AGE AND VISION
- Infants' Vision
- Pre-School Children's Vision
- School-Age Children's Vision
- Eyes Over 40
The visual system undergoes dramatic change when we are children. At birth, infants are only capable of distinguishing light and large shapes. As the nerve pathways begin to pass more and more visual information to the brain and the eyes begin working together, by 2-3 months of age babies can focus on a nearby face and follow moving objects with their eyes. By 5 months, they are developing color and depth perception, and their acuity is almost 20/20. By 9-12 months, babies can judge distances pretty well, and by 2 years their hand-eye coordination should be well developed.
Parents can do many things to help their baby's vision develop properly:
- Use a nightlight in the room
- Change the crib's position
- Alternate right and left sides with each feeding
- Hang a mobile, crib gym or various objects across the crib for the baby to grab, pull and kick.
- Give the baby plenty of time to play and explore on the floor.
- Provide plastic or wooden blocks that can be held in the hands.
- Play patty cake and other games, moving the baby's hands through the motions while saying the words aloud.
- Play hide and seek games with toys or your face to help the baby develop visual memory.
- Encourage crawling and creeping.
- Roll a ball back and forth to help the child track objects with the eyes visually.
- Give the child building blocks and balls of all shapes and sizes to play with to boost fine motor skills and small muscle development.
- Name objects when talking to encourage the baby's word association and vocabulary development skills.
Most babies begin life with healthy eyes, but occasionally problems can occur. Parents need to look for the following signs that may indicate serious trouble:
- Appearance of a white pupil may indicate an eye tumor or cataract.
- Extreme sensitivity to light may indicate high pressure in the eye (glaucoma).
- Constant eye turning may indicate the eye muscles are not working together, which can lead to amblyopia (decreased acuity).
- Red or crusted eyelids may indicate an eye infection.
- Excessive tearing may indicate blocked tear ducts.
All babies should have their first eye exam between the ages of 6 and 12 months. Things that the optometrist will test for include:
- excessive or unequal amounts of nearsightedness, farsightedness, or astigmatism
- eye movement ability
- eye health problems.
These problems are not common, but it is important to identify children who have them at this young age. Vision development and eye health problems are easier to correct if treatment begins early.
PRE-SCHOOL CHILDREN'S VISION
According to the American Public Health Association, about 10% of preschoolers have eye or vision problems. However, children this age generally will not voice complaints about their eyes.
Parents should watch for signs that may indicate a vision problem, including:
- Sitting close to the TV or holding a book too close
- Tilting their head
- Frequently rubbing their eyes
- Short attention span for the child's age
- Turning of an eye in or out
- Sensitivity to light
- Difficulty with eye-hand-body coordination when playing ball or bike riding
- Avoiding coloring activities, puzzles and other detailed activities
It is important to know that a vision screening by a pediatrician or at preschool is not a reliable indicator of a child's possible vision problems. Vision screenings usually test visual acuity only, and may miss as many as 60% of children with vision problems! Only a comprehensive optometric examination can determine if:
- the eyes are healthy
- the nerve pathway to the brain is functioning
- the eye muscles are working together properly
- there is a color vision defect
- there is a depth perception problem
By age 3, your child should have a thorough optometric eye examination to make sure his or her vision is developing properly and there is no evidence of eye disease. If needed, an optometrist can prescribe treatment, including eyeglasses and/or vision therapy, to correct a vision development problem.
With today's diagnostic equipment and tests, a child does not have to know the alphabet or how to read to have his or her eyes examined. Here are several tips to make your child's optometric examination a positive experience:
- Make an appointment when the child is rested.
- Talk about the examination in advance and encourage your child's questions.
- Reassure them that there will be no shots!
SCHOOL-AGE CHILDREN'S VISION
We know that that 80% of our learning is visual, therefore good vision and visual function are crucial to school success. A child's eyes are constantly in use in the classroom and at play, so when vision doesn't function properly, school and sports performance suffer.
All parents want to see their children do well in school and most parents do all they can to provide them with the best educational opportunities. But too often one important learning tool may be overlooked - their child's vision.
Because vision may change frequently during the school years, regular eye and vision care is important. The most common vision problem is nearsightedness or myopia. However, some children have other forms of refractive error like farsightedness and astigmatism. In addition, the existence of eye focusing, eye tracking and eye coordination problems may affect school and sports performance.
Myopia has become a worldwide epidemic, caused in large part by the indiscriminate prescribing by eye doctors of single vision correction for children. Research has proven that eyes become longer when they are subjected to "peripheral retinal hyperopic blur", which is caused by single vision lenses. We have had huge success in preventing the progression of myopia by prescribing Ortho-K corneal re-shaping treatment or bifocal contact lenses for children!
