Did you know that the Canadian Association of Optometrists recommends that children have their first eye exam between 6-9 months of age? While most people assume waiting until school age years is the standard, it is actually a much better idea to get children checked much sooner. Many problems require early intervention, and some can actually stop vision from developing properly if not caught early enough. While a pediatric eye exam doesn’t mirror an adult’s (imagine fancy flashlights and finger puppets compared to the air puffs and letter reading you’re used to), it can provide a surprising amount of information about ocular health and vision both.
While this list is by no means comprehensive, this is a general guide to some of the main things being looked for when young children come in to have their eyes checked. There’s a method to the madness.
Refractive error: this is a fancier way of describing glasses prescription. While there is more leeway in what is “normal” at a young age, babies and children aren’t immune from the need for glasses. While a certain amount of farsightedness(hyperopia) is normal when younger, high amounts - or nearsightedness(myopia) or astigmatism prescriptions - need to be corrected to ensure both the vision is developing, and lower vision isn’t hindering a child’s development overall.
Anisometropia: tying in with the above, this is a big difference in refractive error between the two eyes. It’s the hardest to detect problems with at home, as often one eye is functioning perfectly while the other lags behind, so children seem to be seeing just fine. It is problematic in that vision in the eye with the worse prescription may not develop properly if not caught early enough.
Strabismus: This refers to eye turns of varying degree. While some eye turns correct on their own, or can be improved through patching and exercises, some require surgical intervention to get the eyes working together properly.
Amblyopia: Amblyopia is a catch-all term describing an eye that has vision that is underdeveloped - if permanent, even glasses cannot correct it down the road. It may be from a high glasses prescription, or an eye that lags behind/the brain ignores due to anisometropia or strabismus. If not caught before the age of seven or eight it may be irreversible.
Congenital cataract: Cataract refers to a clouding of the lens inside the eye. While it most often associated with older age, it can happen in infants as well. The lens normally focuses the light to the back of the eye, the retina, and if enough is blocked from coming through the eye cannot see properly.
Other: This list is much more extensive, and more rare. From serious tumours of the eye like retinoblastoma, to more benign problems like improper formation of the tear duct system, there are many eye health problems that need to be screened for early on. Premature birth can also cause eye complications, as can other systemic health conditions. Babies with Down’s Syndrome, for example, are at higher risk as well.
While the official recommendation for the first screening is six months old, a good rule of thumb is always to consult with your optometrist any time if you suspect problems at any age. The Government of Saskatchewan covers full eye examinations for children under the age of 18 annually through their health card, and covers more emergent problems at any age.
(*image credits to allaboutvision.com, ABC world news tonight, medicsindex.ning.com, main-line.co.uk)