Your Childs Exam and Common Eye Disorders

A comprehensive pediatric eye exam can diagnose many different eye conditions. Some of the more common eye conditions in children are:

Your child may be nearsighted (myopia), farsighted (hyperopia) or have astigmatism. It is important that children who need glasses, wear them full time when they are young to develop good vision in each eye and three dimensional vision.

If your child cannot identify alphabet letters because of age or development, here is a link to pictures that can be reviewed at home before the vision test at the eye doctor. Visit our optical shop to learn more about our selection of pediatric frames.

Amblyopia or “lazy eye” - Amblyopia occurs when the vision is reduced in one eye, causing it to be weaker than the other. This can occur because there is a difference in prescription between the 2 eyes and one eye becomes more dominant. Or, amblyopia can occur because of strabismus, or misaligned eyes. If an eye turns in or out, it does not see as clearly as the straight one and becomes weaker. Rarely, cataracts or severely droopy eye lids can cause amblyopia as well. The main treatment for amblyopia is patching the stronger, more dominant eye to allow the weaker eye a chance to gain vision. Dilating drops can also be used in some cases to blur the vision in the better eye, in essence working as a patch.

Strabismus or misaligned eyes - Eyes can cross in (esotropia), drift out (exotropia) or be higher or lower than the other (hypertropia or hypotropia). For specific kinds of strabismus, glasses are sufficient to straighten a child’s eyes, otherwise eye muscle surgery is required.

Ocular abnormalities - Rarely, children can also develop cataracts, retinal or optic nerve problems, which can also decrease their vision.

During your child’s comprehensive eye exam, visual acuity will be tested. This test measures the smallest object each eye can see at a certain distance. Normally, each eye will be done individually by covering one eye at a time. It may be necessary to tape a patch over a child's eye to keep him from peeking. The use of the Snellen chart is the most common way to test visual acuity. This chart has letters and numbers that decrease in size. When taking the test, the distance between the patient and the chart is 20 feet.

20/20 vision is normal. If a person has 20/40 vision, they see at twenty feet what a normal eye sees at forty feet. If a person has 20/200 vision, they are legally blind. They only see at twenty feet what a normal eye sees at two hundred feet. If they have 20/15 vision, they see better than normal. They see at twenty feet what the normal eye would have to bring in to fifteen feet to see.

For children that do not know letters and numbers, they can be tested with the Tumbling E chart or pictures. To take Tumbling E test, the child points his/her finger in the same direction as the E is pointing. Children who are younger than four may have trouble with this test so there are several different tests used to obtain a child's accurate visual acuity.

Other testing that will be done at your child’s exam are:

• Check for indications of crossed eyes
• Check to ensure the child is using both eyes
• Tests to determine how well the child's vision skills are developing
• Tests to determine normal color vision

Signs That You Child May Need an Eye Exam:

• Holding a book too close to their eyes.
• Difficulty reading the blackboard in school.
• Complaints of blurry eyesight.
• Squinting a lot.
• Closing or covering one eye in order to see.

If your child is experiencing any of these symptoms, schedule your appointment today at Raleigh Ophthalmology

What to Expect During my Child’s Eye Exam

A typical pediatric comprehensive eye exam includes some procedures which may be unfamiliar.  Parents may wish to review the following with their child in a positive way that can make the exam a pleasant experience.  After checking vision with a wall chart, several measurements are taken which may include the use of:

• A penlight
• Eye cover/occluder
• Fixation toys and video
• Prism Bar
• Silt Lamp
• Phoropter
• Lens trial frame
• Ophthalmoscope

Eye drops are given to dilate the pupils to measure the child’s focus and retina.  Since it takes time for the drops to take effect, there is a waiting period which contributes to a full exam sometimes lasting up to 1 ½ hours.  A playroom is available while waiting with younger children.