Set Your Sights on Healthy Vision - Central Florida Health Care

It’s a fresh start to the school year and a reminder to make sure your children’s vision is clear.

Central Florida Health Care Pediatrician Dr. Jessica Lopez Phelps sees children in the new Bartow Pediatrics Health Center. She says vision assessment is an important part of the medical care of children. It is essential to assess vision starting from birth and continuing as part of every routine well check. If eye problems are not detected and treated timely, they can lead to irreversible vision loss. Studies show that early identification before age 7 years can reduce certain causes of blindness, such as amblyopia (functional reduction in visual acuity), by up to 50%. Poor vision and vision loss can be indications of serious or life-threatening diseases, like retinoblastoma and a variety of metabolic disorders. Ocular problems can also be the first indicator of general health concerns.

Dr. Lopez Phelps says the visual system begins to mature during the first weeks of life; continues to have significant development in the first 2 years of life; and reaches maturity at approximately 4 years of age. The brain needs to receive equally clear, focused images from both eyes for appropriate development of the visual pathways. Eye problems (like refractive error, strabismus, cataract) that affect the development of these visual pathways may result in amblyopia.

Visual behavior and performance evolve with the maturation of the visual system: Visual fixation can be demonstrated shortly after birth. The visual acuity of a newborn infant is estimated to be approximately 20/400. The ability to follow an object is detectable in most infants by three months of age. The ability to perceive depth and three-dimensional structure and ability for the eyes to work together to create a single image from the visual information received from both eyes develops between the ages of three and seven months. Visual acuity reaches the adult level of 20/20 by three to five years of age.

This is why it’s important for parents or caregivers to schedule a wellness check at the doctor’s office where patients receive a vision check. Central Florida Health Care also has a mobile optometry unit to perform more advanced eye exams for pediatric patients. The eye exam consists of external inspection, pupil examination, red reflex testing, the examination of the eye fundus using the ophthalmoscope, and an assessment of visual function. The eye needs to be inspected for structural abnormalities, such as cataract, corneal opacity, and ptosis (a condition where the upper eyelid droops over the eye). The pupils should be equal, round, and equally reactive when light is directed toward either eye.

Because of challenges obtaining full cooperation from young children and infants, the vision screening should also include a medical history. This can be helpful in identifying children at risk.

Questions that can be asked include:

Do your child’s eyes appear unusual?
Does your child seem to see well?
Does your child exhibit difficulty with near or distant vision?
Do your child’s eyes appear straight, or do they seem to cross?
Do your child’s eyelids droop or does one eyelid tend to close?
Has your child ever had an eye injury?

Family history includes eye disorders like cataracts, strabismus, amblyopia, and refractive error; eye surgery; and the use of glasses during childhood in parents or siblings should also be explored.

Infants and children at high risk of eye problems or with a concerning physical exam finding should be referred to a Pediatric Ophthalmologist for further evaluation. Patients at risk include infants born very prematurely; children with family histories of congenital cataracts, retinoblastoma, childhood glaucoma, and metabolic or genetic diseases; and children with significant developmental delays or neurologic difficulties.

The American Academy of Pediatrics recommendations for preventive Pediatric health care guidelines suggest vision risk assessment at all well visits, and vision screening or referral, as indicated, if risk factors are identified. In children younger than two to three years of age, visual behavior, rather than visual acuity, is assessed. The goal is to determine whether visual behavior is normal for age and whether vision behavior is similar between the two eyes. Screening should be attempted until the child is able to do a visual acuity test correctly. Visual acuity testing with eye charts should be attempted in all children three to five years of age. For older children, visual acuity should be assessed at ages 5, 6, 8, 10, 12, and 15 years.

Central Florida Health Care is here for you and your children. Call to schedule a pediatric or eye appointment today at 866.234.8534.