Why is it so important to have annual examinations by a pediatric ophthalmologist?

Natalia Svishchova, an ophthalmologist at the pediatric department of the Excimer Center, a member of the Association of Pediatric Ophthalmologists of Ukraine, and a specialist in orthokeratological treatment, explains why it is dangerous to skip annual eye exams, why you should not avoid glasses, and how to prevent vision deterioration.

Natalia Svishchova

Pediatric ophthalmologist Excimer Center

At birth, babies are necessarily examined in the maternity hospital, and further examinations are carried out according to the doctor's recommendations. However, at school age, professional examinations by an ophthalmologist should be done every year.

The thing is that children don't complain if their vision starts to get worse. After all, the process of vision loss occurs gradually, and they often simply don't notice the problem.

Or, for example, the vision of only one eye deteriorates. The child does not close the right and left eyes alternately, so he cannot analyze that one sees worse than the other. And often because of this difference in vision, the baby develops amblyopia (“lazy eye”), which requires additional, more complex treatment. 

That's why it's essential to visit an ophthalmologist once a year at school age. And if there are problems, then more often. 

Eye problems in preschoolers

Usually it can be astigmatism or a congenital difference in refraction in the eyes. Astigmatism within 0,75 diopters at an early age does not require correction. However, if astigmatism is present in only one eye and the child does not complain, then during a preventive examination the doctor often detects the problem of “lazy eye”. And all because the parents did not consult an ophthalmologist in time and the young patient did not wear glasses.

Often, a doctor diagnoses uncompensated strabismus, which parents do not immediately notice. Up to a year, this is considered an acceptable norm, because binocularity has not yet formed. But even up to a year, such a problem requires a full examination in a specialized clinic, because strabismus can be secondary to congenital defects.

Congenital defects

Mostly parents notice such defects, for example, congenital cataracts or glaucoma. This is visually visible: with glaucoma, the eyes change in size. In the case of congenital cataracts, the pupil, where there should be a black or red reflex, is white. Therefore, it is important for a mother to take a picture of her baby at dusk and see if the eyes glow symmetrically with a red reflex. And if there is something wrong with the eye, be sure to consult an ophthalmologist.

Source: freepik

Problems to consider at an early age 

It is quite common for a baby's tear duct to become blocked. This is usually noticeable in the first weeks after birth. Then you can contact your family doctor to prescribe drops. If in a few weeks, a month at most, dacryocystitis doesn't go away, you need to go to an ophthalmologist. 

It is important to remember: children do not complain about their vision, but they begin to rub their eyes, squint. Sometimes parents notice a slight redness in the corner of the eye. Believing that this is inflammation, they turn to their family doctor, who prescribes drops. It goes away, but then returns again. 

It is important to know that redness occurs not only from inflammation, but sometimes from astigmatism, visual strain that accommodation cannot withstand. Such children are usually diagnosed with hyperopia or astigmatism that is greater than normal. 

Therefore, even a slight redness of the eye is a signal that you should not just put drops in, but seek professional help. Such situations are typical for preschool children and younger schoolchildren. Older students can already adequately assess their vision, they may have other eye problems when they start to squint or look closely.

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The risk of developing myopia

Vision deterioration – the development of myopia – occurs mainly at school age. After all, in addition to the usual visual loads – drawing, watching TV, putting together puzzles or a construction set – first-graders also have to study. 

Young children and preschoolers are most often farsighted. And before the loads, such as writing, reading, their vision was quite good. However, later, due to school loads, even with a sufficient reserve of farsightedness, the student's vision may decrease and, over time, myopia may occur.

So, advice to parents: involve your child in early development only when you are sure that it will not harm. Such activities must comply with the norms. If you start teaching letters early, they should be large - one letter or number per page, so that the child does not have to look closely, look for various small details of the picture, bend low. And of course, you need to dose the learning time.

Source: freepik

Important periods for eye exams

The three most significant reviews:

• Pershiy more or less informative It is carried out at the age of three, when the baby is able to talk about his condition and answer questions. 
• Then after the end of the first grade, because the child is given an unusual load and it coincides with the beginning of his active growth. It is a common situation when children go to school with good eyesight, and after the first grade their eyesight deteriorates, so at the age of 7 it is mandatory to go to an ophthalmologist. 
• Then, you shouldn't miss a full eye exam at 10-11 years old. Teenagers grow rapidly, and so does their eyeballs, which can lead to the development of myopia. So, if your child has grown a head taller over the summer, it makes sense to see an ophthalmologist more often – once every six months.

About glasses, lenses and hardware treatments

At the appointment, the ophthalmologist not only examines the visual apparatus, but also gives recommendations regarding eye strain and prescribes corrective lenses if necessary. 

Yes, if you don't wear glasses in case of anisometropia (different refraction of the eyes), astigmatism, or farsightedness, your vision will deteriorate faster. So when the doctor has detected a problem during the examination and prescribed glasses, you must wear them to avoid developing strabismus or amblyopia in the future, which will be more difficult to treat later. 

In the early stages of mild hyperopia or in the case of accommodation tension (which almost all schoolchildren suffer from now), the ophthalmologist will give other advice - to regulate the visual regime and undergo hardware treatment. This strategy is effective, the main thing is to visit the doctor on time and follow the recommendations.

There are medical indications when it is more convenient to replace glasses with lenses. For example, with a large difference in vision, wearing glasses is quite difficult, because each eye needs a different lens and the image is not focused correctly. Or in the case of high refractive errors, then the shape and size of the glasses themselves are unacceptable.

And sometimes switching to lenses is the most effective way to correct it. This is myopia. Night hard lenses (orthological) are one of the few effective methods that can, firstly, prevent vision deterioration, and secondly, give the child freedom from glasses. 

Why you should have your vision checked by an ophthalmologist, not a pediatrician

During annual school checkups, children's vision is often checked by a pediatrician or family doctor using a chart. 

However, if we do not dilate the pupil and examine the relaxed accommodation environment, we will not obtain reliable data. And we will not provide the first adequate treatment. Therefore, a full examination should be performed by an ophthalmologist, or better yet, in a specialized clinic.

Source: freepik

Expert advice on preventing vision loss

1. First of all, regulate your child's visual load. Be sure to take breaks to rest your eyes. When working on a computer or other gadget, use the 20 x 20 x 20 formula: 20 minutes of work, 20 minutes of rest, and look at a distance of 20 feet (6 meters). 
2. When a student reads, parents should make sure that he does not hold the book closer than 40 cm to his eyes, does not bend low, and maintains a safe distance from his face to the screen. 
3. Scientific studies prove the usefulness of walking outside in daylight for at least 2 hours a day to prevent myopia. 
4. Be sure to alternate visual and physical activity.
5. It is important to undergo annual preventive examinations to prevent deterioration of a child's vision and prevent complications from developing in the future.

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