Checking Your Young Child's Vision

Today's question is:  "What is a good piece of advice for first-time parents?"

My top recommendation is to get your child's vision tested as close to six months as possible. Assessments at six to twelve months of age can determine healthy development of vision. The best way to ensure a baby has healthy vision for successful development now and in the future is by early detection of eye conditions.

Olivia and Sophia in the backyard.

(Taken on December 26, 2007.)

The optometrist will evaluate eye alignment; test for visual acuity; examine eye teaming ability; and determine if there is excessive or unequal amounts of nearsightedness, farsightedness, or astigmatism. The health of your baby’s eyes will be assessed as well.

Olivia with one of her eye patches.

She wore it for 14 hours per week (about 2 hours per day)

so her brain would use her left eye and

she wouldn't lose all the vision in it.

(Taken on November 17, 2011.)

Although problems are not common, it is important to identify children who have specific risk factors at this stage. Eye health problems and vision development can be more easily corrected if treatment is begun early.

I'm recommending this because this is something that I did not know about that should be done.  In fact, it is only because I put Olivia and Sophia in a chair one day a couple of feet from the television. Normally, they didn't watch television when they were young. On this particular day, I needed to get some work done, and thought it would be okay if they would watch a bit of "Sesame Street."

They were watching the show, and I was working in my home office for a bit. Came out to check on them and noticed that Olivia was squinting. Asked her why she was squinting. She couldn't see the picture, she told me.

Called and made an appointment with an optometrist. After examining Olivia, she said she had not seen vision that bad, and recommended seeing an ophthalmologist. 

Olivia's ophthalmologist.

Source 

The ophthalmologist confirmed what the optometrist thought: Olivia was legally blind in both eyes. What was challenging was that her left eye was significantly worse than her right eye. Potentially, her brain would use her right eye and not her left eye; and from non-use she would lose all sight in it.

For several years, Olivia wore a patch on her right eye so it would strengthen her left eye. Generally this was done at home and/or in the car, not when she was in public.

Quarterly, she would go to the ophthalmologist to have her vision tested. About every 6-9 months, she needed a new pair of glasses because her vision was changing.

The ophthalmologist said she was proud of Olivia for wearing her eye patch and doing things while wearing it - like coloring, looking at pictures in books, and playing. Because of this and her glasses, the vision in her left eye was improving. (Some parents put the patch on their child and then the child takes a nap. It is counter-productive to do this since the eye isn't being used when the eyelid is closed.)

Olivia coloring in one of her coloring books.

(Taken on November 4, 2008.)

In addition to her vision issue, the lashes on her upper eyelids were rubbing on her corneas and scratching them. She needed a nightly "goopy medicine" (as we called it).  This protected her corneas from being further scratched.

In the picture above, Olivia was not wearing her glasses so I kept trying to tell her to look up a bit more so she would look at the camera. I don't think she knew exactly where to look.
   She had been frustrated at that time because she didn't like wearing her glasses or eye patch (she had to wear it daily for 2 hours so she didn't lose all her vision in her left eye). "I wish I wasn't blind," was her new comment almost daily when she was about 5 years old. (Taken on June 30, 2008.)

There were also times when she needed eye drops when her eyes needed to be dilated for eye appointments. These had to be given to her three days in advance of an appointment so her pupils were fully dilated. Needless to say, this was not comfortable for her (imagine having dilated pupils and all the light going into your eyes for multiple days).

Olivia doing embroidery work.

Although wearing an eye patch was not 
her favorite part of the day,

her willingness to wear it was helping improve her vision.

(Taken on October 23, 2008.)

Eventually, as she started to get older, her eyelids changed their shape enough that the eyelashes flipped up rather than towards her eyes. The "goopy medicine" could be stopped.

At this point, her vision is as good as it probably will get with glasses. She is now down to a yearly eye appointment. This is a major change from the quarterly appointments.

Olivia at her most recent eye appointment 

when she was told the good news:

you don't have to come back until a year from now!

Her eyes will still be changing as she goes through her tween and teen years. If she's anything like Sophia, there will be major changes in her vision. (Sophia went from being able to see perfectly one year to being able to see only six inches in front of her face by the next year.)

So, if you've missed the six month mark, it's not too late to your child in to have her vision checked. There's so much that can be done proactively these days; and that will have a life-long impact on a child's vision and health of her eyes.