When it comes to the health of your children, the earlier the eye exam the better.
Vision screening is of utmost importance throughout infancy and early childhood as it can detect a treatable abnormality that can otherwise lead to permanently decreased vision. About 5 percent of children have an eye problem that requires a comprehensive eye examination.
The first vision screening generally takes place in the newborn nursery where the practitioner examines the eyes, pupils and retinal reflexes. Subsequent age-appropriate vision screenings are performed by the child’s pediatrician at well-child office visits. Ideally, several screenings are performed over time as a problem can easily be missed with only a one-time screening. If a child has a risk factor or a family history of eye problems, it may be appropriate to schedule a comprehensive eye examination.
Signs and symptoms of an eye problem can also be evident in the home. “Strabismus” is a misalignment of the two eyes and occurs in up to 5 percent of children. If untreated, strabismus can lead to permanent loss of vision (amblyopia) in the deviating eye. Occasional inward “crosseyed” or outward “wall-eyed” misalignment of the eyes is considered normal in infants up to 12 months of age. However, if this is constant or occurs after 12 months of age, a comprehensive eye exam is recommended.
The red reflex is a reflection of light from the inside of the eye that causes the pupils to appear red in photographs or bright light. This reflex should be equally bright in both eyes. An unequal reflex may be a sign of cataracts, glaucoma, an optical abnormality or even a tumor inside the eye that can result in permanent loss of vision if not treated in a timely manner.
Unfortunately, about one-third of all eye injuries occur in children. Types of trauma include blunt trauma, sharp trauma or chemical trauma. Injuries can occur to the skin and eyelids, to the bones of the orbit that support the eye, and even to the eyeball itself. An injury to any of these areas requires an urgent comprehensive eye exam as there could be damage to the eye or to the tissue surrounding the eye that could lead to long-term complications, loss of vision or even loss of the eye.
The most important step in a chemical injury is to immediately irrigate the injured eye(s) prior to seeking an eye exam. Most pediatric ocular trauma occurs during play. Prevention of these injuries by wearing approved and tested eye/face/head protection when appropriate, while playing baseball for example, is imperative to achieve eye safety.
Dr. Robert Morris is a founding physician of Retina Specialists of Alabama, Birmingham. He is president of the Helen Keller Foundation for Research and Education, chairman of the International Society of Ocular Trauma and an associate clinical professor of Ophthalmology at the University of Alabama at Birmingham. Dr. Morris is an innovator in vitreoretinal surgery since 1980, while also managing a large clinical practice.
Dr. Vikram Saini is a second-year vitreoretinal fellow with the UAB Retina Specialists of Alabama Retina Fellowship Program, and the Helen Keller Foundation for Research and Education, both headquartered in Birmingham, Alabama. Dr. Saini earned his medical degree from the University of Tennessee College of Medicine and completed his residency in ophthalmology at the Ochsner Clinic at LSU in New Orleans, Louisiana.