Eye Alignment Problems

Strabismus
Vision  is the term for a misalignment of the eyes
is arguably the most important of the five senses  it is important that it is detected and treated early so the
It plays a crucial role throughout childhood and beyond vision in both eyes develops properly.
 If not treated may lead to amblyopia or "lazy eye”

AWARENESS OF SIGNALS OF POOR VISION

≈ one eye turns or crosses, that eye may not see as well as
the other eye
≈ 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?

Babies have poor vision at birth because it takes some time to
Because it is essential to make sure your kids have the visual
develop the visual system.
skills they need to do well in school, sports and other activities.
 but can see faces at close range, even in the newborn
nursery Moving into the preschool and school-age years, parents face a
new set of worries:
AT When should my child have his first eye exam?
six weeks a baby's eyes should follow objects
four months should work together - to detect problems that may interfere with learning
 Over the first year or two, vision develops rapidly  Children without symptoms and who are at low risk for eye
 A two-year-old usually sees around 20/30, nearly the same problems should have their eyes screened by six months of
as an adult. age, then examined at age three and again at the start of
school. Risk-free children should then continue to have their
Tips: To help stimulate your 2- to 3-month-old child's vision eyes examined at least every two years throughout school.
development, the American Optometric Association (AOA) has Who Should I See for My Eye Exam?
these recommendations:
There are three different kinds of eyecare professionals:
• Add new items to their room or frequently change the ophthalmologists, optometrists and opticians. Who you should
location of their crib or existing items in the room. see depends on your needs.
• Talk to your baby as you walk around the room. Ophthalmologists are medical doctors (MDs or DOs) who
• Keep a night light on to provide visual stimulation when specialize in eyecare. Not only do they prescribe eyeglasses and
contacts, but they also perform eye surgery and treat medical
they are awake in their crib.
conditions of the eye. Ophthalmologists are doctors who have
• While infants should be placed on their backs for sleep to received 12 or more years of training.
decrease the risk of sudden infant death syndrome (SIDS), Optometrists (ODs) are eye doctors who can prescribe glasses
put them on their stomachs when they are awake and you and contacts and treat medical conditions of the eye with eye
can supervise them. This provides important visual and drops and other medicines. Optometrists generally receive eight
motor experiences.
or more years of training. Optometrists prescribe glasses, insufficiency): Eye doctors will also assess the ability of eyes to
contacts, low vision aids, vision therapy and medication to treat pull inward (convergence) to provide correct focusing.
eye diseases, as well as perform certain minor surgical Focusing (accommodation), color vision, and/or depth
procedures. perception problems: The eye doctor may also test your
Opticians are not doctors, but eyecare professionals who adjust child's focusing (accommodation) ability. The child's depth
and repair glasses, instruct patients in contact-lens use and grind perception or ability to gauge distances between objects may
and assemble spectacles. In some cases, specially trained also be examined. Color vision may be tested through methods
opticians can determine your prescription and fit contact lenses. such as placing a dot pattern of symbols within a pattern of dots
Opticians generally receive their training either "on the job" by made up of other colors. [Read more about color vision and how
apprenticeship or from technical schools. the eye refracts light.]
• What tests should a complete children's eye exam General eye and eyelid health: To assess a child's general
include? eye health, the eye doctor will examine his or her eyelids and lid
margins, looking for shape irregularity and discharge on the
According to the American Optometric Association (AOA)
lashes or lid margins. The eye doctor may turn the lower lids
 infants should have their first comprehensive eye exam at
inside out (evert) to look for abnormal or infected eyelash
six months of age
follicles, bumps (papillae), discharge, and swelling (edema). Your
 Children then should receive additional eye exams at
eye doctor may examine the cornea, iris, and lens to look for
three years of age, and just before they enter
cloudiness (opacities) or other irregularities.
kindergarten or the first grade at about age five or six
 For school-aged children, the AOA recommends an eye • What type of sunglasses should my child wear?
exam every two years if no vision correction is required.  kids spend much more time than most adults do outdoors
and in direct sunlight, UV protection for the eyes is extra
Eye tests and general examinations often are conducted to important.
detect the possible presence of these types of eye problems  Sunglasses are essential for preventing sun damage to your
commonly found in young children: eyes; at the same time, they can improve your vision and
Lazy eye (amblyopia): Your eye doctor will want to rule out help you make a unique fashion statemen
amblyopia, which is a lazy eye with decreased vision in one or  specialty stores like Sunglass Hut, optical chain stores like
