Tuesday, April 28, 2015

Ensuring Good Vision for Your Child

By Charlotte M. Akor, MD
Abilene pediatric ophthalmologist
TMA Leadership College Class of 2015

One of the best ways to ensure your child has good vision from birth and throughout childhood is to be an observant parent who attends all your child’s routine appointments with your pediatrician. The most common cause of vision loss in children is amblyopia. Amblyopia has several causes including droopy eyelids, cataracts, crossed eyes, or a need for glasses. If this condition is not detected and treated by age 9, a child’s vision cannot be restored. There is also a type of severe amblyopia called occlusion amblyopia. If this type of amblyopia is not detected and treated during infancy, there will be irreversible vision loss.

Your child most likely had his or her first eye exam in the hospital. The pediatrician examines your infant’s eyes in the newborn nursery. The pediatrician checks for normal eyelids and lashes, a clear cornea and lens, and a normal red reflex. The doctor is checking for droopy eyelids, cataracts or cloudy lens, and serious pediatric eye cancers like retinoblastoma. In addition to vision loss from these conditions, amblyopia can cause additional vision loss. If the pediatrician finds no abnormalities on this exam and your child blinks to light, he or she has normal eyes. At the 2-month, 4-month, and subsequent visits, the pediatrician checks for strabismus or misalignment of the eyes and continues to make sure the eyes appear normal.

Sometimes parents can be the first person to pick up retinoblastoma by an abnormal red reflex when they take a picture. The red eye in the picture does not appear normal or appears unequal to the other eye. If parents detect an abnormal red reflex and express concerns to the pediatrician, a complete eye exam with a pediatric ophthalmologist or eye physician is a must. Retinoblastoma can cause serious visual disability and/or death if left untreated.

Many times parents are the first ones to notice strabismus or misalignment of the eyes. Crossed or misaligned eyes are normal the first two to three months of life. If present after that time, the condition can lead to blindness called strabismic amblyopia or vision loss caused by crossed eyes. If crossed eyes are still present at age 6 months, it is very unlikely it will go away by itself.  Often misaligned eyes run in the family. Treatment for this condition can include glasses, patching, and/or eye surgery. A complete eye exam with the pediatric ophthalmologist will help you find a plan to ensure good vision in your child.

Your child will be asked to read a pediatric eye chart or have a vision screening at age 3 or 4 years at the pediatrician office. This exam will determine if your child will see the eye doctor to prescribe glasses. The type of amblyopia or vision loss caused by not obtaining glasses at the appropriate age is called refractive amblyopia. If glasses are not obtained at a young age, the child will not be able to develop 20/20 vision.

Close monitoring is important to make sure a child has proper vision development. Additional information about children and visual development is available at the following websites.


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