Healthy eyes and good vision play a critical role in how infants and children learn to see. Eye and vision problems can lead to developmental delays if not caught early on. Therefore, the American Optometric Association is recommending that infants have their first eye exam around 6 months of age, again at 3 years, and then before starting school. At the 6 month well-baby check-up a pediatrician may do an eye screen, but an eye screen cannot always detect an eye problem. A pediatrician is able to identify basic eye disorders, but some eye problems can go undetected due to limited time and equipment. The American Optometric Association found that about 10% of children have a visual impairment. Early infant eye exams can detect potential eye and vision problems before they interfere with development. Waiting till the start of school can make treating some of these problems difficult.
A comprehensive eye exam is more than just a screening. An optometrist will look for things such as refractive errors (nearsightedness and farsightedness), astigmatism, strabismus (misaligned eyes), ambloyopia (lazy eye), ocular diseases, and age appropriate development of eye teaming, tracking, visual acuity and depth perception.
What Eye Tests Can They Do With an Infant?
During the eye exam an optometrist will test for pupil response, ability to fixate and follow, preferential looking, refractive errors, and overall health of the eye. Pupil response is assessed by the pupil’s ability to open and close properly in the presence or absence of light. The optometrist will check the infant’s ability to fixate and follow with their eyes using finger puppets, toys, or even a parent’s face. Since an infant can not use the typical eye chart, special cards with one blank side and one side with stripes are used. The side with stripes should attract the infant’s gaze. The optometrist will then use eye drops to dilate (temporarily enlarge) the infant’s pupils to test for a refractive error, astigmatism, and ocular diseases such as retinoblastoma, the seventh most common pediatric cancer.
Preparing for the Exam
When scheduling an appointment, remember to select a time when your child is alert and happy. Take a bottle with you on the day of the appointment, as infants tend to be more alert and cooperative when eating. It’s also a good idea to bring some familiar toys and comfort items. Since it can be a challenge keeping your infant entertained in the waiting room, see if you can have all paperwork that needs completed sent to you prior to the appointment. This way you can fill it out at home and bring it with you on the day of the appointment.
The American Optometric Association has teamed up with The Vision Care Institute of Johnson and Johnson Vision Care Inc., to develop InfantSEE, a public health program to ensure that infants nationwide are getting the vision care they need. Participating member optometrists are providing a no-cost comprehensive infant eye and vision assessment for infants within the first year of life regardless of income or insurance coverage. For more information on InfantSEE and for a list of providers in your area visit www.InfantSEE.org.
By Tracy Shea-Derby (Teacher of the Visually Impaired)