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Davis Vision - Vision Screening for ChildrenVision Screening For Children

Protect Life's Greatest Learning Tool
By
Robert Elsas
Vice President of Marketing Support

Carl Moroff, O.D.
Chief Operating Officer

Joseph Wende, O.D.
Vice President of Professional Affairs

One out of every four children between ages five to twelve has a vision problem, which can adversely effect the child's educational performance. Many parents regularly take their children to the family doctor for medical checkups, yet they rely on vision screenings offered in schools to detect vision concerns. While school screenings may identify problems with a child's vision, they are not thorough enough to expose problems of eye muscle coordination, eye disease, peripheral vision or shortcomings in near/distance vision. A child's visual learning capabilities depend on these areas.

Parents should not wait until their children report visual problems. Most children assume that they see the same as everyone else. Delaying a child's complete eye examination can have a significant impact on the child's physical, mental and emotional well being. Parents and teachers sometimes label children as lazy, unmotivated or "poor students" when the children simply can't see clearly or move their eyes properly. This only discourages children. Eventually they believe that they just can't learn. Optometrists, however, have found that 80 percent of these children have difficulty in eye control and coordination.

New evidence has even indicated a link between undetected vision impairment and illiteracy. In a recent study, almost 75 percent of 54 illiterate adults exhibited visual limitations during a comprehensive eye examination. More than 60 percent couldn't "track" or move their eyes properly across a printed page. And 13 percent failed a near-vision acuity test. The economic and social implications of illiteracy are significant. Illiteracy can place a severe burden on the economy. Non-reading individuals are more likely to report physical, mental, or health disabilities resulting in poor performance in work and daily activities. It is a disability that hinders a person's quality of life. An "ounce of prevention", an eye examination and vision correction, could give more children the necessary tools for a fulfilling adult life.

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Early Detection... Greater Success
A visual impairment can significantly handicap a child's development and education. Some visual skills reach full development at about age five. Others may not be fully developed until age ten or eleven. Therefore, waiting until a child can read an eye chart (school age) could be too late for a first eye examination and annual eye examinations become necessary throughout childhood. The eye doctor must evaluate a child's visual skills within the context of their age-related developmental standards. Visual defects discovered before age five can be treated with a relatively high degree of success. Some eye diseases, such as amblyopia ("lazy eye") can even be detected and treated in child between one and three years old.

It is vital then, for parents to schedule regular eye examinations as recommended by the American Optometric Association (AOA). Parents should mention milestones in the child's developmental history. Growth and developmental stages play a large role in the child's vision. History should include the ages that the child first sat up, crawled, walked, etc. The development of many motor skills links closely to a child's visual development. Parents also need to pay close attention to their child's visual behavior.

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Any of the following unusual symptoms should be reported to the doctor:

  • Squinting
  • Covering/closing one eye
  • Eyes pointing in different directions
  • Twisting or tilting the head to favor one eye
  • Headaches and dizziness
  • Blurred or double vision
  • Frequent blinking or rubbing of eyes
  • Reading from books held unusually close to the face
  • Ability to read only for a short period of time
  • Using a finger to follow words when reading
  • Avoidance of close-up work
  • Inability to judge distance properly (bumping into things)
  • Poor school performance
  • Poor athletic performance.

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The Comprehensive Eye Examination
The American Optometric Association recommends the following examination guidelines for early detection of visual problems:

Age Group Eye Examination Frequency
Infants (birth to 24 months) By 6 months of age
By the age of three to four months an infant's eyes should focus on small objects. They eyes should appear straight or parallel. At six months the infant should be able to focus on both distant and near objects.
Pre-school Age (2-5 years) At ages 3 and 5
Instead of a standard eye chart, the doctor uses pictures to measure visual acuity. To detect differences in focussing power, a child only needs to look briefly at an object. These, and other tests, require very little input from the child.
School Age (6-19 years) Annually
By this age, the examination is very similar to that of an adult. If properly approached, children should respond to examination techniques with the same reliability as an adult.

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A child's eye examination involves comprehensive testing of anatomical, functional and perceptual development. Before the test to check visual acuity or clarity of vision, the examination usually reviews the family's medical history (to reveal hereditary visual problems), and the child's medical and visual history. The eye doctor performs an external examination for structural anomalies such as the eye position in the socket, the extent of tearing, lubrication, etc. The doctor may also test for glaucoma and other eye diseases. For the internal examination, the doctor uses an "ophthalmoscope" to look into the eye and examine the retina or inner lining of the eye.

Subsequent testing may evaluate the child's ability to:

  • interpret color information.
  • visually track a moving object.
  • verify proper eye alignment for given distances.

Children may even be screened for appropriate eye-hand-foot coordination and motor skills. Judging from the child's developmental, behavioral or health history, the optometrist may also need to determine if the child's vision and perceptual skills are developing on schedule. The optometrist may even observe the child playing with blocks or completing another age specific task.

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A comprehensive eye examination includes tests for:

Near Vision Ability to see clearly without strain at 13 to 16 inches (common distanced when working at a desk).
Distance Vision Ability to see clearly without strain at 20 feet or more (such as reading a chalkboard).
Astigmatism Usually a reduced ability to see either vertical or horizontal lines clearly due to an irregularly shaped cornea (the clear "window" into the eye).
Focusing Ability Ability to see clearly while changing distances.
Eye Coordination Ability to use both eyes together.
Depth Perception Ability to judge relative distances and move accurately through three-dimensional space.
Peripheral Perception Ability to detect objects at the side while looking straight ahead.
Color Perception Ability to distinguish colors. Deficiencies in color perception affect one boy out of 12 and only one girl out of 200. This is a hereditary condition.
Lazy Eye (Amblyopia) Loss of or reduced ability to see clearly with one or both eyes. If not corrected quickly, full correction may not be possible.
Crossed Eye (Strabismus) Misalignment or irregularities in the two eyes working together to track visual objects.

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The eye conditions and deficiencies listed above can have a negative effect on a child's performance in school and in other activities. Quick and painless eye examinations can detect minor problems that, if left untreated, can turn into major problems.

For those children who require corrective eyewear, parents should select a sturdy frame and polycarbonate lenses. Today, frame materials, including space-age metals (titanium, carbon/graphite compounds, and stainless steel) as well as advanced plastics provide durability, lightweight comfort and stylish design for children of all ages. The high-index polycarbonate plastic increases the lenses' impact resistance. This provides exceptional protection against both eye injury and breakage. Children involved in contact sports (basketball, soccer, volleyball) should wear one-piece plastic sports frames.

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These frames should include the following features:

  • Padded or rubber bridges
  • Deep-grooved eyewires to keep the lenses in place
  • Headband attachments to keep glasses on the face
  • Shapes that allow a wider field of vision.

For high-risk sports, such as football and lacrosse, they should also wear eye-face guards designed to wear over other glasses.

Giving children every opportunity to succeed includes scheduling annual eye examinations. Vision is one of a child's greatest learning tools. Early detection of a problem can often mean the difference between success and failure in the classroom and beyond.

"Nothing on this web site is intended, nor should it be construed, as professional advice. Those reviewing the information should consult with a qualified professional."

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