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Infant Vision

Your baby has a whole lifetime to see and learn. But did you know your baby also has to learn to see? As a parent, there are many things that you can do to help your baby’s vision develop. At about six months of age, you should take your baby to your eye doctor for his or her first thorough eye examination. Things that the optometrist will test for include excessive or unequal amounts of nearsightedness, farsightedness, or astigmatism. Dr. Price Kowaleski will also test eye movement ability as well as check for eye health problems. These problems are not common, but it is important to identify children who have them at this stage. Vision development and eye health problems can be more easily corrected if treatment is begun early. Unless you notice a need, or your eye doctor advises you otherwise, your child’s next examination should be around age three and then again before he or she enters school.

During the first four months of life, your baby should begin to follow moving objects with their eyes and reach for things, first by chance and later more accurately as hand-eye coordination and depth perception begin to develop.
To help, use a nightlight or other dim lamp in your baby’s room; change the crib’s position frequently and your child’s position in it. Keep reach-and-touch toys within your baby’s focus, about eight to twelve inches. Also talk to your baby as you walk around the room; alternate right and left sides with each feeding; and hang a mobile above and outside the crib.

Between four and eight months, your baby should begin to turn from side to side and use his or her arms and legs. Eye movement and eye/body coordination skills should develop further and both eyes should focus equally.
Enable your baby to explore different shapes and textures with his or her fingers; give your baby the freedom to crawl and explore; hang objects across the crib; and play “patty cake” and “peek-a-boo” with your baby.
From eight to twelve months, your baby should be mobile now, crawling and pulling himself or herself up. He or she will begin to use both eyes together and judge distances and grasp and throw objects with greater precision.
To support development don’t encourage early walking – crawling is important in developing eye-hand-foot-body coordination; give your baby stacking and take-apart toys; and provide objects your baby can touch, hold and see at the same time.

From one to two years, your child’s eye-hand coordination and depth perception will continue to develop and he or she will begin to understand abstract terms. Things you can do are encourage walking; provide building blocks, simple puzzles and balls; and provide opportunities to climb and explore indoors and out.
There are many other affectionate and loving ways in which you can aid your baby’s vision development. Use your creativity and imagination. Ask your eye doctor to suggest other specific activities.

Preschool Vision

During the infant and toddler years, your child has been developing many vision skills and has been learning how to see. In the preschool years this process continues as your child develops visually guided eye-hand-body coordination, fine motor skills and the visual motor skills necessary to learn to read.

As a parent, you should watch for signs that may indicate a vision development problem, including a short attention span for the child’s age, difficulty with eye-hand-body coordination in ball play and bike riding or avoidance of coloring and puzzles and other detailed activities.

There are everyday things that you can do at home to help your preschooler’s vision develop as it should.

These activities include reading aloud to your child and letting him or her see what you are reading. Provide your child a chalkboard, finger paints and different shaped blocks and show your child how to use them in imaginative play. Provide safe opportunities to use playground equipment like a jungle gym and balance beam and allow them time for interacting with other children and for playing independently.

By age three, your child should have a thorough eye examination to make sure your preschooler’s vision is developing properly and there is no evidence of eye disease. If needed, your doctor can prescribe treatment including glasses and/or vision therapy to correct a vision development problem.

Tips to make your child’s optometric examination a positive experience:

  • Make an appointment early in the day and allow about one hour.
  • Talk about the examination in advance and encourage your child’s questions.
  • Explain the examination in your child’s terms, comparing the E chart to a puzzle and the instruments to tiny flashlights.

Unless recommended otherwise, your child’s next eye examination should be at age five. By comparing test results of the two examinations, your eye doctor can tell how well your child’s vision is developing for the next major step into the school years.

School-Age Vision

A good education for your child starts with good schools, good teachers and good vision. Your child’s eyes are constantly in use in the classroom and at play. When his or her vision is not functioning properly, learning and participation in recreational activities will also suffer.
The basic vision skills needed for school use are:

  • Near Vision. The ability to see clearly and comfortably at 10-13 inches.
  • Distance Vision. The ability to see clearly and comfortably beyond arm’s reach.
  • Binocular coordination. The ability to use both eyes together.
  • Eye movement skills. The ability to aim the eyes accurately, move smoothly and shift them quickly and accurately.
  • Focusing skills. The ability to keep both eyes accurately focused at the proper distance and to change focus quickly.
  • Peripheral awareness. The ability to be aware of things located to the side while looking straight ahead.
  • Eye/hand coordination. The ability to use the eyes and hands together.

If any of these or other vision skills are lacking or do not function properly, your child will have to work harder. This can lead to headaches, fatigue and other eye strain problems. As a parent, be alert for symptoms that may indicate your child has a vision or visual processing problem.

Symptoms to watch for that may indicate your child has a vision or visual processing problem!
It is important to let us know if you notice your child frequently:

  • Loses their place while reading
  • Avoids close work
  • Holds reading material closer than normal
  • Tends to rub their eyes
  • Has headaches
  • Turns or tilts head to use one eye only
  • Makes frequent reversals when reading or writing
  • Uses finger to maintain place when reading
  • Omits or confuses small words when reading
  • Consistently performs below potential

Since vision changes can occur without you or your child noticing them, your child should visit the eye doctor at least once a year. If needed, the doctor can prescribe treatment including eyeglasses, contact lenses or vision therapy.

Amblyopia Vision (Lazy Eye)

“Lazy eye” affects about four million people in the United States. It occurs when, for one of several reasons, one eye is used less than the other. If one eye is crossed or turns out, the individual sees double, so he or she learns to “shut off” or ignore that eye. If the two eyes are very different, one nearsighted and the other farsighted, the same thing can occur. After a while, vision in the unused eye is reduced.

For many years it was thought that amblyopia, or “lazy eye” – when one eye sees poorly and cannot be helped with corrective lenses – was a permanent condition unless it was detected and treated before the age of six. Many optometrists no longer accept this, believing that even adults can improve their sight – if not completely correct their lazy eye – through special therapy.

The American Optometric Association agrees that current research proves the old theory wrong. The success rate does drop off as one gets older, but the cut-off at age six is arbitrary. Age should not be a barrier, though the longer the condition has existed the more difficult it becomes to treat.

Treatment varies depending on the extent of the condition, the patients’ age and the optometrist. Small children often have their stronger eye patched for several hours a day. This stimulates the use of the weak eye while they perform exercises such as coloring, cutting things out and tracing.

Vision therapy – usually several hours a week, in the doctor’s office and at home – will often correct the underlying reason for the lazy eye. Very small children can improve in a month or two; older children may take several months to a year to respond.
With adults, treatment is basically the same, but it takes longer. Adults may not wear a patch at all if vision is very poor, or only for an hour or two at home while doing fine tasks such as coloring in the 0’s of a newspaper. Patients do exercises designed to improve focusing, tracking and spatial judgment.

Many times after treatment, 50 percent of the older children and adults see as well or almost as well with their lazy eye as with their normal eye, and four out of five of the rest at least show improvement. Results are permanent when both the amblyopia and the underlying problem are corrected. When the latter can’t be treated, patients should continue the exercises on a less-frequent basis and visit their optometrist periodically so that the eye does not weaken again.

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