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All About Vision

Treatment of Macular Degeneration

While there is no cure for macular degeneration, treatments do exist that can delay the progression of the disease, preserve existing vision and sometimes even improve vision loss.

Currently, there are no approved treatments to prevent or cure dry AMD, although there is evidence that indicates that certain nutritional supplements, including omega 3 fatty acids, lutein and zeaxanthin, can prevent the progression of the disease to the more advanced wet form, which can cause more severe vision loss.

There are a couple of options for treating wet AMD to slow the progression of vision loss which include medicated injections and laser therapy. These therapies are designed to stop the development of new blood vessels, to destroy existing ones and to prevent leakage into the macula – the main dangers with wet AMD.

Unfortunately, while much research continues to be conducted, currently there is no treatment and no way to fully regain vision lost by AMD. Those who have suffered significant vision loss can benefit from the many low vision devices on the market which utilize your existing vision to assist in maintaining your independence. Such devices include standing and hand-held magnifiers and telescopes and other aides that can help to improve your vision.

If you have been diagnosed with AMD, regular vision tests are essential. Close monitoring and adherence to treatment can not only prevent further vision deterioration but can sometimes even improve vision.

PRK

Photorefractive Keratectomy or PRK is a type of refractive laser eye surgery used to correct a patient’s vision to eliminate or reduce their dependence on glasses or contact lenses. PRK is the style of laser eye surgery that preceded LASIK, having been the former most common type of refractive surgery until LASIK came along.

PRK is effective in correcting nearsightedness (myopia), farsightedness (hyperopia) and astigmatism and has very similar rates of success and outcomes as LASIK. PRK remains a common option for laser eye surgery.

How Does PRK Differ From LASIK

PRK and LASIK both permanently reshape the cornea to improve vision by using a laser (an excimer laser to be exact) to remove part of the tissue underneath the corneal epithelium. The epithelium first needs to be removed in order to get access to the tissue and how this is done is what differentiates the two procedures. While LASIK creates and lifts a flap on the outer corneal layer, reshapes the corneal tissue underneath and then replaces the flap, PRK removes the outer layer of the cornea completely. The outer layer will regenerate usually within a few days.

Advantages of PRK

Since PRK completely removes the outer corneal layer, there is a greater area of the cornea to work with. This is ideal for patients with a thin cornea who would otherwise be at risk with LASIK. It is also usually recommended for patients with chronic dry eyes. With PRK, there is also less risk of infection or issues having to do with the flap and the related healing process. This is an advantage for individuals who lead a lifestyle in which they are at risk for eye injuries (athletes, military, law enforcement etc.) which may subject the flap to injury or complications.

So, Why Is LASIK More Popular?

The main advantages that LASIK has over PRK are two-fold and mainly have to do with comfort and recovery time. First of all, PRK patients usually experience slightly more discomfort during the first couple of days of recovery, mainly because it takes time for the outer corneal layer to heal. They will be prescribed eye drops to be taken for several months to prevent infection, increase comfort and assist the healing process. LASIK patients on the other hand, typically experience less discomfort and if they do, it subsides very quickly.

Additionally, vision recovery takes longer with PRK. While LASIK patients can typically see normally within a few hours after the surgery, with vision gradually continuing to improve within the next few months, PRK patients may experience blurred vision for up to three days and it can take up to six months until they achieve full visual clarity. While patients who undergo LASIK can usually drive and resume normal functioning within a day or two, PRK patients shouldn’t plan on returning to normal for at least several days until the outer layer of the cornea has grown back.

Whether PRK or LASIK is a better option for you depends on a number of factors, including the health and structure of your eye. This is a decision that your eye doctor or surgeon will help you make. Rest assured however, that both procedures have been shown to be incredibly successful in correcting vision, with minimal complications.

What You Need to Know About PRK

Prior to any laser correction surgery, you will meet with a surgeon for a thorough exam to assess your eye health and determine whether you are a candidate and if so, which type of surgery would be best suited to your needs. During this exam it is essential to tell the doctor any relevant medical history (injuries, hospitalizations, diseases etc.) and existing conditions you have. The surgeon will determine if you are currently eligible for surgery and if not, if you will be at a future point, and whether you require any specialized care pre or post surgery.

