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Do children need eye examinations? Why and when?

The American Academy of Ophthalmology (AOA) recommends all infants should get a screening eye examination at birth and followed periodic examination periodically to detect eye problems early, prevent vision loss and ensure normal learning and development of the child. Children at the age of 3 and 6, just before entering primary school are also encouraged to have scheduled eye exam done. As for those children who are required to wear eyeglasses or contact lenses are recommended to have their eyes checked annually.

There are a few signs and symptoms which may suggest eye problems. I would suggest to get your kid’s eyes checked especially when you observe any of the signs & symptoms below even if it is not during the ages mentioned above:

  • the eye are not aligned or not pointing in the same direction

  • discomforts when trying to focus on something or complaining of headaches

  • challenges in reading– children hold books close to their face or when the child frequently misses or loses the line or words he/she was reading

  • hand-eye coordination issue. For example, they may struggle to play ball games

  • being unusually clumsy

  • regularly straining or rubbing their eyes

  • sitting too close to the TV

There are various common eye diseases which can be detected early via proactive comprehensive eye examination:

  • pediatric cataracts which may be present as cloudy patch in the vision since birth

  • lazy eye (amblyopia) – happens when vision in one eye doesn’t develop as well as the other

  • squint (strabismus) – when eyes are not aligned or eyes appear to look in different directions

  • short-sightedness (myopia) – very common condition among children where nearby objects can be seen clearly while distant objects appear blurred.

  • long-sightedness (hyperopia) – less common than myopia. Nearby objects appear blurred and distant objects can be seen clearly

  • astigmatism – this occurs the outermost layer of the eye called cornea has imperfections in its curvature

  • color vision deficiency (color blindness) – children with this condition may have trouble distinguishing between different colors and this may or may not interfere in their studies and/or selected day-to-day activities depending on the type of color blindness and its severity

What tests may be carried out?

The red reflex test

The red reflex test is also referred to as examination of pupil reflections. This test can reveal some of the problems with cornea, lens and sometimes the vitreous (the clear gel between the lens and retina). Usually done as part of newborn checks.

The pupil reflex test

The pupil controls the amount of light which gets into the eye. Ophthalmologists will assess pupillary reflex (how the pupils reacts to light) by shining light into the eye.

Attention to visual objects

This is a simple test to check whether a newborn baby pays attention to visual objects. A midwife or doctor will try to attract your baby's attention with an interesting object. They then move it to see if the child's eyes follow.

Snellen other visual acuity charts

This tests are similar to the vision chart used to assess vision in adults. When a child can recognize the letters or numbers, they will be asked to read out or match the letters they can see from a specific distance.

Range of movement tests

This test will enable ophthalmologists to assess how well the eye muscles work. To test the range of movement of each eye, a child's attention will be drawn to an interesting object, which is then moved to 8 different positions: up, down, left, right, and halfway between each of these points.

Refraction test

Refraction test is used to diagnose myopia, hyperopia and astigmatism. A refraction test is usually done by an optometrist to determine if the child needs to wear spectacles and if so, the prescription for the spectacles.

Color vision deficiency test

Color vision deficiency tests, also known as color blindness tests, are usually carried out in older children if a problem is suspected. Ishihara Color Vision test can be used for screening. You are probably familiar with it. Does the image below ring a bell?

A more thorough color blindness test is Farnsworth-Munsell 100 Hue Test, a more detailed color blind test which can measure how severe the condition is.

Why eye checks are important

Vision is the most important sense children need for learning and even other development. In most cases, children will not know when they have a vision problem. Hence, without routine examination, there's a risk a problem may not be discovered at all.

Early detection of eye problems are crucial to enable the child to get treatment and support they need. Early diagnosis also helps to prevent future complications and disease progression. Do not hesitate to call for an appointment to learn more or to schedule an eye exam. Contact details here.


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