both eyes without detectable anatomic damage. Tools for helping Pearle Vision and LensCrafters, and your local optician or
detect amblyopia include general assessment of vision optical shop
capabilities as well as posture evaluation and determination of
• What if he won't wear his glasses? Can he wear
how each eye sees in relation to the other eye. Unfortunately,
contact lenses?
amblyopia is not always correctable with eyeglasses or contact
lenses and may require eye patching to strengthen the weaker  Myopia control is another great reason for children to wear
eye. [Read more about amblyopia or lazy eye.] contact lenses.
 Gas permeable (GP) contacts may be the best choice.
Misalignment of eyes (strabismus): Crossed or misaligned
According to several studies
eyes (strabismus) can have different causes, such as problems
 Physically, the eyes can tolerate contact lenses at a very
with muscle control in the affected eye or eyes. If strabismus
young age. Some babies are fitted with contact lenses due
persists in young children, a condition known as lazy eye or
to eye conditions present at birth.
amblyopia (see above) can develop along with related vision
 Contact lenses may be a safer vision option than glasses
problems. [Read more about strabismus.]
for recreation use.
Inability to maintain alignment of both eyes for correct
focus as distant objects move nearer (convergence
  If a child wears eyeglasses for sports, polycarbonate The recommended distance between the monitor and the eye for
lenses are a must. But their eyeglass frames are still children is 18-28 inches. By viewing the computer screen closer
vulnerable to breakage. than 18 inches, children risk straining their eyes.
• Will his vision problem affect his learning?
Vision therapy is sometimes called vision training, visual training,
Vision-Related Learning Problems behavioral optometry or developmental optometry.
Vision obviously is an important part of learning.
Other names are actually types of vision therapy. Orthoptics, also
The state of the eyes pertains to eye health, visual acuity and called optometric vision therapy, is the use of eye exercises for
refractive errors such as nearsightedness, farsightedness and conditions such as amblyopia and strabismus. You might hear
astigmatism. about vision therapy for children with learning disabilities as
The functioning of the eyes encompasses focusing, the eyes well: usually, tinted lenses (also called Irlen lenses) or eye
working in tandem and eye movement. A child with a focusing exercises. Another branch is dedicated to reducing refractive
problem may have difficulty reading the chalkboard because she errors, such as nearsightedness. Finally, syntonics, also called
cannot change focus rapidly from near to far. If her eyes do not optometric phototherapy or photoretinology, is the use of colored
function properly as a team she may have eyestrain, double lights for a wide range of visual ailments.
vision, headaches and difficulty sustaining attention. Inability to Orthoptics, the use of eye exercises to improve vision, is the
control eye movements means she will lose her place frequently most widely studied type of vision therapy. Clinical studies have
while reading. shown it to be effective in treating amblyopia, strabismus,
Visual perception includes understanding what you see, convergence insufficiency and certain accommodation problems.
identifying it, judging its importance and linking it to previously So what exactly are these eye exercises? Actually, many
stored information. Eye-hand coordination also has to do with exercises are available, and the therapy is individualized for each
visual perception. Visual perception relates to visual memory, child. Exercises to improve accommodation, for example, may
too. This means, for example, recognizing words that you have involve looking at a specific far object with one eye covered,
seen previously, and using the eyes and brain to form a mental then looking at a specific near object (with the eye remaining
picture of the words you see. covered); the child would repeat these actions several times,
Turning or tilting the head to use one eye only, or closing or then switch eyes.
covering one eye. Orthoptics is not the only type of treatment available for these
Placing the head close to the book or desk when reading or conditions. Other strabismus and amblyopia treatments include
writing. eyeglasses, patching, eyedrops and surgery. For convergence
insufficiency and accommodation dysfunctions, eyeglasses may
Excessive blinking or rubbing the eyes.
be appropriate.
Losing place while reading, or using a finger as a guide.
Management
• Should I worry about how his computer use is affecting his **Health Dieting – very important for your eyesight
eyes? Vitamin A is the key to solving many eye problems
Many pediatric computer vision eye doctors believe that heavy Beta carotene – vitamin A
computer use among children puts them at risk for early myopia. • Yellow and orange fruits and vegetables like apricots,
Sitting for hours in front of a computer screen stresses a child's mangoes, sweet potatoes, and carrots and green vegetables
eyes because the computer forces the child's vision system to like spinach and cabbage.
focus and strain a lot more than any other task – Vitamin A is the key to solving many problems
Parents of school-age children should stay informed about
Tips vision correction options, such as using contact lenses instead
of glasses to control nearsightedness and protective sports
eyewear
Ensuring that children wear sunglasses is very important, too.