The surgery itself is an ambulatory procedure. It takes about 15 minutes or less for both eyes and you go home the same day. You will need someone to drive you home from the procedure.

The first step in the procedure is that your eye will be anesthetized using numbing eye drops and then a device will be inserted to prop your eyelids open so you won’t blink. Once the eye is numb, the surgeon will remove the outer epithelial layer of the cornea to expose the underlying tissue. Then the surgeon will use the laser to reshape the corneal tissue. You may feel a small amount of pressure during this step. Lastly, the surgeon will apply medicated eye drops and place a temporary contact lens that is used as a bandage to protect the eye.

Following the surgery you will be instructed to apply medicated eye drops multiple times each day to reduce the risk of infection and you may also be given prescription pain relievers to alleviate any pain or discomfort.

As with any type of surgery, it is critical to carefully follow your surgeon’s instructions after PRK. Make sure that you take your medication as prescribed, get enough rest, and call your eye doctor immediately if you experience any problems.

It is normal for it to take several days or even weeks for your vision to improve and up to 3-6 months for full recovery to clear and stable visual acuity. Usually, your doctor will require you to refrain from driving for a week and up to three weeks depending on how fast your vision recovers.

Risks and Complications of PRK

While serious complications are rare, like any surgery, there are some risks to PRK, and these happen to be very similar to any laser corrective surgery like LASIK. They include:

  • Dry eyes- this condition usually goes away within a couple of months, but there is a chance that it could become chronic.
  • Infection or Inflammation- the risk of infection is greatly reduced if you take proper care to follow your doctor’s instructions following the procedure.
  • Vision Problems- which can include glare, seeing halos around lights poor night vision and sometimes a general haziness.
  • Incomplete Vision Correction – sometimes an additional procedure might be needed to achieve optimal visual acuity.

In general, PRK is considered to be a relatively safe and effective treatment for vision correction. If you wish to live a life without depending on your glasses or contact lenses, speak to your eye doctor about whether PRK is an option for you.

LASIK – How to Measure Success or Applicability

Is laser eye surgery for everyone?

Below are some guidelines to help you decide if LASIK is a good choice for you.

  • Vision stability: Young adults often experience annual changes in their prescription for eyeglasses or contact lenses. A 12-month period of maintaining the same prescription is highly recommended prior to LASIK. Otherwise there is a considerable risk of requiring repeated LASIK surgery in the future.
  • Healthy Eyes: Problems, diseases or conditions related to your eyes could cause increased risks to both the actual surgery and the healing process. If you have a condition that can be treated such as dry eyes, pink eye (conjunctivitis) or any eye injury speak to your doctor. It is probably best to wait until the condition is resolved to schedule your LASIK surgery. Conditions like cataracts, glaucoma, and other more serious conditions may disqualify you from LASIK altogether.
  • Age: 18 is the minimum age of consent for LASIK. Younger patients may be able to get special exemptions based on certain circumstances.
  • Vision prescription range: A very high degree of myopia may require removal of too much corneal tissue. This may exclude your candidacy for LASIK or make another refractive surgery a better option. For example, many surgeons conclude that a phakic IOL procedure provides better results and possesses less risk than LASIK for nearsighted prescriptions higher than -9.00 diopters.
  • Pregnancy: Normal hormonal changes of pregnancy may cause swelling of the cornea which can alter vision. Dry eye is also common during pregnancy. Additionally, medications (antibiotics or steroids) which are administered for LASIK could cause risk to the embryo or nursing infant. It is recommended to delay LASIK for several months after childbirth until the eyes stabilize and risks are reduced.
  • Systemic and autoimmune diseases such as rheumatoid arthritis, type 1 diabetes, HIV or AIDS may disqualify or delay candidacy for LASIK. If your body has trouble healing, your cornea may not heal properly after LASIK surgery. Opinions vary among professionals as far as which diseases automatically disqualify and which ones pose acceptable risks. Discuss this in depth with your doctor if applicable.

