Back to school – yearly eye exam

Photo courtesy of Patrick on Flickr

Photo courtesy of Patrick on Flickr

Backpack, pencils, paper, binders, new clothes … an eye exam? When you think about getting ready to start a new school year, I’m sure that an eye exam is not on most people’s back to school list, though it should be. It is estimated that 80 percent of all learning is done with our eyes. In today’s modern classroom, students use their eyes constantly to read from a board, view projected digital images, use computers and tablets, read and to participate in sports and other classroom activities. So give your children the tools they need to succeed in school by having annual eye exams with a doctor of optometry.

According to the American Optometric Association, your child needs much more than just good vision in order to “see” properly. Every child needs to have the following vision skills for effective reading and learning:

  • Visual acuity: the ability to see clearly at the distance for viewing the chalkboard, at an intermediate distance for the computer and up close for reading a book.
  • Eye Focusing: the ability to quickly and accurately maintain clear vision as the distance from objects change, such as when looking from the chalkboard to a paper on the desk and back. Eye focusing allows the child to easily maintain clear vision over time like when reading a book or writing a report.
  • Eye tracking: the ability to keep the eyes on target when looking from one object to another, moving the eyes along a printed page or following a moving object like a thrown ball.
  • Eye teaming: the ability to coordinate and use both eyes together when moving the eyes along a printed page, and to be able to judge distances and see depth for class work and sports.
  • Eye-hand coordination: the ability to use visual information to monitor and direct the hands when drawing a picture or trying to hit a ball.
  • Visual perception: the ability to organize images on a printed page into letters, words and ideas and to understand and remember what is read.

Why school screenings don’t cut it

Unfortunately, while children do receive vision screenings from their pediatrician or at school, most do not have a comprehensive eye exam. In published guidelines for vision screenings, the American Academy of Pediatricians recommends a vision screening to include:

Visual acuity by Snellen method (reading letters at a distance)

  • External (penlight) examination for surface abnormalities of the eye and surrounding tissues
  • Pupillary examination
  • Ocular motility and alignment (ocular movements, cover test and corneal reflections)
  • Ophthalmoscopy for red reflexes and examination of retina and optic nerve

As you can see, vision screenings do not examine needed visual skills. Even if a child passes a vision screening and can see 20/20, he or she can still have vision problems. Luckily, every child in the United States has the ability to receive a comprehensive eye exam. To emphasize the importance of vision care, the Affordable Care Act has required every health plan to provide pediatric eye exams as an essential benefit. In addition, the volunteer doctors of optometry of the InfantSee program provide a comprehensive infant eye assessment between 6 and 12 months of age as a no-cost public service. Give your child the tools to succeed in school. Have an annual comprehensive eye exam.

For more information: California Optometric Association at http://www.eyehelp.org, American Optometric Association at http://www.aoa.org and http://www.Infantsee.org

 

~ Steven Sage Hider, OD
California Optometric Association
http://www.coavision.org
http://www.eyehelp.org

What if my child’s eyes are crossed? Strabismus 411.

HELP! It looks like my child’s eye is turning in, or out or I’m not sure. What do I do? What is strabismus anyway?

Photo courtesy of mjtmail (tiggy) on Flickr

Photo courtesy of mjtmail (tiggy) on Flickr

Strabismus, or crossed eyes, is a condition in which both eyes do not look at the same place at the same time. It occurs when an eye turns in, out, up or down. Strabismus is classified by the direction the eye turns:
• Esotropia = Inward turn
• Exotropia = Outward turn
• Hypertropia = Upward turn
• Hypotropia = Downward turn

There are six muscles attached to each eye that control eye movement. Normally, the eyes work together so both eyes look at the same place at the same time. An eye turn may be visible when there are problems with eye movement control.
The eye turn may be present constantly or only at certain times such as when the person is tired, ill, or has done a lot of reading or close work. One eye or both eyes may alternate turning.

Proper eye alignment is important to avoid seeing double, for good depth perception, and to prevent the development of poor vision in the turned eye.

What causes strabismus?

There are many causes, including:

  • Eye muscle problems.
  • Problems with the nerves that transmit information to the muscles.
  • Trouble with the control center in the brain that directs eye movements.
  • General health conditions or eye injuries.

What are risk factors for developing strabismus?

  • Family history – Those with parents or siblings who have strabismus are more likely to develop it.
  • Refractive error – Especially a large amount of uncorrected farsightedness (hyperopia).
  • Medical conditions – Including Down syndrome, cerebral palsy, stroke or head injury.

How is strabismus diagnosed?
Strabismus is diagnosed through a comprehensive eye exam. Testing may include:

  • Visual acuity, or vision – “Normal” distance visual acuity is 20/20.
  • Refraction – Determine the appropriate lens power needed to compensate for any refractive error (nearsightedness, farsightedness, or astigmatism).
  • Alignment and focusing testing – How well the eyes focus, track, move and work together.
  • Examination of eye health – This includes the front and back of the eyes. Eye pressure is also evaluated.

Because vision may change frequently during the school years, regular eye and vision care is important.

How is strabismus treated?
There are several treatment options to treat strabismus, including:

  • Eyeglasses or contact lenses – For some conditions, glasses alone will align the eyes.
  • Prism lenses – Prisms align the images seen by both eyes, so the eyes can fuse or see the same image, restoring visual clarity and depth perception.
  • Vision therapy – Vision therapy trains the eyes and brain to work together more effectively.
  • Eye muscle surgery – Surgery may be able to physically align the eyes so they appear straight. A vision therapy program may also be needed after surgery.

What can happen if the eye turn is not treated?

Photo courtesy of jmoneyyyyyyy on Flickr

Photo courtesy of jmoneyyyyyyy on Flickr

Potentially an untreated eye turn can lead to amblyopia, otherwise known as lazy eye. Amblyopia is permanently reduced vision in one eye.

When does a child develop strabismus?
Typically strabismus develops in infants and young children by age 3. It may be present in older children and adults. Children do not “outgrow” strabismus.

Most importantly…
If detected and treated early, strabismus can often be corrected with excellent results. Eye examinations are important for all children and adults, starting at 6 months of age. If any eye turn is in question, schedule a comprehensive eye examination immediately.

~Melissa Barnett, OD, FAAO
California Optometric Association
http://www.eyehelp.org
http://www.coavision.org