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Vision
is arguably the most important of the five senses
It plays a crucial role throughout childhood and beyond

Babies have poor vision at birth because it takes some time to
develop the visual system.
\ue000but can see faces at close range, even in the newborn
nursery
AT
six weeks a baby's eyes should follow objects
four months should work together
\ue001Over the first year or two, vision develops rapidly
\ue001A two-year-old usually sees around 20/30, nearly the same
as an adult.

Tips: To help stimulate your 2- to 3-month-old child's vision
development, the American Optometric Association (AOA) has
these recommendations:

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Add new items to their room or frequently change the
location of their crib or existing items in the room.
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Talk to your baby as you walk around the room.
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Keep a night light on to provide visual stimulation when
they are awake in their crib.
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While infants should be placed on their backs for sleep to
decrease the risk of sudden infant death syndrome (SIDS),
put them on their stomachs when they are awake and you
can supervise them. This provides important visual and
motor experiences.

Eye Alignment Problems
Strabismus
\ue002is the term for a misalignment of the eyes
\ue002it is important that it is detected and treated early so the
vision in both eyes develops properly.
\ue002If not treated may lead to amblyopia or "lazy eye\u201d
AWARENESS OF SIGNALS OF POOR VISION
\u2248
one eye turns or crosses, that eye may not see as well as
the other eye
\u2248
If the child is uninterested in faces or age-appropriate
toys, or if the eyes rove around or jiggle (nystagmus)
Why detect poor vision early?
Because it is essential to make sure your kids have the visual
skills they need to do well in school, sports and other activities.
Moving into the preschool and school-age years, parents face a
new set of worries:
When should my child have his first eye exam?
- to detect problems that may interfere with learning
\ue002Children without symptoms and who are at low risk for eye

problems should have their eyes screened by six months of
age, then examined at age three and again at the start of
school. Risk-free children should then continue to have their
eyes examined at least every two years throughout school.

Who Should I See for My Eye Exam?

There are three different kinds of eyecare professionals:
ophthalmologists, optometrists and opticians. Who you should
see depends on your needs.

Ophthalmologists are medical doctors (MDs or DOs) who
specialize in eyecare. Not only do they prescribe eyeglasses and
contacts, but they also perform eye surgery and treat medical
conditions of the eye. Ophthalmologists are doctors who have
received 12 or more years of training.

Optometrists (ODs) are eye doctors who can prescribe glasses
and contacts and treat medical conditions of the eye with eye
drops and other medicines. Optometrists generally receive eight

or more years of training. Optometrists prescribe glasses,
contacts, low vision aids, vision therapy and medication to treat
eye diseases, as well as perform certain minor surgical
procedures.

Opticians are not doctors, but eyecare professionals who adjust
and repair glasses, instruct patients in contact-lens use and grind
and assemble spectacles. In some cases, specially trained
opticians can determine your prescription and fit contact lenses.
Opticians generally receive their training either "on the job" by
apprenticeship or from technical schools.

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What tests should a complete children's eye exam
include?
According to the American Optometric Association (AOA)
\ue002infants should have their first comprehensive eye exam at
six months of age
\ue002Children then should receive additional eye exams at
three years of age, and just before they enter
kindergarten or the first grade at about age five or six
\ue002For school-aged children, the AOA recommends an eye
exam every two years if no vision correction is required.

Eye tests and general examinations often are conducted to
detect the possible presence of these types of eye problems
commonly found in young children:

Lazy eye (amblyopia): Your eye doctor will want to rule out

amblyopia, which is a lazy eye with decreased vision in one or
both eyes without detectable anatomic damage. Tools for helping
detect amblyopia include general assessment of vision
capabilities as well as posture evaluation and determination of
how each eye sees in relation to the other eye. Unfortunately,
amblyopia is not always correctable with eyeglasses or contact
lenses and may require eye patching to strengthen the weaker
eye. [Read more about amblyopia or lazy eye.]

Misalignment of eyes (strabismus): Crossed or misaligned

eyes (strabismus) can have different causes, such as problems
with muscle control in the affected eye or eyes. If strabismus
persists in young children, a condition known as lazy eye or
amblyopia (see above) can develop along with related vision
problems. [Read more about strabismus.]

Inability to maintain alignment of both eyes for correct
focus as distant objects move nearer (convergence
insufficiency): Eye doctors will also assess the ability of eyes to
pull inward (convergence) to provide correct focusing.
Focusing (accommodation), color vision, and/or depth
perception problems: The eye doctor may also test your

child's focusing (accommodation) ability. The child's depth
perception or ability to gauge distances between objects may
also be examined. Color vision may be tested through methods
such as placing a dot pattern of symbols within a pattern of dots
made up of other colors. [Read more about color vision and how
the eye refracts light.]