LASIK Risks and Complications

LASIK is the most common refractive eye surgery, partially due to the fact that the risks and complications are low. The majority of patients don’t experience any long term complications as a result of the surgery. Nevertheless, as with any surgical procedure there are some risks, however rare they are and it is important to know them and to discuss them with your eye doctor or surgeon prior to undergoing the surgery.

Side effects of LASIK

There are a number of side effects that are somewhat common immediately post-op and in some instances can last longer – sometimes indefinitely. Those include:

Dry Eyes

About half of LASIK patients experience dry eyes, which are usually a temporary side effect that resolves within 3-6 months after the surgery. Your doctor will likely prescribe artificial tears in the days and weeks following the surgery which should be continued as long as the symptoms persist. Because of this, it is usually recommended that patients with a history of chronic dry eyes opt for another type of refractive surgery such as PRK, another style of laser refractive surgery with reduced risk.

Eye Infection or Irritation

While not common due to the eye drops and checkups prescribed post surgery, there is a chance of developing an eye infection. If this does occur, it can be treated with antibiotic eye drops, anti-inflammatories or sometimes may require other treatment such as oral antibiotics. If you are experiencing symptoms of an eye infection such as redness, pain, discomfort, discharge or any change in vision, see your eye doctor immediately. As a precaution, it is imperative to follow your surgeon’s instructions for your post-operative care including prescription medications and doctor’s visits.

Vision Issues

Following surgery, you may experience certain vision issues such as such as poor night vision, double vision, halos around lights or glare. These side effects are common and can last up to a few weeks, but typically go away. Some patients report a lasting reduction in vision in low light conditions and may require vision aids for seeing better at night.

Other risks of LASIK include surgical errors, many of which can be corrected by a follow-up surgery. These include:

Overcorrection or Undercorrection

The key to vision improvement in LASIK is accurate reshaping of the corneal tissue. If too much is removed or not enough is removed, your vision will remain imperfect and when possible may require a follow up procedure to obtain the clear vision being sought.

Flap Complications

Perhaps the greatest risk involved in LASIK is the accurate creation and healing of the flap of the cornea that is lifted to reshape the underlying tissue and replaced after. If the flap in the cornea is not made accurately, cut too thick or too thin and not carefully replaced back on the eye, it can cause complications in the shape of the eye surface and therefore clear vision. Studies indicate that these complications occur usually in under 6% of cases and the experience and skill of the surgeon play a large role.

There can also be complications in the healing process of the flap which include infection or excessive eye tearing.

Vision Loss

There is a chance, albeit small that the surgery can result in a loss of vision or reduction in visual clarity due to complications with the surgery.

It is quite rare for any permanent damage or vision loss to occur as a result of LASIK and usually any vision problems can be corrected by a follow-up procedure. However, as with any surgical procedure, there are risks, so it is important to reduce your risks by finding an experienced surgeon and carefully considering your suitability for the surgery in the first place.

LASIK

LASIK or laser-assisted in situ keratomileusis is a refractive surgery that is used to correct myopia (nearsightedness), hyperopia (farsightedness) and astigmatism as an alternative to eyeglasses or contact lenses. LASIK is currently the most common of the refractive eye surgeries, largely because of the relatively low risk and the quick recovery and improvement in eyesight.

Also known as laser eye surgery or laser vision correction, LASIK uses a laser to reshape the cornea which is responsible for clear vision. The procedure is quick and relatively painless and eyesight is usually improved to 20/20 vision within one day of the surgery.

How Does LASIK Work?

LASIK is an outpatient procedure, which takes about 15 minutes for the actual surgery on both eyes and an hour total with recovery. A topical anesthetic drop is used and there is no need for bandaging or stitches following the procedure. The doctor will start by stabilizing the eye and then making a small flap in the outer layer of the cornea. Then with access to the underlying tissue, he uses a laser to reshape the corneal tissue and re-closes the flap, which will heal on its own. The nature of the corneal reshaping depends on the type of refractive error.