Please prepare to be surprised, shocked, and amazed at the latest information available on this topic at the following websites:
Myopia Prevention and Control
All About Vision-Myopia Control
In addition to refractive errors, the existence of problems with eye focusing, eye tracking and eye coordination may affect school and sports performance.
As children progress in school, they face increasing demands on their visual abilities. The size of print in schoolbooks becomes smaller and the amount of time spent reading and studying increases significantly. Unfortunately, the visual abilities of some students aren't performing up to the task. When certain visual skills have not developed, or are poorly developed, learning is difficult and stressful, and children will typically:
- Avoid reading and other near visual work as much as possible.
- Attempt to do the work anyway, but with a lowered level of comprehension or efficiency.
- Experience discomfort, fatigue and a short attention span.
Some children with learning difficulties exhibit specific behaviors of hyperactivity and distractibility. These children are often labeled as having "Attention Deficit Hyperactivity Disorder" (ADHD). However, undetected and untreated vision problems can elicit some of the very same signs and symptoms commonly attributed to ADHD. Due to these similarities, some children may be mislabeled as having ADHD when, in fact, they have an undetected vision problem!
Vision is more than just the ability to see clearly, or having 20/20 eyesight. It is also the ability to understand and respond to what is seen. Basic visual skills include the ability to focus the eyes, use both eyes together as a team, and move them effectively. Other visual perceptual skills include:
- recognition (the ability to tell the difference between letters like "b" and "d"),
- comprehension (to "picture" in our mind what is happening in a story we are reading), and
- retention (to be able to remember and recall details of what we read).
Every child needs to have the following vision skills for effective reading and learning:
- Visual acuity — the ability to see clearly in the distance for viewing the chalkboard, at an intermediate distance for the computer, and up close for reading a book.
- Eye focusing — the ability to quickly and accurately maintain clear vision as the distance from objects change, such as when looking from the chalkboard to a paper on the desk and back. Eye focusing allows the child to easily maintain clear vision over time like when reading a book or writing a report.
- Eye tracking — the ability to keep the eyes on target when looking from one object to another, moving the eyes along a printed page, or following a moving object like a thrown ball.
- Eye teaming — the ability to coordinate and use both eyes together when moving the eyes along a printed page, and to be able to judge distances and see depth for class work and sports.
- Eye-hand coordination — the ability to use visual information to monitor and direct the hands when drawing a picture or trying to hit a ball.
- Visual perception — the ability to organize images on a printed page into letters, words and ideas and to understand and remember what is read.
If any of these visual skills are lacking or not functioning properly, a child will have to work harder. This can lead to headaches, fatigue and other eyestrain problems. Parents and teachers need to be alert for symptoms that may indicate a child has a vision problem.
A child may not tell you that he or she has a vision problem because they may think the way they see is the way everyone sees. Signs that may indicate a child has vision problem include:
- Frequent eye rubbing or blinking
- Short attention span
- Avoiding reading and other close activities
- Frequent headaches
- Covering one eye
- Tilting the head to one side
- Holding reading materials close to the face
- An eye turning in or out
- Seeing double
- Losing place when reading
- Difficulty remembering what he or she read
Your child should receive an eye examination at least once every year. If the doctor detects a vision problem, he can correct it with eyeglasses, contact lenses, or vision therapy exercises.
Congratulations! (We can hear you grumbling: "Thanks a lot".)
You may have noticed that your near vision is starting to become blurry or that it is more difficult to focus on small print than it used to be. This is NOT because your focusing muscles are getting weaker. It is a result of the crystalline lens inside the eye becoming less elastic from normal aging processes. Ultraviolet rays, poor dietary habits, and smoking can contribute to the aging processes, and ultimately lead to cataract formation sooner than normal.
This decrease in the crystalline lens' elasticity is a universal human occurrence. Eventually every person will need to wear some sort of reading prescription to do the work that the eye can no longer perform on its own (unless they are just nearsighted enough that they can see up close without a prescription).
Currently we have many different options to correct this problem:
- Single vision reading glasses.
- Lined bifocal glasses.
- Progressive (no-line) bifocals.
- Lined trifocal glasses.
- Bifocal contact lenses.
- Monovision contact lenses (one eye for far, the other for near).
- Distance contact lenses with reading glasses.
- Specialty bifocal glasses, e.g. double bifocal (one segment below, the other above the pupil)
- Computer trifocals (specially designed large middle area for intermediate, arms length vision).