General eye and eyelid health: To assess a child's general

eye health, the eye doctor will examine his or her eyelids and lid
margins, looking for shape irregularity and discharge on the
lashes or lid margins. The eye doctor may turn the lower lids
inside out (evert) to look for abnormal or infected eyelash
follicles, bumps (papillae), discharge, and swelling (edema). Your
eye doctor may examine the cornea, iris, and lens to look for
cloudiness (opacities) or other irregularities.

\u2022
What type of sunglasses should my child wear?
\ue002kids spend much more time than most adults do outdoors
and in direct sunlight, UV protection for the eyes is extra
important.
\ue002Sunglasses are essential for preventing sun damage to your
eyes; at the same time, they can improve your vision and
help you make a unique fashion statemen
\ue002specialty stores like Sunglass Hut, optical chain stores like
Pearle Vision and LensCrafters, and your local optician or
optical shop
\u2022
What if he won't wear his glasses? Can he wear
contact lenses?
\ue002Myopia control is another great reason for children to wear
contact lenses.
\ue002Gas permeable (GP) contacts may be the best choice.
According to several studies
\ue002Physically, the eyes can tolerate contact lenses at a very
young age. Some babies are fitted with contact lenses due
to eye conditions present at birth.
\ue002Contact lenses may be a safer vision option than glasses
for recreation use.
\ue002If a child wears eyeglasses for sports, polycarbonate
lenses are a must. But their eyeglass frames are still
vulnerable to breakage.
\u2022
Will his vision problem affect his learning?

Vision-Related Learning Problems
Vision obviously is an important part of learning.
The state of the eyes pertains to eye health, visual acuity and

refractive errors such as nearsightedness, farsightedness and
astigmatism.

The functioning of the eyes encompasses focusing, the eyes
working in tandem and eye movement. A child with a focusing
problem may have difficulty reading the chalkboard because she
cannot change focus rapidly from near to far. If her eyes do not
function properly as a team she may have eyestrain, double
vision, headaches and difficulty sustaining attention. Inability to
control eye movements means she will lose her place frequently
while reading.

Visual perception includes understanding what you see,
identifying it, judging its importance and linking it to previously
stored information. Eye-hand coordination also has to do with
visual perception. Visual perception relates to visual memory,
too. This means, for example, recognizing words that you have
seen previously, and using the eyes and brain to form a mental
picture of the words you see.

Turning or tilting the head to use one eye only, or closing or
covering one eye.
Placing the head close to the book or desk when reading or
writing.
Excessive blinking or rubbing the eyes.
Losing place while reading, or using a finger as a guide.
\u2022
Should I worry about how his computer use is affecting his
eyes?

Many pediatric computer vision eye doctors believe that heavy
computer use among children puts them at risk for early myopia.
Sitting for hours in front of a computer screen stresses a child's
eyes because the computer forces the child's vision system to
focus and strain a lot more than any other task

Tips

The recommended distance between the monitor and the eye for
children is 18-28 inches. By viewing the computer screen closer
than 18 inches, children risk straining their eyes.

Vision therapy is sometimes called vision training, visual training,
behavioral optometry or developmental optometry.

Other names are actually types of vision therapy. Orthoptics, also
called optometric vision therapy, is the use of eye exercises for
conditions such as amblyopia and strabismus. You might hear
about vision therapy for children with learning disabilities as
well: usually, tinted lenses (also called Irlen lenses) or eye
exercises. Another branch is dedicated to reducing refractive
errors, such as nearsightedness. Finally, syntonics, also called
optometric phototherapy or photoretinology, is the use of colored
lights for a wide range of visual ailments.

Orthoptics, the use of eye exercises to improve vision, is the
most widely studied type of vision therapy. Clinical studies have
shown it to be effective in treating amblyopia, strabismus,
convergence insufficiency and certain accommodation problems.

So what exactly are these eye exercises? Actually, many
exercises are available, and the therapy is individualized for each
child. Exercises to improve accommodation, for example, may
involve looking at a specific far object with one eye covered,
then looking at a specific near object (with the eye remaining
covered); the child would repeat these actions several times,
then switch eyes.

Orthoptics is not the only type of treatment available for these
conditions. Other strabismus and amblyopia treatments include
eyeglasses, patching, eyedrops and surgery. For convergence
insufficiency and accommodation dysfunctions, eyeglasses may
be appropriate.

Management

**Health Dieting \u2013 very important for your eyesight Vitamin A is the key to solving many eye problems Beta carotene \u2013 vitamin A

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Yellow and orange fruits and vegetables like apricots,
mangoes, sweet potatoes, and carrots and green vegetables

like spinach and cabbage.
\u2013 Vitamin A is the key to solving many problems
Parents of school-age children should stay informed about
vision correction options, such as using contact lenses instead

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