Wavefront LASIK

Wavefront LASIK uses computer mapping technology to guide the laser treatment based on the precise shape of the cornea. This can correct very precise issues, provide much sharper vision than non-wavefront LASIK and can reduce complications such as halos, glare and problems seeing at night.

What to Expect During and After LASIK?

During the procedure you may feel some pressure on your eye while the laser is working. Immediately following you will likely experience some blurriness and may feel burning or itching (be sure not to rub your eyes!). For your journey home you will be given protective shields to guard your eyes and will need someone to drive you. You will also be prescribed medicated eye drops for a week or so to aid in healing and prevent infection. Your doctor may also recommend artificial tears to moisten the eyes and keep them comfortable in the days following the procedure.

The day after the surgery you will be asked to visit your eye doctor (or the surgeon) for a checkup and to evaluate whether you are able to drive. Most people experience an improvement in vision by then, although for some it can take a few days or even a week. Your eyes may be sensitive to light for a day or two as well. You will likely be advised to rest for a day or two and to refrain from strenuous physical activity for about a week until further healing has taken place.

Most people achieve at least 20/20 vision following the surgery, although this can vary and there are cases where 20/40 vision is obtained or where people continue to wear glasses or contacts with a much lesser prescription. Some patients have light sensitivity, particularly when driving at night, also suffering from seeing halos around lights or glare. There are glasses and lenses available to reduce this glare and assist with night driving.

For some, it can take weeks or even months until the vision completely stabilizes. Occasionally, after a few months, patients who do not experience perfect results will schedule an enhancement or touch up surgery to correct the vision even further.

Am I a Candidate for LASIK?

The ideal LASIK candidate is a patient over 18 with generally healthy eyes. Since the procedure involves shaping the cornea by removing some of the tissue, it is not ideal for individuals with a thin cornea or any sort of corneal condition or disease. Patients with chronic dry eyes might also be disqualified as LASIK can often exacerbate these symptoms.

During a comprehensive eye exam your eye doctor will assess your eligibility by looking at the general health of your eye including your cornea, your pupil, the moisture in your eye, the type of refractive error you have and whether you have any other eye conditions of concern.

For the right candidate, LASIK can offer a lifestyle improvement in giving clear vision without the need for glasses or contact lenses, however, the results are not guaranteed. You and your eye doctor need to weigh the benefits and the potential risks based on your personal needs.

Corrective Eye Surgery Basics

In recent years there have been tremendous advances in the field of vision correcting eye surgery which is also known as refractive or laser surgery. Corrective eye surgery offers patients clear vision without the use of glasses and contact lenses. There are a number of types of refractive surgeries that are able to correct different vision problems, so if you are considering surgery here are some of the options you should know about.

LASIK

LASIK (laser-assisted in situ keratomileusis) surgery is perhaps the most well-known refractive surgery today. LASIK can help patients with myopia (nearsightedness), hyperopia (farsightedness) and astigmatism. During the procedure, the doctor makes a flap in the outer layer of the corner to reach the underlying tissue and then uses a laser to reshape the tissue which allows the cornea to then focus light properly. The procedure is usually painless and vision is usually clear within a few hours.

Recent advances in the field have developed subcategories of LASIK surgery such as Bladeless LASIK, which uses a laser rather than a mechanical tool to make the initial flap or Wavefront (custom) LASIK which uses computer mapping to guide the reshaping of the cornea and is able to create a much more precise visual correction for very subtle optical imperfections. There is also a procedure called Epi-LASIK in which following the procedure, the doctor applies a soft contact lens to protect the surgical area, holding the flap in place while it heals.

PRK

PRK (photorefractive keratectomy) also uses a laser to correct mild to moderate myopia, hyperopia and astigmatism. PRK was a precursor to LASIK which eliminated many of the complications of prior surgeries such as glare, seeing halos around lights, blurred vision and regression of vision. Unlike LASIK, the procedure only reshapes the surface of the cornea and not the underlying tissue. Consequently, there is often some discomfort for a couple of weeks until the outer layer of the cornea heals. Additionally, the patient may experience blurred vision during this period of healing. PRK does offer an advantage over LASIK in that there is less risk of certain complications. Wavefront technology is also available for PRK surgeries.

