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Pediatric Vision Q & A with Dr. Vishal Sud

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Dr. Vishal Sud Answers the Most Frequently Asked Questions About Kids’ Vision

Q: From what age should a parent bring in their children for an eye exam?

A: The first comprehensive eye exam should be at 6 months of age, and then additional eye exams should occur at each additional year of age.

Q: What about preschoolers? Are there signs parents should look for that would indicate a trip to the optometrist is necessary?

A: Some signs to keep a lookout for are:

  1. Red itchy watery eyes
  2. Sensitivity to lights
  3. Frequent blinking or squinting
  4. Failure to maintain eye contact
  5. Frequently closing one eye. Often preschoolers will do that.
  6. Headaches
  7. Holding objects too close to their face, or pushing or holding objects away from their face.

Q: Because many children may be too young to read, how is an eye exam conducted if they cannot read a Snellen Chart?

A: Preschoolers don’t need to be able to read to conduct an eye exam. To measure the visual acuity of a child who cannot read yet, we use a LEA Chart or LEA symbols. This is an eye chart that is very similar to an adult vision chart, specifically designed for young children who are unable to read yet. Instead of letters, it has symbols that are familiar to the child. In addition, the doctor can also shine light into the preschooler’s eyes and can observe the reflex from the back of the eye to objectively determine the glasses prescription for a child.

In addition, besides the vision test, important tests that can be performed on any age child (infants and older) to make sure the eyes are developing normally are: testing the pupil response, the ability of the child to fix and follow and to view the back of the eye, the retina.

Q: One of the greatest tasks of a school-aged child is learning to read and in older children, the amount of reading required. What should parents be on the lookout for concerning their child’s reading and potential vision problems?

A: We need to understand all of the many facets involved with reading. It is more like an integration of all of the vision skills required for reading:

  1. Visual acuity – how well someone sees
  2. The ability to fixate
  3. Accommodation – The ability to focus
  4. Binocular fusion – The ability of the two eyes to work together
  5. Form perception
  6. Field of vision

Signs of potential vision problems, which can hinder a child’s ability to read are:

  1. Having a hard time focusing
  2. Skipping lines when reading
  3. Having lots of headaches

Q: Vision Therapy appears to be making a comeback and is being utilized by some students to address their vision problems. Can you talk about vision therapy and when it is right for your child?

A: Vision therapy is a doctor-supervised, non-surgical customized program of visual activities, designed to correct certain vision problems, or even improve certain visual skills.

The goal is to teach the visual system to correct itself. Unlike glasses or contacts, which just compensate for vision problems, vision therapy actually teaches and corrects the flaws in the visual system. A few examples of vision flaws that can be helped with vision therapy are: children with amblyopia – Lazy Eye syndrome, turned eyes – strabismus, or children with eye movement or focusing disorders.

Q: Is there a minimum age for vision therapy? How early can vision therapy treatment be started?

A: It is really hard to put an age limit on vision therapy. Vision therapy is such that most treatments can begin at any age.