The reason that an eye exam is so important is that 80% of a child’s learning in school is done through his or her eyes. This means that if there is any kind of problem with your child’s eyes, your child’s learning in school may be impaired.
What are some of the eye problems or concerns eye doctors look for during a child’s eye exam?
The first thing we will check is visual acuity to ensure the child has good vision in each eye. If vision is good in each eye, then we have ruled out amblyopia or lazy eye, which is our number one enemy. Amblyopia is a condition in which visual acuity is reduced in an eye and not completely correctable by glasses or contact lenses. If vision is 20/30 or less in an eye, it is diagnosed as amblyopia or lazy eye.
Another concern is strabismus where the two eyes are not aligned in the same direction at the same time. Strabismus is commonly known as an eye-turn or squint.
A further concern is anisometropia which is a significant difference in vision or refractive error between the two eyes. What this means is that one eye is significantly more nearsighted, far sighted or has more astigmatism than the other eye.
Amblyopia is caused by anisometropia, strabismus or high refractive error in one or both eyes. Therefore, during a child’s eye eyam, we are not only looking for vision problems that are correctable with glasses or contact lenses, but we are also looking for amblyopia and its causes.
There is a 6.7% prevalence of amblyopia and strabismus and they are the most common visual abnormalities in children. Approximately 50% of childhood strabismus starts within the first year of life, with the rest starting before the age of 5 or 6. The earlier amblyopia is detected, the easier it can be treated. This is because there is a critical period up to the age of about 6 or 7 during which visual development occurs where it is much easier to reverse the effects of amblyopia. After this visual development period, it becomes more difficult to treat amblyopia although it is still possible. That is why we hear of adults with a lazy eye whose vision in one eye cannot be fully corrected, even with their glasses or contact lenses. The brain favors the retinal image of the good eye and starts to suppress the image of the bad eye. When this happens, the visual cells in the bad eye do not fully develop during this critical visual development period. The eye becomes lazy and amblyopia forms. New research, however, has shown that adults have been able to correct their amblyopia with vision therapy.
The American Optometric Association recommends that a child’s eyes should first be examined at 6 months of age. It is highly recommended that you have your child’s eyes examined at least before the age of 3 and again before the age of 5, and then every year thereafter. Your eye doctor will use completely different methods and techniques during your child’s eye examination compared to the eye examination of an adult.
I hope this article helps illucidate the importance of the back to school eye exams that we hear so much about at this time of year and why it is so important to have your child’s eyes examined by an optometrist or ophthalmologist.
Meyer Izaac, O.D.