Our Focus
is your child's vision

Frequently Asked Questions

The interactions of a child’s eyes with the brain, the world, and each other are complex and can be difficult to understand. See below for the answers to questions we frequently encounter at our practice.

Early eye exams assure
that your child's vision
is developing normally

Common Questions

Don’t see your question here? Send us an email at info@nwpediatriceyecare.com, and we will add it to the list.

 

1. When should I have my child’s eyes examined?
2. Why not just do a vision screening?
3. Why do my child’s eyes need to be dilated?
4. How do you prescribe glasses for young children who cannot give reliable responses?
5. What is the difference between nearsightedness and farsightedness?
6. How does astigmatism affect my child’s vision?
7. If my child can see 20/20 without glasses, why does he/she need them?
8. Is there a way to stop the progression of nearsightedness?
9. How do glasses make my child’s eyes straight?
10. Does patching therapy reduce the need for glasses?
11. Does vision therapy treat dyslexia or other learning disabilities?
12. At what age is my child eligible for contact lenses?
13. Why does my child frequently rub his/her eyes?

 

1. When should I have my child’s eyes examined?
The American Optometric Association recommends an eye exam at 6 months, 3 years, 5 years, and every year afterward. In the absence of crossing or other vision concerns, we recommend the first exam be around 10 months of age. Through the InfantSEE® program, we are happy to provide this service at no charge.

2. Why not just do a vision screening?
Vision screenings measure with limited reliability a child’s ability to see clearly in the distance. They give no information on the amount of effort that must be exerted to achieve that clarity. Furthermore, close-up vision, visual efficiency, eye alignment, and ocular health are all essential components of a comprehensive exam that are not covered in a vision screening.

3. Why do my child’s eyes need to be dilated?
Dilation relaxes the focusing muscle in the eye. In adults, the focusing muscle is relatively stable, and a reliable glasses prescription can often be obtained without dilation. In children, however, the focusing muscle is powerful and active and can often mask the true prescription. Dilation allows us to determine an appropriate glasses prescription with much greater accuracy.

4. How do you prescribe glasses for young children who cannot give reliable responses?
Retinoscopy is a procedure that allows us to find a glasses prescription without requiring input from the child. This can be very challenging for practitioners and is one of the skill sets that distinguishes us as pediatric specialists. In this procedure, a combination of lights and lenses are used to objectively determine the correct glasses prescription.

5. What is the difference between nearsightedness and farsightedness?
Nearsightedness causes blurring of distance vision. A child cannot focus through nearsightedness and must wear glasses or contact lenses to achieve clear distance vision. Farsightedness is not simply the opposite of nearsightedness. Farsighted children can focus through their prescription, which is more difficult when looking close than far away. Farsighted children can wear glasses to reduce the focusing effort required to make their world clear.

6. How does astigmatism affect my child’s vision?
Astigmatism is similar to nearsightedness and farsightedness in that it can be corrected with glasses, but instead of inducing blur, it creates a distortion of vision. For example, a single traffic light may have an overlapping “ghost image” so that the light appears stretched in one direction. The same effect may be experienced when reading small text and can result in eye strain.

7. If my child can see 20/20 without glasses, why does he/she need them?
As stated above, children can focus through their farsightedness to make their world clear. However, when present in moderate to large amounts, it comes with a cost. Imagine holding a bag of groceries out at arm’s length. It doesn’t seem difficult at first, but after a few minutes your arm will grow tired and have a much harder time performing its task. Now imagine doing the same task with the groceries resting on the countertop. The countertop (glasses) reduces the workload on your arm, making the groceries (farsightedness) easier to handle.

8. Is there a way to stop the progression of nearsightedness?
Myopia control is an intensely researched topic, and while the internet is rampant with claims of a cure, there is no quick or easy solution. There are, however, two methods that appear promising. Recently published studies support the use of multifocal soft contact lenses to slow the rate of progression by inducing a refractive change in the peripheral retina. This is a comparatively safe and affordable procedure, but its long-term effectiveness is still under research. The second method, called corneal reshaping therapy or orthokeratology, uses a hard contact lens that is worn overnight to mechanically flatten the cornea, thereby reducing the amount of nearsightedness during the day. For myopia control, the lenses must be worn as long as the eyes are changing, which extends into the early 20’s for most people. A number of factors must be considered when determining your child’s candidacy for the procedure; these include compliance, duration of treatment, overnight comfort, risk of infection, variability of vision, cost, and long-term efficacy.

9. How do glasses make my child’s eyes straight?
If your child has a crossed or wandering eye, glasses may help to realign the eyes. This is due the relationship between focusing (making images clear) and convergence (making images single). When the eyes focus on an object, they also converge or diverge in response. Glasses can change the amount of focusing by the eyes, which in turn changes the amount of convergence or divergence, thereby changing the alignment of the eyes.

10. Does patching therapy reduce the need for glasses?
No. Patching therapy helps stimulate vision development in the brain, while glasses improve visual acuity in the eye. In children with amblyopia (lazy eye), vision development is impeded by the lack of a clear image from the eye. When one eye creates a poor image, the brain will eventually ignore it; this results in the inability to see 20/20 in the ignored eye, even with the best possible glasses prescription. Patching therapy blocks the vision in the good eye which forces the brain to use the ignored eye and reactivate its visual development. Once patching therapy is finished, glasses must still be worn to maintain a clear image from each eye and promote continued development.

11. Does vision therapy treat dyslexia or other learning disabilities?
No. Dyslexia and other learning disabilities are disorders of central processing in the brain. We uphold the official position of the American Optometric Association that vision therapy does not aim to treat these central processing disorders. However, visual deficits may coexist with or masquerade as a learning disability. In these cases, vision therapy can work to resolve any concurrent visual dysfunction, making the true learning disability easier to manage.

12. At what age can my child wear contact lenses?
With proper training, contact lenses can be worn successfully at any age. There are some conditions in which contact lenses are a viable treatment option even in infants and toddlers. In the absence of medical necessity, the minimum age of successful wear depends on the child’s maturity and the degree of parental involvement – typically around 8 years old. Our training sessions are personally supervised by one of our technicians or doctors. Patients and parents are instructed step-by-step how to safely insert and remove the lenses; in addition, lens cleaning and care regimens, lens replacement routines, red-eye protocols, and troubleshooting tips are discussed.

13. Why does my child frequently rub his/her eyes?
The most common cause of chronic eye rubbing is itching due to ocular allergies. In most cases the symptoms will resolve quickly with once-daily use of anti-allergy eye drops. Beware that chronic, aggressive eye rubbing, especially in patients with atopic dermatitis, may lead to serious ocular complications including retinal detachment*. It is therefore critical that all eye rubbing behaviors are discouraged.

*Multicenter retrospective study of retinal detachment associated with atopic dermatitis. Jpn J Ophthalmol. 2000 Jul-Aug;44(4):401-18.

Northwest Pediatric Eye Care
Forest Office Park
14645 Bel-Red Road
Building E, Suite 102
Bellevue, WA 98007

Phone: 425.732.6056
Fax:     425.732.6059
Email:   info@nwpediatriceyecare.com

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