Your Child's Second Eye Exam

Your child's vision is important to us at Artisan Optics Boise Idaho

Children's vision care is a critical part of their preventative health care routine. Many parents are shocked to find out just how young eye exams should start. But when you think about it, children use their vision to explore their environment and to learn. So if you missed the first eye exam at 9 months old, let us talk about your child's second eye exam.


Eye exams check for more than just visual acuity at Artisan Optics Boise Idaho

If you missed our last pediatric eye care blog, check out “Your Child's First Eye Examination”. Both the American Academy of Ophthalmology and American Optometric Association (AOA) recommend comprehensive eye exams in early life. The first eye exam should occur between 6 and 12 months of age and should be performed by a Residency-Trained Pediatric Optometrist or Pediatric Ophthalmologist. This is an important consideration for parents because the vast majority of eye doctors do not specialize in pediatric eye care. In fact, in the Treasure Valley there are only 3 pediatric eye care specialists; one Residency-Trained Pediatric Optometrist and two Pediatric Ophthalmologists. These three doctors have the specialized training required to see infants, toddlers and young children.


Your young child is developing at a rapid rate, and their eyes and visual system are changing too. This is why the second eye examination is recommended at 3-years-old if the first eye exam revealed no concerns.


What is important about the second examination?

The second examination is designed to assess visual developmental milestones and ocular health. A child's visual skills have really progressed from infancy! Not only has a child developed new ocular skills but they are refining previously developed skills. A properly working visual system makes a positive difference in skills like coordinated movements and mobility.


What are some of the skills that have been refined from infancy?

  • Visual acuity: Visual acuity is a measure of visual ability (20/20). An infant is unable to appreciate 20/20 vision because the macula (retinal structure responsible for fine detail vision as well as color vision) isn't fully developed until 3 years of age.

  • Oculomotility (eye-movements): Eye movements entail saccades, pursuits, and fixations. Saccades are responsible for making accurate jumps between two targets. Pursuits are smooth movements across targets. Fixations are prolonged viewing of a stationary target. All of these skills are important for activities involving eye-hand coordination as well as education activities such as reading.

  • Depth perception: Around 5 months of age an infant can appreciate depth (3D vision). As a child's binocular skills improve their depth perception will improve so they can appreciate finer disparities.

  • Accommodation: Accommodation is the skill that allows the eyes to accurately focus on objects at near and in the distance.

  • Convergence: Convergence is the eyes' ability to turn inward together in a controlled manner to view objects at near.


NOTE: The development of these skills contributes to noticeable changes in the child's eyes and vision. Many children will develop an eye turn (strabismus) around 2 or 3-years-old. These cases warrant an immediate examination by a Residency-Trained Pediatric Optometrist or Pediatric Ophthalmologist. Many parents are relieved to learn that these eye turns can be successfully managed; often times without the need for surgery.


What are some of the newly developed skills?

  • Visual Perceptual Skills: Visual perceptual skills encompass a variety of visual tasks that allow a child to use visualization skills as well as visual comprehension skills. Some of these skills are as follows:

    • Visual Discrimination: The ability to determine the unique characteristics of similar forms and use those characteristics to determine “same” versus “different”. In reading, this skill is used to distinguish between words with similar beginnings or endings.

    • Visual Memory: The ability to recall a visual form. This skill enables a child to recognize sight words or recall what they have just read by processing the text through their working memory. Difficulties with visual memory will result in reduced reading comprehension.

    • Spatial Relations: The ability to identify differences among several similar objects. This skill allows children to understand relationships between objects and the underlying concepts of letter formation and math. In school, this skill is critical for reading, math, and science.

    • Form Constancy: The ability to rotate or manipulate objects in the “mind's eye” and predict the result. This skill is important when determining differences in shape, size, and orientation. Deficiencies in form constancy may lead to letter reversals or difficulties with math, especially geometry.

    • Sequential Memory: The ability to recall a series of visual objects (letters, numbers, shapes) in the correct order. This skill is important for spelling accuracy and sight word recognition. Difficulties with sequential memory often contributes to poor spelling skills or sub-vocalization during writing or copying tasks.

    • Figure-Ground: The ability to identify a form within a crowded background. Children with poor figure-ground skills will often struggle as print becomes smaller and more crowded on a page. They will frequently lose their place while reading.

    • Visual Closure: The ability to visualize, or fill in missing information within an incomplete picture. This skill is important for spelling, reading comprehension, and reading fluency.


If a child is having difficulty with skills that their peers seem to excel at such at recognition of shapes, colors, etc. they may have some areas of difficulty that should be addressed before entering kindergarten.


Of course there are other things that can inhibit learning besides visual perceptual difficulties. The Vision in Preschoolers research group released a study that indicates if a child has a high hyperopic (far-sighted) prescription that is associated with decreased near visual acuity and stereopsis (3D vision) they perform more poorly than their peers.


A strabismus (eye-turn) may also occur at this time that was not present during their previous examination. A strabismus may not always be cosmetically noticeable and can be easily missed during a vision screening. Keep in mind that vision screenings do not assess the previously mentioned skills except for visual acuity.


Remember that eye examinations are preventative care and should be considered part of a child's primary care routine. A brief visual screening at the pediatrician or school does not replace a comprehensive eye exam. Children rarely complain about their vision as they assume they see just like everyone else. A proactive approach to vision care will keep your child's eyes healthy and seeing well.

Bring your child to Idaho's first residency trained pediatric optometrist at Artisan Optics Boise Idaho


Posted by Artisan Optics at 7/6/2016 4:41:00 PM
Share |
Comments (0)
No comments yet, login to post a comment.
Current Weblogs
There are no blogs in this Group.