Due to the increased comfort of LASIK there was a period that PRK saw a decline. Recent studies show however that LASIK and PRK have similar long-term success for improved visual acuity and with the assistance of newly developed effective pain medications, PRK has become more popular again as an option.

LASEK

In LASEK or laser-assisted sub-epithelial keratomileusis, the doctor creates a flap smaller but similar but to LASIK, and then uses an alcohol solution to loosen the tissue around the cornea which is pushed aside, and then a laser is used to reshape the cornea itself. In an Epi-LASEK procedure, the doctor may apply a soft contact lens to hold the flap in place to assist in reattaching to the cornea as the eye heals. Patients that undergo LASEK generally experience less discomfort and quicker vision recovery than PRK patients. LASEK may be preferred over LASIK as a safer option for patients with a thin cornea.

Cataract Surgery

Cataract Surgery is a very common refractive surgery that removes the clouded natural lens of the eye and replaces it with an artificial lens called an IOL (intraocular lens). Many patients these days will receive a lens that also corrects any refractive error they have such as nearsightedness, farsightedness or presbyopia.

RLE

RLE or refractive lens exchange is a non-laser procedure the replaces the natural lens of the eye. This is the same as the surgery that is used to treat cataracts, ,yet for non-cataract patients, RLE is used to correct severe nearsightedness or farsightedness. The procedure involves the doctor making a small cut in the cornea, removing the natural lens and replacing it with usually a silicon or plastic lens. It is particularly useful for patients with minor corneal problems such as thin corneas or dry eyes.

RLE is more risky than the other procedures mentioned and can affect the patient’s ability to focus on close objects, possibly requiring reading glasses following the procedure. However, in cases of severe vision correction it is often the preferred method.

PRELEX

PRELEX or presbyopic lens exchange is for patients with presbyopia, the age-related condition in which you lose the flexibility of your lens and can no longer focus on close objects. Patients that prefer not to wear reading glasses or multifocals, can opt for a procedure in which the doctor removes the natural lens of your eye and replaces it with a multifocal artificial lens. This procedure is often done in conjunction with cataract surgery.

Phakic Intraocular Lens Implants

Phakic IOLs are implants that are used for individuals with very high nearsightedness who do not qualify for LASIK or PRK. The implant is attached to your iris or inserted behind your pupil, while the natural lens remains intact. Because this is a procedure that involves the inner eye, it is more risky than LASIK or PRK and is therefore also typically more expensive.

Conductive Keratoplasty (CK)

CK uses a hand-held radio wave device to shrink tissue on the cornea to reshape it. The procedure is typically used to treat mild farsightedness and presbyopia, particularly for patients who have already undergone LASIK.

Any surgical procedure has risks and may have some side effects or complications that you should research before you decide to go ahead with the surgery. Nevertheless, as technology advances these complications are being significantly reduced making refractive surgery a great option for vision correction in many patients.

Controlling Nearsightedness in Children

Childhood myopia or nearsightedness is a common condition that causes blurred distance vision and can usually be easily corrected with either glasses or contact lenses. Unfortunately, simply getting a pair of glasses doesn’t always solve the problem, because often myopia is progressive which means that every year the vision gets worse. This usually continues until sometime around the child’s 20th birthday when his eyes stop growing and eyesight levels off.

It can be worrisome and quite disconcerting for both the parent and the child when each visit to the eye doctor results in a higher prescription. There could be a number of factors involved in progressive myopia, involving hereditary factors as well as possible environmental or behavioral factor such as frequent close-up tasks such as reading or using an electronic device. In fact, studies show that children that spend more time outdoors playing have a lower incidence of myopia. Much research is currently being done into treatments for slowing or stopping myopia progression in children. Here are some of the treatment options currently being offered:

Orthokeratology (Ortho-k)

Ortho-k is a process that uses specially designed rigid gas permeable contact lenses worn at night to gently reshape the cornea, eventually allowing clear vision during the day. The lenses are worn every night or every couple of nights depending on the results of the individual. Ideal for mild to moderate myopia, ortho-k usually takes a few weeks to show results, during which time the patient may need to temporarily continue wearing glasses or contact lenses.

