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Children's Vision and Safety

Eye health and safety is important at any age. Just as a yearly physical keeps your body in shape, a yearly eye exam can do the same for your eyes. Taking care of your eye health can and should start at a young age because there are different conditions that affect different age populations, including kiddos. Early detection and intervention is key for successful outcomes. The American Optometric Association (AOA) recommends that children receive comprehensive eye exams between 6-12 months of age, at age 3, before they start kindergarten (around age 5), and annual exams thereafter [1]. Vision is especially important for a child’s development since about 80% of learning is achieved through visual processing [2], and significantly impacts motor and coordination skill development [3]. Read on to see some common Q&A eye doctors often have with patients and their families. If you’d like even more information after reading, you can talk with your friendly neighborhood optometrist, or visit COVD.org.


Why does my child need an eye exam if they have “20/20” vision?

When we say a person has “20/20” vision, we are only describing their distance acuity – how well do they see at a distance. While distance vision is important, our visual functioning and behavior are just as (if not more) important and more complicated than that. Plus, a child’s learning environment is more complicated than just being able to see the whiteboard at the front of the classroom. They need to read, write, and visually process what’s going on around them, and there are eye conditions that can interfere with those critical learning and visual skills.

Photo: https://www.visiontherapycalgary.com/vision-learning/


What does visual function and behavior mean? What conditions affect those aspects of a child’s vision?

When reading, the eyes must be able to focus on the words, work together to keep words clear and single, and track the letters and words across the page – all before the brain can fully process the meaning of the words. Here are some common visual conditions that may affect a child’s ability to learn:

  • Convergence Insufficiency – when we look close to read, our eyes work together as a team to naturally turn in toward our nose to help us keep the words single. Sometimes, a person can have difficulty turning their eyes in, leading to double vision and/or eye strain and fatigue with prolonged reading tasks.

Photo: https://www.covd.org/page/Convergence

  • Accommodative Insufficiency – our eye’s focusing ability is known as accommodation. When looking at words on a page, some people have difficulty with this focusing ability, which can also lead to headaches, eye strain, and blurry vision up close.

  • Saccadic Dysfunction – our ability to read from left to right involves intricate and precise eye tracking movements called saccades that allow us to move from word to word quickly and accurately. If the saccades are inaccurate by overshooting or undershooting a word or skipping a line of text, this can lead to a lot of re-reading text and slow reading.


How are these conditions treated?

Several methods have been shown to help treat the conditions listed above. One intervention scientifically proven to improve these conditions is known as vision therapy (VT). Like physical therapy, VT consists of both in-office and at-home eye exercises. However, unlike physical therapy, VT isn’t working to strengthen eye muscles, but instead aims to strengthen eye teaming, tracking, and focusing skills by improving neuroplasticity [4]. A study found that in-office VT improved the signs and symptoms of Convergence Insufficiency for 73% of study participants compared to only home-based and placebo treatments [5].


My child had a vision screening at school and everything was normal. Do they need an exam?

Typical screenings may detect if a child needs glasses for distance, but they can miss up to 50% of learning-related vision problems [6] such as those mentioned above. A comprehensive exam is the best way to fully exam a child’s visual and eye health.


How can a 6-month-old child get an eye exam? What exactly are optometrists looking for during infant exams?

Though infants and toddlers cannot read the letters on the eye chart, there are many ways to assess a baby’s vision and eye health without verbal input, and ensure they are developing normally. The main conditions we look for are signs of disease in the back of the eye and risk factors for amblyopia (aka “lazy eye”), which is when one eye does not receive proper visual input for the brain’s vision centers to fully develop. When these conditions are identified early, treatment can be extremely effective to allow for better visual function long term.

Photo: https://www.eyecarecenterwausau.com/infantsee


How can I help protect my child’s eyesight for years to come?

In addition to regular eye exams, following proper eye safety is also crucial to make sure a person has good vision for life. Some common actions and their benefits include [7]:

  • Wear sunglasses that block 100% of UVA and UVB light ~~helps delay cataract formation and prevent harmful sun exposure to skin and eye

  • Wear safety goggles or safety eyewear appropriate for the sport(s) they play ~~helps prevent eye injuries

  • Avoid eye rubbing ~~helps to keep eyes clean, prevent scratches, and decreases risk for keratoconus

  • Wash hands before and after touching the eyes ~~helps to prevent infection

  • Eat right and exercise ~~helps to keep the body healthy which keeps the retina and optic nerve healthy

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[1] AOA – Championing Children’s Eye Care https://www.aoa.org/news/inside-optometry/aoa-news/championing-childrens-eye-care?sso=y

[2] Zaba JN. Children’s Vision Care In The 21st Century And Its Impact On Education, Literacy, Social Issues, And The Workplace: A Call To Action. J Behav Optom 22;2:39-41.

[3] https://www.aoa.org/news/inside-optometry/aoa-news/championing-childrens-eye-care?sso=y

[4] COVD – What is Vision Therapy? https://www.covd.org/page/vision_therapy

[5] Randomized clinical trial of treatments for symptomatic convergence insufficiency in children. Arch Ophthalmol 2008;126(10):1336-49 .

[6] COVD – Learning Related Vision Problems https://www.covd.org/page/learning

[7] 10 Tips to Teach Children about Eye Safety – https://www.eyecaredoctors.com/2016/08/30/10-tips-to-teach-children-about-eye-safety-2016/

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