We are proud to participate in a national vision program called INFANTsee. Under this partnership, Ocean Eye provides complimentary pediatric vision exams for infants under the age of 1. This is a great program aimed at educating parents of the importance of regular eye exams for their children. For more information on this program, please click on the video below.
Why should I take my baby to an InfantSEE® provider?
An InfantSEE® assessment between six and 12 months of age is recommended to determine if an infant is at risk for eye or vision disorders. Since many eye problems arise from conditions that can be identified by an eye doctor in the infant’s first year of life, a parent can give an infant a great gift by seeking an InfantSEE® assessment in addition to the wellness evaluation of the eyes that is done by a pediatrician or family practice doctor.
One in every 4 children is at risk from undiagnosed eye and vision problems, yet only 13 percent of mothers with children younger than 2 years of age said they had taken their babies to see an eye and vision care professional for a regular check-up or well-care visit. Moreover, many children at risk for eye and vision problems are not being identified at an early age, when many of those problems might be prevented or more easily corrected. Some 4.02 million children were born in 2004, according to the U.S. Census Bureau. In approximately 4 percent, strabismus (misalignment of the eyes) will develop, and amblyopia (lazy eye) will develop in 3 percent. This equates to as many as 100,000 infants born each year who are at risk for serious eye and vision problems.
Early intervention is critical to successful and cost-effective treatment. Despite the nation’s present system of preschool vision screening, there exists a lack of understanding by the public of the importance of periodic professional eye and vision assessments. Unfortunately, during the course of their young lives, most children probably never see an eye care practitioner who can provide the kind of professional eye assessment necessary to identify critical eye and vision problems at an early stage, explain those conditions to parents, and provide the care necessary to correct those problems.
What are the visual skills that my baby is learning?
Vision is a dominant process in the growth, development and daily performance of children. Good vision includes healthy eyes, age appropriate visual acuity, visual integration and visual skills such as eye teaming, eye focusing and eye motility. Optometrists can evaluate these components and help ensure your child reaches his or her potential.
Visual acuity: Visual acuity is the ability to see objects appropriate for your child’s age. It can be measured by your optometrist long before your child can read or recognize letters.
Eye health: Eye disease can impair vision or lead to vision loss if not diagnosed and treated. Most conditions can be treated best if caught early.
Visual integration: The ability to process and integrate visual information, which includes and coordinates input from our other senses and previous experiences so that we can understand what we see. The eye-hand coordination involved in tossing a ball, or a game of patty-cake, requires a great deal of teamwork between the senses.
Eye teaming: The ability of the eyes to work together.
Eye focusing: The ability of the eyes to focus clearly at different distances quickly, accurately, and for sustained periods of time.
Eye motility or tracking: The ability of the eyes to smoothly follow moving objects and to move accurately from one object to another.
Why do you suggest getting the eyes tested at 6 months?
Clinical experience and research have shown that at 6 months, the average child has reached a number of critical developmental milestones, making this an appropriate age for the first eye and vision assessment. Many visual abilities are fully functioning by the age of 6 months. Interference with development during this very critical phase may lead to serious lifelong effects on vision. Successful treatment can be obtained more quickly with early intervention.
The good news about a trip to the optometrist is that there are no shots or cold stethoscopes. While the doctor will be shining a light in the baby’s eyes, and may spray a mist on eyelids or use eye drops to dilate the baby’s pupils, many infants seem to enjoy the “games” they play as part of the professional assessment.
Are children with eye and vision problems ‘falling through the cracks’?
In a word, yes.
Fact: Vision disorders are the fourth most common disability in the United States and the most prevalent handicapping condition during childhood.
Fact: Below the age of 6, only about 14 percent are likely to have had an eye and vision examination.
Fact: Pediatricians provide an important base-level eye screening that is designed to detect gross eye abnormalities. A comprehensive eye assessment by an optometrist is designed to detect much more and is an important part of your well baby care.
Fact: The American Public Health Association adopted a resolution that recognizes the shortcomings of vision screenings, encourages regular eye examinations at the ages of 6 months, 3 years, and 5 years, and urges pediatricians to recommend that all children receive eye examinations at these intervals.