Studies show that the use of ortho-k can permanently reduce the progressive lengthening of the cornea which is responsible for nearsightedness and can therefore slow or stop the childhood progression of the condition. Therefore, in addition to being used for myopia correction, it is now also being offered as a therapeutic treatment to halt myopia progression in children.

Multifocal Eyeglasses or Contact Lenses

Bifocal or multifocal soft contact lenses or glasses have been shown in some studies to slow myopia progression. This therapy is based on the idea that the eye is strained from accommodating to see close up and that by providing multiple focusing powers, this allows the eye to relax when doing near work, which reduces the progression of the refractive error. This treatment has been shown to delay or slow the advancement of myopia in some children.

Atropine Drops

Treatment with atropine drops is another therapy that is used to relax the eye from “focusing fatigue” which may be a culprit in myopia progression. Research is still being done but some studies show that daily use of low doses of atropine drops do slow the progression of myopia. Atropine drops dilate the pupil which temporarily prevents the eye from being able to focus, thereby allowing this mechanism to relax. Research is still being done to determine dosages, but the results are promising.

If your child has progressive myopia, seek out a pediatric optometrist who is knowledgeable about the options available. Finding the right treatment could give your child the gift of better eyesight for life.

Are Contact Lenses a Good Choice for Kids?

Many children who wear glasses want to switch to contact lenses, especially older children who are concerned with their appearance. So, how do you know if and when contact lenses might be an option for your child?

Contact lenses may not only improve a child’s confidence in their appearance but they can also be very convenient for active children who play sports or those who tend to lose or break their glasses.

Yet before you jump to schedule an appointment with the optometrist, it’s important to know that while contact lenses are a great solution for many, they are still medical devices that require care and responsibility. Carelessness with contact lenses can lead to infections, irritation, scratched corneas, pain, and sometimes even vision loss. So if you want to know if contact lenses are a good choice for your child, read below and think about whether your child is mature and responsible enough to take proper care of his or her eyes.

At What Age Can a Child Start Wearing Contact Lenses?

The recommended age for kids to start considering contact lenses varies however it is generally accepted that sometime between 11 and 14 is ideal. Some doctors will recommend them even for children as young as 8 years old who have shown that they are responsible enough to use them. Contact lens use requires good hygiene and cleanliness so if your child shows those traits, she may be ready. Additionally, if he is highly motivated to wear contacts and if he has the support of his parents, this will help in ensuring that the daily regimen is a success.

What is the Process of Getting Fitted for Contacts?

The first step is to schedule an appointment for a contact lens exam with your optometrist. The eye doctor will perform a vision exam and go over the different options for contact lenses, depending on the prescription, the health of the eye and lifestyle and personal preferences. Contact lenses are designed with a number of options including the lens materials used (soft or rigid gas permeable), the replacement schedule (if disposable, how often you replace the pair – daily, weekly, biweekly or monthly) and the wear schedule (daily or extended overnight wear). Often doctors will recommend daily lenses for children because they are thrown away after each use so there is less care involved, less buildup and less risk for infection.

Then the doctor will give a training on inserting and removing the lenses as well as instructions for proper care. Your child will probably be given a schedule for wearing the lenses for the first week or so in order to allow their eyes to adapt. During this time you may have to be in touch with your eye doctor to assess the comfort and fit of the lenses and you may have to try out a couple of options in order to find the best fit.

Purchasing Contact Lenses

As a medical device, contact lenses require a prescription and should only be purchased from a licensed distributor such as an eye doctor. Unauthorized or unmonitored contact lenses can cause severe damage to your eyes that could result in blindness. This is true also for cosmetic lenses such as colored lenses or costume lenses. Any time you are putting a lens in your eye, you must have a proper prescription.

