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Children’s vision and eye exams

children's vision

The main cause of eye disease in children is genetics. For example, if one of the parents is nearsighted, the child is likely to have the same problem. But this is only a possibility, not a determining factor. Nevertheless, both parents must pay close attention to this issue. They must have their child’s eyes examined regularly and take precautions.

Reasons for vision abnormalities can be:

– Congenital: developed in the fetus during the mother’s pregnancy.

– Acquired: developed under the influence of external factors.

Diseases of the visual organs as well as general diseases can affect the visual development of a child. Anomalies of the cardiovascular and endocrine systems, kidneys, lungs, ENT organs, and childhood infections can also lead to visual impairment.

Primary Diagnosis

The visual system of infants is not fully developed. Typically, their vision is twice as poor as that of adults. The first eye examination is usually performed when the child is three months old.

During the examination, the doctor makes an external examination of the visual system. The doctor checks whether the baby is able to focus his eyes on a stationary object or follow a moving object with his eyes. Then the doctor performs slit-lamp examination, measures the refractive ability of the eyes, and examines the fundus.

Mild, occasional strabismus is considered an age norm. In this case, babies should be able to both focus their eyes and follow an object with their eyes very well. Eye mobility should be complete, with both eyes aligned and moving together in all directions.

The ophthalmologist uses a lighted instrument to illuminate the baby’s eyes and watch the way the shadows move in the pupil. The doctor places lenses on each eye in turn and watches until the shadows stop moving. After a few measurements, he or she can make a diagnosis. To get more accurate results, the doctor recommends atropine therapy and the use of special eye drops 5 days before the examination. The standard visual acuity in a three-month-old baby is +3.0 – +3.5 diopters, while farsightedness is diagnosed in the majority of healthy infants. This can be explained by the small size of the eyeball.

Eventually, visual acuity becomes clearer and reaches normal. During a fundus exam, the doctor examines the back of the eye and checks the clarity of the crystalline lens and other parts of the visual system. The result is very different in infants and adults. An infant’s retina is pale pink, and the nerve head is grayish and slightly flattened.

Primary examination to detect disease. Ophthalmologists rarely check a baby’s visual acuity, which is usually 0.1. But they can examine the baby’s visual system right after birth in the delivery room.

Such diagnostics are performed in children under 2 kg. The comprehensive complex examination can be performed after one month at the doctor’s discretion. It concerns infants with eye problems: trauma during passage through the birth canal, asphyxia and premature birth, constant shedding of tears. An important ability at this time is the ability to focus the eyes. If you show a bright object to a baby, he should fix his eyes on it for a few seconds.

Diagnosis at 6 months and 1 year

Vision develops rapidly in babies after 3 months, and they are able to focus their eyes on toys and pick them up with their hands. Parents should also be aware of some warning signs: frequent redness of the eyeballs; severe strabismus; rhythmic eye movements. If you notice at least one of these symptoms, don’t wait for the scheduled check-up; take your baby to a specialist as soon as possible. The 6-month eye exam is the same as the 3-month eye exam. Farsightedness may remain the same or improve slightly. It is also a good idea to compare the results of the current eye exam with the previous one. Strabismus is usually not present at this age. The retina is pink and the optic nerve head is pale pink and has the correct shape.

сhildren's visionWhen the baby is one year old, he or she usually recognizes objects and begins to imitate others, but it should be noted that vision at this age is still different from adult vision. To determine refraction, an ophthalmologist can measure visual acuity using autorefractometry. Farsightedness should be somewhere around +2.5-+3.0 diopters, which is less compared to previous results. Visual acuity is tested at 2 years, one year later (usually at 3 years), at 4 years, and before the child starts school. Usually there should be no vision problems at this time. During the school years, such examinations should take place once a year.

Eye exam after three years

During this examination, the doctor examines the child’s eyes. He or she assesses the size and shape of the eyes, the ability of the pupils to move together. A good specialist is able to detect various disorders at once, for example, strabismus, infections, inflammations, etc. Orlova’s vision chart is used to test the visual acuity of three-year-old children. In this table there are pictures instead of letters, which become smaller as you look at them from top to bottom. The child should sit 5 meters away from the table. In most cases, the eye test is performed without corrective lenses. In case of visual impairment, the diagnosis is made with the help of slit lamp biomicroscopy and autorefractometry. The doctor can also perform the following procedures at this age:

  • Biomicroscopy – to assess the clarity of the optical components of the eye;
  • Fundoscopy – to examine the fundus;
  • Peripheral vision – to check the level of peripheral vision.

Vision Standards in Children

сhildren's visionOne of the main criteria for determining the normal state of the visual system is the age of the child. These are standard values of visual acuity in children:

2 years: 0.4-0.7;

3 years: 0.6-0.9;

4 years: 0.7 – 1.0;

5 years: 0.8 – 1.0;

6 years and older: 0.9-1.0.

Over time, farsightedness decreases because the eyes grow rapidly during the first three years of a baby’s life, and then this growth slows down a bit. The reduction of farsightedness should correspond to the age. If farsightedness is reduced too quickly, there is a risk of developing nearsightedness. If farsightedness is still high and doesn’t decrease over time, pathological farsightedness may develop. Children with eye problems should be examined at least twice a year. Examinations in clinics and hospitals can ensure timely detection of complications and proper treatment.

Possible problems

The most common eye problems in children are nearsightedness, farsightedness and astigmatism. The optical system of the eye is made up of several lenses. When light passes through these lenses, it is refracted and focused directly on the retina. If the focal point is in front of the retina, the child is nearsighted; if the visual image is focused behind the retina, the children can’t see clearly when looking at objects in front of them. In such cases, it is advisable to pay attention to age-related changes in visual acuity and correct them in time. Such problems can even lead to amblyopia, when impulses are not transmitted to the brain and the image is not created, so the child can’t see even if he or she wears glasses.

Vision is very important for a happy life. If you notice any symptoms that indicate possible problems in the development of the visual system, see an eye doctor as soon as possible. Early treatment and correction can prevent many negative consequences.