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While pediatricians and schools often do eye screening exams, a visit to an eye specialist— an ophthalmologist or optometrist — is important to catch problems that a simple screening may miss, said Dr. Andrew Spinak, of Spinak Medical Eye Center in Pearl River and Stony Point, N.Y and attending physician at Montefiore Nyack Hospital.
A comprehensive exam involves the use of eye drops to dilate the pupils, so doctors can thoroughly examine the overall health of the eyes and the visual system. A child’s vision can also be tested with an eye chart or photo screening, which do not require a young child to cooperate with the test.
Doctors will also look for misaligned eyes and "lazy eye.” “It’s important to find and begin treating these conditions as early as possible, by age 8 or 9 at the latest,” said Spinak. “The sooner these conditions are corrected, the greater the chance of success.”
In strabismus, the eyes are not aligned properly and point in different directions; one eye may look straight ahead, while the other turns outward, inward, up or down. “Sometimes strabismus is obvious, but sometimes it’s only a slight change, and a parent may not detect it,” said Spinak. In some cases, eyeglasses can be used to straighten the eyes. Other cases require surgery to correct unbalanced eye muscles.
In amblyopia, vision loss occurs when the nerve pathways between the brain and the eyes aren’t properly stimulated. The brain ends up favoring one eye, due to poor vision in the other eye. “It’s important to catch amblyopia early, so the brain has time to rewire itself,” he said. Amblyopia is generally treated by patching or blurring the stronger eye to force the weaker eye to get stronger. “It’s like exercising the bad eye.”
Several common signs of vision problems in children include:
- Squinting
- Sitting very close to the TV—or very far away
- Frequent eye rubbing or blinking
- Avoiding reading or other close activities
- Frequent headaches
- Covering one eye
- Tilting the head to one side
- Holding reading materials close to the face
- An eye turning in or out
- Seeing double
- Losing place when reading
Children who wear eyeglasses or contacts should be examined every year, while those without corrective lenses should be checked every two years. “Kids grow quickly, and as their bodies change, their eyes do, too," said Spinak.
For more information on the services offered by Montefiore Nyack Hospital, click here.