Following are some basic contact lens safety tips. If your child is responsible enough to follow these guidelines, he or she may be ready for contact lens use:

  1. Always follow the wearing schedule prescribed by your doctor.
  2. Always wash your hands with soap before applying or removing contact lenses.
  3. Never use any substance other than contact lens rinse or solution to clean contacts (even tap water is a no-no).
  4. Never reuse contact lens solution
  5. Follow the eye doctor’s advice about Don’t swimming or showering in your lenses
  6. Always remove your lenses if they are bothering you or causing irritation.
  7. Never sleep in your lenses unless they are extended wear.
  8. Never use any contact lenses that were not acquired with a prescription at an authorized source. Never purchase cosmetic lenses without a prescription!

Contact lens use is also an ongoing process. As a child grows, the lens fit may change as well, so it is important to have annual contact lens assessments. Plus, new technology is always being developed to improve comfort and quality of contact lenses.

Contact lenses are a wonderful invention but they must be used with proper care. Before you let your child take the plunge into contact lens use, make sure you review the dangers and safety guidelines.

Your Infant’s Visual Development

Your baby’s visual system is not fully developed at birth and continues to develop gradually over the first days and months of life. In fact, from your baby’s perspective at birth, the world is black and white, blurry and rather flat. As the days and months go on, they begin to focus, move their eyes and start to see the world around them. While each child will grow and develop on his or her own schedule, knowing an infant’s vision milestones will help you ensure that your infant is on track to achieving good vision and eye health and start treatment early if there is a problem.

Birth – 3 months

Because newborn babies’ eyes and visual system are underdeveloped, they can not focus their eyes on close objects or perceive depth or color. Babies need to learn to move, focus and coordinate eye movements to team the eyes (have them move together as a team). The brain also needs to learn how to process the visual information from the eyes to understand and interact with the world. In fact, until about 3 months, the optimal distance a baby can focus on is about 8 – 10 inches from their face, about the distance their parents face will be during feeding.

Your baby will start to be able to perceive color within the first 2-3 weeks, however it will take a few months to learn how to focus and use the eyes, to track objects, differentiate between two objects and shift from one object to the other. During this time you may notice that the eyes appear crossed and do not work together or team. This is quite common at the early stages of development, however if one eye appears to be constantly turned in or out, seek a doctor’s evaluation.

At around three months, as hand-eye coordination begins to develop, a baby should be able to follow a moving target with their eyes and reach for objects.

4-6 Months

By 6 months, your baby will begin to move his eyes with more speed and accuracy, seeing at farther distances and focusing well. Color vision should be fully developed and the eyes should be able to work as a team and follow moving objects with relative ease. Hand-eye coordination and depth perception should be greatly improved as your baby will begin to understand the 3-dimensional world around them.

At six months, you should take your baby for his or her first comprehensive eye exam to ensure that the eyes are developing on track and there are no signs of congenital or infant eye disease.

7-12 Months

At this stage of development babies will be coordinating vision and body movements by crawling, grasping, standing and exploring the surrounding world. They should be able judge distances accurately, throw a ball toward a target and pick up a small object with their fingers. Delays in motor development can sometimes indicate a vision problem.

The First Eye Exam

While at 6 months, your baby will not be able to read an eye chart, eye doctors can perform an infant eye exam through non-verbal testing to assess visual acuity (for nearsightedness, farsightedness or astigmatism), eye teaming abilities and eye alignment. The eye doctor will also be able to see inside the eye for any signs of disease or problems that could affect eye or vision health.

InfantSEE®

InfantSEE® is a public health program in which participating optometrists provide a free comprehensive infant eye exam to babies between 6 and 12 months of age. The program was initiated to provide accessible eye and vision care for infants to ensure they have the best chances for normal development and quality of life.

If your child has any unusual symptoms such as excessive tearing, constant eye misalignment, red or crusty eyes or extreme light sensitivity consult an eye doctor as soon as possible.

Children’s Vision – FAQ’s

Most parents believe that if their child had an eye or vision problem they would know. However, this is far from the truth for a number of reasons. First of all, children often can’t express or don’t realize the difficulty they are having, and often vision problems will be overlooked by the associated behavioral issues that come as a result of frustration. Further, many eye or vision problems don’t show symptoms until they have progressed significantly which often makes the condition harder to treat.

