Children’s Vision

The InfantSEE program was developed to promote the importance of infant eye care. Participating optometrists donate their time and provide a comprehensive eye and vision assessment to children between 6 and 12 months of age. Dr. Cara Frasco was one of the first local optometrists to begin examining babies under the InfantSEE program in 2005. The InfantSEE program serves to complement the well child screenings conducted by the child’s physician. At the conclusion of the InfantSEE examination a summary report is forwarded to the child’s primary care physician to inform him of the examination results.

Approximately 1 out of every 30 preschoolers suffers from amblyopia or strabismus. The eyes of children with amblyopia (or lazy eye) are normal and healthy but their visual system remains underdeveloped. This condition typically affects one eye and the development of vision is delayed because of a high glasses prescription and/or a turning of one eye. The child typically sees normally in the other eye and therefore the parent may not have an indication that the child is not seeing clearly. Amblyopia is the most common form of visual impairment in children and can persist for life if left untreated. A comprehensive eye examination between 3 and 4 years of age provides an ideal opportunity to identify and improve the vision of these little patients.

A child needs many abilities to succeed in school. It has been estimated that as much as 80% of a child’s learning occurs through the visual system. Reading, writing, chalkboard work and using computers are among the visual tasks students perform daily. When his or her vision is not functioning properly, education and participation in sports can suffer.

Sharp eyesight is vital to seeing the chalkboard and books clearly. School screenings routinely check the sharpness of a child’s distance vision and children that might be unable to see from the back of the classroom are referred for an eye examination.

However vision is more than just the ability to read 20/20 on the eye chart. Basic visual skills include the ability to focus the eyes for near work, to use both eyes together as a team and to organize, understand and remember what we see. Children likely will not tell you that they have a vision problem because they may not recognize the way that they see as unusual.

Signs of vision problems include:
• Frequent eye rubbing or blinking during visual tasks
• Avoiding reading or other close activities
• Frequent headaches during homework or after reading class
• Covering one eye
• A crossed or wandering eye
• Losing one’s place when reading
• Difficulty remembering what he or she read

Vision changes can occur without your child or you noticing them. Therefore, your child should receive an eye examination at least every 2 years – more frequently if specific problems arise or if recommended by your eye doctor. The earlier a vision issue is detected and treated, the more likely treatment will be successful. When needed, the doctor can prescribe treatment including eyeglasses, contact lenses or vision therapy to correct the vision problems.

Adapted from aoa.org

When we look between far away and up close, our eyes change focus rapidly to provide clear vision for the desired object. This internal focusing system in our eyes is known as accommodation.

Accommodation is the primary visual ability which allows someone to maintain clear, comfortable vision when performing near tasks such as reading or computer work. Around the age of 40, our ability to sustain accommodation decreases and this leads to the need for reading glasses or bifocal lenses.

Normally, children and young adults have a large amount of focusing capacity. However some children also exhibit inadequate focusing. As they read for longer periods of time their eyes fatigue and the text begins to look blurry. The effort required to maintain clear vision often results in eyestrain, headaches or avoidance of near tasks.

Reading glasses or bifocal lenses are often the first treatment suggested for individuals with accommodation problems. The glasses lessen the amount of focusing required by the eyes and therefore the child can maintain clear vision without eyestrain.

Research has shown that accommodation ability can also be improved with vision therapy. In fact vision therapy is the more appropriate treatment for individuals that have difficulty altering their focusing ability or who continue to exhibit fatigue with reading glasses. The vision therapy activities increase the maximum accommodative effort and improve the flexibility of the focusing system.

Each eye snaps a picture of the object at which you are looking. The pictures captured by the right and left eyes are sent to the brain for processing. The brain then merges the two images into one picture. The two images are combined by matching up the similarities and comparing the small differences.

Problems arise when each eye is not pointing at the same object. It becomes difficult for the brain to overlap the two pictures. More concentration must be dedicated to properly align the eyes. This added effort can result in eyestrain or tired eyes. When reading, this condition can make print appear blurred or look like the print is moving.

Vision therapy or bifocal lenses can frequently improve a child’s ability to compensate for eye teaming problems.

When reading our eyes do not slide across the lines in a book, instead our eyes stop and start along the way. The pauses are known as fixations and are the times when you are reading the text. These fixations are connected by saccades, the small jumping eye movements that move the eyes between words. The eyes need to hop from word-to-word from left to right in an organized fashion. When the eyes instead move in an erratic fashion this inefficiency can cause reading difficulties. In particular, poor eye movements result in loss of place when reading, the frequent need to re-read lines of print and misreading words.

If a child cannot perceive and copy simple geometric forms, it can be assumed the child will struggle when he needs to be able to perceive the wiggly lines which make up letters, which in turn make up words, which in turn make up sentences which stand for abstract ideas. Visual perceptual skills provide a system for organizing visual information. Delays in visual perceptual skills affect how readily a child ‘catches on’ to information presented in the classroom.

Poor visual perceptual skills can also be associated with a global lack of visual spatial development--consistently knowing left from right, either in relationship to her body or in the world around her. It is this child with a poor sense of laterality or directionality that demonstrates letter reversals.