Pediatric Eye Exams

Pediatric Eye Exams in Olympia

The Importance of Pediatric Eye Examinations for Children

Comprehensive pediatric eye examinations are critical for monitoring vision and overall eye health in children.

A pediatric eye exam is more than a simple screening, it is an assessment of your child's visual function and development and eye health including:

  • Eye diseases and disorders
  • Infections
  • Evidence of visual-motor, cognitive, and neurological deficits. 

An accurate description of visual strength not only takes acuity into account but our ability to gather and process visual information. A child may have "perfect" vision but struggle with optometric deficits that affect learning. Studies show that most vision problems that affect learning are not caused by poor eyesight. In many instances, there is nothing wrong with the visual system. Often, issues related to visual-motor or cognitive-developmental delay can be detected during such examinations.

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Vision Development

While fundamental stages of visual advancement take place in infancy and toddlerhood, it is possible to develop these skills in young adulthood and beyond. They are important for monitoring conditions that might affect learning in school which can lead to stress and anxiety. Vision is crucial for learning and development for the following reasons:

  • More than 85% of our brain is linked to vision
  • It is the brain’s fastest and most effective way of processing information. 
  • The early development of visual skills and neuroplasticity allows children to meet age-related visual demands as they get older.  As new nerve pathways are developed, they have a greater chance of being visually on par with their peers. 
  • It allows children to develop critical skills needed to process what they read, learn, and how to interact with the world around them.

Who is at Risk For Eye Disorders?

Although certain populations are at greater risk for developing eye disorders than others, it is important to remember that child development is very individual and must be treated as such. All children should be evaluated for eye disorders even if they do not seem to be at risk.

Individuals at particular risk include those who with:
  • Neurological or developmental challenges
  • Autism
  • Downs Syndrome
  • Cerebral Palsy
  • Genetic disorders
  • Were born prematurely
  • Present with a family history

Signs of Visual Problems

  • Reduced hand-eye coordination: An example can be seen when a child is unable to catch a ball that is thrown towards them. The inability to do so points to their difficulty in interpreting speed in relation to where they are. 
  • Compensation: When a child points to each word they read. Doing so is often a way for them to compensate for their inability to track words. 
  • Avoidance: If a child finds it too difficult to read or track the words on a page, she may avoid the material altogether. This kind of avoidance is often displayed through excessive movements, such as squirming in their seat, speaking out of turn, or "spacing out" because they cannot focus on the material.

Physical Symptoms

Eye problems that involve an inability to focus or poor vision often present as physical symptoms. These include:

  • Headaches
  • Red eyes
  • Eye rubbing
  • Eyestrain
  • Complaints of poor vision ("I can't see!")

Knowing What to Look For Problems with Visual Perception

A child who struggles with visual perception will often struggle with mastery of any number of tasks. That is why it is important to recognize the signs that suggest the presence of a deficit, particularly if they have:

  • Poor handwriting
  • Difficulty in copying from a whiteboard
  • A tendency to omit or re-read words
  • Poor reading comprehension
  • Difficulties with letter and number reversals, such as confusing “b” with “d”.

Emotional Symptoms of Visual Perceptual Problems

The emotional effects of having a visual perception problem can be devastating. The inability to perform well in school often leads to low self-esteem and can lead a child to think they are stupid, causing them to lose the motivation needed to succeed. Being able to identify signs of emotional distress is critical, particularly if a child exhibits:

  • Signs and symptoms of depression or stress
  • Extreme irritability or temper tantrums
  • A short attention span
  • Difficulty focusing on tasks

Common Eye Problems Found In Children

Many optometrists recommend at least one comprehensive pediatric eye exam before your child begins school. Some common eye conditions in children include:

  • Myopia (nearsightedness)
  • Hyperopia (farsightedness)
  • Genetic diseases
  • Astigmatism
  • Amblyopia (lazy eye). This condition occurs in  the absence of normal visual development. Treatments include vision therapy, patching, and eye drops.
  • Strabismus (double vision)

Vision Screening from a Pediatrician vs. Eye Exams From A Pediatric Optometrist

It's important not to get confused between a rudimentary screening performed by a pediatrician (or a school nurse) and a comprehensive eye examination from a pediatric optometrist. The former is done by a pediatrician as part of a standard physical exam. The latter is an exam by a trained eye doctor, which can extensively test all aspects of visual health. 

Anatomy of a Pediatric Eye Exam: What to Expect

The examination will begin with a case history of the child, including family and personal medical history, observations from the school, and complaints from the child. Following this, the optometrist will examine the following:

  • "Good vision" or visual acuity: Tests involve the eyes working together and the individual eye. For children and babies unable to communicate there are special technologies for babies using pictures to assess their vision.
  • Usage: Tests include the cover test, testing for color, 3d, track
  • Phoropter for older children to check if they need prescription lenses.
  • Slit-lamp gives a good look at the eye
  • dilating drops allow for analysis of the back of the eye.
  • Review of findings, recommendations, treatments, scheduling future testing

Early Stages of Testing

  • Newborns: Newborns require a proper assessment to check the startle reflex and any noticeable signs of eye disease, in particular if there is a family history of such complications. Such tests can be done by the pediatrician.
  • Babies 6-12 months: Within the first year, the pediatrician will assess eye movement, alignment, and overall eye health.  
  • 12 to 36 months: Overall eye health is assessed often with the aid of photo screening to monitor for signs of eye problems.  If any problems are noted, follow-up will usually involve an eye doctor. 
  • 3-5 years: The child will be checked for issues of alignment and vision. If there are signs that further intervention is required, they will usually involve an optometrist.
  • 5 years and older: Further assessment of eye alignment and to gauge visual acuity. Signs of eye issues will be addressed by an optometrist.

Common Questions

The challenges for a pediatric eye exam depend on age, maturity, and temperament. Depending on the child, an exam can seem scary, tedious, boring, etc. Many pediatricians are wonderful with children and they are trained to deal with different types of children using humor and friendliness to make the exam more fun. Do your research to find practitioners with excellent reputations working with children. Additionally, prepare your child before the exam.
Problems include squinting, eye-rubbing, headaches, blurry vision, needing to sit near the board, etc.
Neither a school vision screening nor a pediatric screening is sufficient for assessing overall ocular health. They are rudimentary tools for identifying possible problems to be followed up with an optometrist.
Most exams follow a similar layout in terms of tests performed. There is a visual acuity test, retinoscopy, refraction, external exam, slit lamp, and a dilation. These tests center around clarity of vision, retinal health and general eye health.
Dr. Zurcher cartoon

Pediatric Eye Exams Are Important

There are no substitutes for routine pediatric examinations to monitor and maintain overall ocular health to detect eye disorders and visual motor neurological deficits. Contact us to find out more.

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Working Hours

Monday-Thursday
8:30AM-5:00PM

Friday
8:30AM-3:00PM

Saturday-Sunday
Closed

Location
400 Yauger Way SW. Bldg 1, Ste A Olympia, WA 98502
Fax
(360) 459-1097
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