Conditions such as amblyopia (lazy eye) or strabismus (crossed-eyes) can be corrected more effectively when they are diagnosed and treated early at a young age. Further, the sooner you diagnose and correct a vision problem, the sooner your child will be able to achieve his or her potential without struggling with these difficulties. This is why it is critical to have your child’s eyes examined by an eye doctor at regular intervals. Here are some FAQ’s and answers about Children’s Vision that every parent should know:

Q: At what ages should children have their eyes examined?

A: The official recommendations for the American and Canadian Optometric Associations are that infants should have their first eye exams at 6 months. Following that, children with no known vision issues should have another exam at 3 years and then prior to entering kindergarten. Children who do not require vision correction or therapy should have a vision checkup every year or two years and those who use vision correction should have an annual eye exam. Of course if your child is experiencing difficulty in school or after school activities that may be due to a vision problem schedule an eye exam immediately.

Q: My child passed a vision screening by the nurse at school. Does he still need an eye exam?

A: Yes. Many schools implement a basic vision screening test to assess whether the child sees clearly at a distance, however these tests are limited in scope. They do not assess functional vision such as the child’s ability to focus, track words on a page or the eyes’ ability to work in tandem. They also do not look at the health of the eye itself. These tests are essential to know the comprehensive picture of how healthy the eyes are and how well they are doing their job. In fact, studies shown that up to 43% of children with vision problems can pass a vision screening test! A comprehensive eye exam will assess all of these functions as well as color vision, depth perception, and eye coordination.

Q: My child was diagnosed with strabismus and amblyopia. Can this be treated and if so, what are the options?

A: Especially when diagnosed early, chances of a complete correction for strabismus and amblyopia are good when treated properly. The optimal age for this to occur is before 8-10 years old. Depending on the severity of the strabismus (crossed-eye), surgery may be required to straighten and properly align the crossed eyes. Amblyopia (lazy eye) can then be treated using eyeglasses, eye patching, or vision therapy to strengthen the weak eye and train the eyes to work together. A doctor that specializes in pediatric optometry can assess the condition and discuss treatment options on an individual basis.

Q: What is vision therapy?

A: Vision therapy is a doctor-supervised, individualized program of exercises to strengthen the functions of the eye. It is used to correct issues with eye alignment, focusing, coordination, tracking and more. Vision therapy often utilizes tools such as specialized lenses or prisms and involves exercises both during office visits and at home to reinforce the changes. The process usually takes about 6 months to see lasting improvement.

Q: My son’s nearsightedness keeps getting worse – he needs a new prescription every year. Is there a way to stop this?

A: There is research that shows that progressive myopia can be stopped or slowed during the childhood years. There are a number of therapies that are used for what is called “myopia control” including multifocal eyeglasses or contact lenses, orthokeratology (ortho-k) or atropine eye drops. Speak to a pediatric optometry specialist to learn more about the options and what might work best for your child.

Q: Every morning it is a fight to get my child to wear her glasses. What can I do?

A: It may take time for your child to adapt to the feel of the glasses and to be comfortable seeing with them. For little children, you can find glasses that come with integrated headbands that can help to hold the glasses in place. It helps to be consistent in putting them on to allow the child to adapt to the feel of the glasses.

Very often, especially for small children that can’t tell you what is bothering them, the reason for a child’s refusal to wear glasses is that something is not comfortable. It could be that the prescription is not right, that the glasses pinch or that are feeling heavy. It could be worthwhile to take the glasses back to the eye doctor to ensure that they are in fact a proper fit.

Q: At what age is it acceptable for a child to wear contact lenses?

A: Contact lenses can be a great convenience, especially for kids that are active or tend to break or lose their glasses. However, they are a medical device that must be treated with proper care and hygiene. If a child is not responsible enough to take care of them properly he could end up with a serious eye infection, a scratched cornea or worse. Most experts agree that the youngest age that contact lenses should be considered would be between 10-12 depending on the child’s maturity and cleanliness. Consult with your eye doctor about what would be best for your child.