minimal cost for the exam is a small price to pay, because sight is something a child simply cannot replace later in life.

Early detection is the key to good eye health; therefore, a visit to a pediatrician or pediatric ophthalmologist can help insure that a child will be able to see to the best of their ability. For more information, visit the AAPOS website at http://med-aapos.bu.edu.