All About Eye Health

Vision
Many conditions may affect a child's vision. Most, if not all, can be caught and prevented through timely regular check-ups and vision screenings with the child's doctor.

Eye checks:

• Vision is evaluated at most Well-Child Checks
  • Even newborn babies have their eyes checked!
• Vision screening is one more reason why it is important to see the pediatrician regularly
• The type of screening a child undergoes depends on the age and development of the child
• Eye problems can cause poor school performance. If a child cannot see well, the child could have problems reading and following directions.

Common conditions affecting vision:

1. Strabismus:
   • Condition where one or both eyes turn in or out
   • Misaligned eyes or "crossed eyes"
   • Strabismus can lead to blindness if not corrected
2. Amblyopia
   • "Lazy eye"
   • Can lead to permanent blindness if not treated early and regularly.
   • Treated with glasses or by patching the good eye so that the brain relies on the "lazy eye" to see
3. Refractive error:
   • Vision problem that occurs when the shape of the eye prevents good focus.
     Examples:
     • High hyperopia (farsightedness)
     • High myopia (nearsightedness)
     • Astigmatism (blurred vision due to eye's difficulty focusing)

How Are Eye Problems Treated?

• Eye doctor: The child's pediatrician will refer the child to the eye doctor (ophthalmologist or optometrist) for a more in-depth evaluation
• Glasses: When children are prescribed eyeglasses, it is very important for them to wear them. Glasses can help prevent blindness in some conditions!
• Patches: If a child is prescribed an eye patch, it is important to wear it every day when the child is awake for the full amount of time that the eye doctor recommends. Some families encourage this compliance by pretending to be pirates.
• Early Intervention (Alliance For Infants) for vision therapy: Children with prematurity and/or vision problems should be evaluated by Early Intervention to find out if they qualify for therapies
• Special education: Some children with vision problems qualify for special education. It is helpful to keep this in mind so that caretakers and caseworkers can advocate for the child.

Retinopathy of Prematurity:

• The retina is the light-sensitive layer of tissue at the back of the inner eye
• Retinopathy of prematurity (ROP) is a condition in which there is abnormal blood vessel development in the child's retina. This occurs in babies that were born too early (premature babies).
• ROP is a specific cause of vision loss in some premature babies
• If a baby is born prematurely, the blood vessels in the retina might not develop properly. The vessels could grow abnormally or could leak because they are fragile. If this happens, there could be scarring on the retina. This scar tissue could pull on the retina and cause vision problems in the baby.
• Premature babies are screened by eye doctors (ophthalmologists) to see if they have ROP. When the baby is in the hospital, these examinations happen in the neo natal intensive care unit (NICU). When the baby goes home, these exams happen in the ophthalmologist's office.
• Regular exams help the eye doctor catch and treat problems early to help prevent partial or total blindness. This treatment is time sensitive. Missing appointments or a delay in care can cause blindness, and this is considered medical neglect, and a ChildLine will be filed.
• Premature babies should be evaluated by Early Intervention for therapies, including vision therapy

Content Sources:
American Academy of Pediatrics: www.healthychildren.org
Center for Disease Control: www.cdc.gov
KidsHealth, Nemours Center for Children's Health Media: www.kidshealth.org
National Center for Environmental Health: www.cdc.gov/nceh
Up To Date: www.uptodate.com
U.S. National Library of Medicine: www.nlm.nih.gov/medlineplus