Fact: Healthy People 2010, a national disease prevention initiative of the U.S. Department of Health and Human Services, also recognizes the importance of preventive vision care. One of its goals is “to improve the visual health of the Nation through prevention, early detection, treatment, and rehabilitation.” These national efforts to inform the public about the importance of early eye care and the current limitations of vision screening are issues that all optometrists need to discuss within every community until all children receive professional eye examinations on a regular basis throughout childhood.
How should I prepare for my baby’s first exam?
Everyone understands that the young patient may be cooperative for only a limited period of time. We ask that you fill out all paperwork prior to coming in for the exam. These forms are located under the patient resources tab on the left side of this screen. Please click on Patient Intake Form and submit at least 24 hours prior to your exam time.
When setting an appointment time, let the office staff know if you have any special concerns or conditions. Set an appointment time that is most agreeable to the baby’s schedule, avoiding nap time.
On the day of the visit, change the infant’s diaper at home just before leaving for the exam. Children in this age group generally perform best if the assessment takes place when they are alert. Because infants tend to be more cooperative and alert when feeding, it is also helpful to bring a bottle to feed the child. Bring a security toy or object for the infant, but also toys or games that will hold older siblings’ interest if they are coming too. If possible, arrange for only the infant and the parent to be in the exam room during the assessment. If possible, we ask that you bring a caretaker for any other children you may be bringing.
During the assessment, most likely you will be asked to hold the baby on your lap, or on a lap pillow. Parents should be present for the assessment to help the baby focus on the doctor, so avoid talking to the baby or adults during the assessment. You may be recruited to hold targets or be a puppet master to hold the baby’s attention during certain procedures.
Babies can’t speak. How do you test their vision?
Our pediatric optometrist has the clinical background and expertise necessary to provide eye and vision assessments for any non-verbal patients, including infants. Dr. Harwood is looking for answers to the same questions you are:
- Does the patient history suggest a problem?
- Can the baby see?
- Are the eyes straight?
- Are the eyes healthy?
- Is intervention necessary?
Some eye conditions are strongly linked to family history, so the first step for the doctor is to compile a history on the child. A comprehensive patient history for infants may include any problems you have noticed, visual and ocular history, general health history, family eye and medical history, developmental history and demographic data.
Factors placing an infant, toddler, or child at significant risk for visual impairment include:
- Prematurity, low birth weight, oxygen at birth
- Family history of eye diseases such as retinoblastoma, congenital cataracts, or metabolic or genetic disease
- Infection of mother during pregnancy (e.g., rubella, toxoplasmosis) or drug/alcohol use during pregnancy
- Sexually transmitted diseases, cytomegalovirus, or HIV
- Difficult or assisted labor, which may be associated with fetal distress or low Apgar scores
Because traditional eye chart testing requires identification of letters or symbols and demands sustained attention, this test cannot be used with infants and toddlers. Assessment of visual acuity for infants and toddlers may include tests to assess that the infant can fix his eyes on an object and follow the object, or at which objects the baby prefers to look, and at what distances.
The doctor may use lenses and light from a small hand-held instrument to assess how the eye responds to particular targets. The doctor may also repeat this test after using eye drops to enlarge the pupil and stabilize the baby’s focusing.
The typical infant may have some degree of nearsightedness, farsightedness, and astigmatism not requiring correction. Studies show that 30 to 50 percent of infants under 12 months have significant astigmatism, which declines over the first few years of life, becoming stable between approximately 2½ to 5 years of age. Low amounts of anisometropia (where the prescription is not the same in both eyes) are common and variable in infants.
Using her hands, a light, or a toy, the doctor catches the baby’s attention and observes how the baby follows the movements of the object.
Eye Alignment/Binocular Potential:
By covering one eye at a time, the doctor gathers information about the eye muscles and acuity. While identifying strabismus is important in itself, the presence of strabismus may indicate any number of disease entities.
The doctor will examine the eye’s structure as well as eyelids, tear ducts, and other parts of the eye. Pupil function will be checked, and a hand-held biomicroscope may be used for evaluation of the front of the eye. A test to assess visual field will be completed and an examination of the inner eye through a dilated pupil will be done. An ideal time for evaluation of the posterior segment is when the infant is in a calm, relaxed, condition (i.e., being bottle fed or sound asleep).
The doctor will immediately share the results of the examination with you and send summary letters to the infant’s pediatrician, family physician, or other appropriate practitioner, reporting and explaining any significant condition diagnosed in the course of the assessment.