"EYE" Have Been Away

By , July 12, 2007 7:54 pm

I have been very silent for the past couple of days, but we were away in Albuquerque for our annual visit to the pediatric ophthalmologist. During the long drive home, I was pondering my next post. Since most of my readers probably have children, I thought that children’s eyes might be a good subject for a post. My experience with my oldest daughter has taught me a lot that I did not know before…and that you may not know either.

When my oldest daughter (now 6) was 1, we took her to a pediatric ophthalmologist to have a congenitally blocked tear-duct surgically opened. During our initial visit, the doctor did a thorough eye exam, including a vision test. Many people (including me before this event) do not realize that it is possible to test the vision of an infant.

During the exam he discovered that not only was my daughter far-sighted, but her two eyes had a huge difference in the level of vision. This latter issue, as I learned, is a real problem that if left untreated, can actually cause blindness in the eye with the worse vision.

During childhood, if there is a big difference in the quality of vision between the two eyes, the brain will use only the good eye and will ignore information from the bad, or “lazy” one. This is known as amblyopia, or lazy-eye. Many people do not realize that a child does not have to exhibit an actual misalignment of the eyes in order to have “lazy eye.” My daughter had absolutely no physically obvious manifestation of any vision problem.

Common treatment consists of patching the good eye to force the “lazy” eye to be used, or prescribing glasses for the same purpose. My daughter is being treated with glasses, which she has had since age 1.

Apparently, 2 to 3 out of every 100 children are affected by this condition. What is scary to me is that routine, very early vision testing is still fairly unusual.

The earlier treatment occurs, the better. My understanding has always been that treatment must occur before age 7 or 8, otherwise it is too late. However, a study by the National Eye Institute (NEI) found that children up to age 17 can still derive some degree of benefit from treatment, although dramatic improvement seems to be less likely as age increases.

Of course, although I have had many “careers” in my lifetime, I am not a doctor! I am simply trying to pass along what I learned from this experience with my daughter – get your children’s eyes tested at as early an age as possible, even if everything seems fine!

Having learned about this issue with my oldest, I have had my two subsequent children tested early. My son first went to the pediatric ophthalmologist at age 1 (and was retested at 3, and again today at 5 to rule out any possible vision changes), and my second daughter had her first visit today (at age 18 months). Fortunately, the two younger children, so far, seem to have absolutely uniform, normal vision.

The little ones hate being tested, especially the eye drop part, but the whole process is quick and painless. The chance of detecting and preventing a potentially severe and irreversible vision problem seems well worth suffering through a few moments of uncooperative behavior! I also recommend seeing a pediatric ophthalmologist if possible, since they are used to dealing with unwilling patients and are perhaps more familiar with the vision issues of childhood.

Resources and information:

NEI Amblyopia Resource Guide

30 second video animation of Amblyopia and treatment by patching

Find a Pediatric Ophthalmologist

The American Association of Pediatric Ophthalmology and Strabismus

Prevent Blindness America

Taking Care of Your Child’s Sight

Thanks to the National Eye Institute, National Institutes of Health for the anatomical diagram of the eye.

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7 Responses to “"EYE" Have Been Away”

  1. Gattina says:

    My pediatrician took care of that at a very early age, that was part of the usual check up. It’s very important I know from experience because when I was 10 (a very long time ago, lol) I was shortsighted and of course nobody noticed it. An eye check didn’t exist. But then at school it got worse and worse so finally they had my view checked and the bad notes came from the fact that I couldn’t read so far at the blackboard !

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  2. Karen says:

    Interesting post. Another link you may want to check out is my husband’s pediatric podcast. Episode two deals with lazy eye:
    http://www.pediascribe.com/podcast/20060726/pediacast-episode-2-news-swimmers-ear-lazy-eye/

    We’re off to the ped optho today for ds. Dh has a horrible family history of glaucoma and both of my kids have elevated pressures in their eyes. None that need treatment yet, but frequent monitoring.

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  3. Andamom says:

    First, I am glad that the two younger children don’t exhibit any problems — and that your older child is being treated.

    My husband’s paternal grandmother has macular degeneration and is nearly blind. His vision isn’t stellar either — and without strong contact lenses or thick glasses, he can see very little. As a result, I am cognizant that vision problems could potentially affect my son (now almost 14 mos).

    That scares me — but I know that early action is important. As such, your post is such an important one — and I hope that your other readers will take their kids for exams.

    Also an FYI. There was an article in Parents Magazine a few months ago (maybe May?) on hearing problems. It said something similar about the number of children affected — and it being more common than most parents realize. So, hearing tests are another must-do.

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  4. CelticMommy says:

    Wow! Thank you for all that information! I was just wondering about when to take Em (he’s now 3) to get his vision checked. Everything seems fine, but my entire husbands’ family has/have terrible vision problems… you’re so full of useful info!! :-)
    ~Hettie

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  5. nina says:

    Our pediatrician insisted on vision checking for our internationally adopted daughter but the first routine exam didn’t show any problems. As you might remember she developed accommodative esotropia and now wears glasses.

    Thanks for posting this information. It reminds me that I need to get her back to the eye doctor for a check to see if the glasses are working. And while I am there I will take my ds.

    Great post.

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  6. Jen says:

    And another thing to consider is a behavioral opthamologist. A went to one for a screening and it was determined that he needed vision therapy. Thankfully that was joined with the sensory OT he needed and it made a huge difference. They check to see how the eyes are working, if they’re working together properly.
    It’s all this stuff that you never think of while pregnant that knocks you for a loop.

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  7. Anonymous says:

    DO NOT take your child or yourself to a primary care doctor for eye problems. A child needs to have his or her eyes examined by a trained and licensed eye specialist; an Optometrist. Four years bachelor’s, and four years doctorate (last four solely eye study). You’re pediatrician or PCP gets maybe 20 hours of eye related topics in school. Any eye irritation is always “pink eye” diagnosed by a Peds or PCP doc. Take them to an expert in eyes.

    Dr. M

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