Q: I’ve heard conflicting ideas about whether or not my pre-school child should have a regular eye examination or just a school screening. Which is best?

A: This topic has been hotly debated amongst different health care groups for some time. However, a recent study completed by the Vision Council of America found full examinations to be highly effective and very cost effective in detecting vision problems which would interfere with academic achievement and development of normal vision. The study, done by experts from optometry, ophthalmology, pediatrics and public health, found school screenings, which are frequently done by lay volunteers, missed a high percentage of visual problems. At the conclusion of the study the group urged health care associations that have opposed full vision examinations to abandon their opposition and join in supporting the concept.

This study reinforces the recommendations of many groups that a child receive his or her first examination before the age of three and yearly during the school years.

Q: When should my child have her eyes examined?

A: A child’s first examination should be done before age three. The American Optometric Association advises a complete examination every year after that while the child is in school. The reason is that this is the time of most rapid visual change, and a high percentage of school reading difficulties are related to undetected visual problems. Are school vision screenings a substitute? No. Though they often detect nearsighted children, school screenings usually miss many of the children with the type of visual problems that most severely impact reading. Complete examinations before the age of three would greatly reduce the complications of “lazy eye”. Do your children an enormous favor and get them in the habit of yearly eye examinations.

Q: My baby’s eyes are crossing sometimes. I asked my pediatrician about it and he said she would grow out of it. Is this true?

A: There are several types of strabismus, or eye turn, which occur in infants. One type, known as infantile esotropia, becomes obvious when the child is between several months old and one year of age. New research on this type of strabismus indicates that only about 27% of the children will “grow out” of the condition. The other 73% will have the condition all their lives. All the other types of strabismus that occur in infants will NOT go away. These children will not only have the condition all their lives, but will be at high risk for amblyopia, or lazy eye. This condition frequently results in the child permanently losing vision in one eye. This condition may have a lifelong impact on sports and academic performance if therapy is not started as early as possible. Any infant that shows signs of an eye turn should be evaluated by an eye doctor willing to provide activities designed to stimulate the eye and help provide normal development.

Q: I recently saw former President Jimmy Carter discussing the importance of infant eye examinations. However, when I asked my eye doctor to examine my baby and he seemed uncomfortable with it. Please comment.

A: President Carter is the Honorary Chair of the InfantSEE Program, a national public health program designed to detect eye diseases in infants when they are more effectively treated. Such a program has been discussed for years, but was only recently launched by the American Optometric Association with support of the American Public Health Association and other professional health care organizations. Our office is one of the participating InfantSEE offices, which means we will give FREE eye examinations to all infants between six months and one year of age. Because kids this age are a challenge to examine, not all eye doctors like to do it. To see President Carter discuss the program, visit infantsee.com.

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