When to visit a pediatric ophthalmologist

Why are preventive examinations by a specialist so important, what are the possible dangers to the eyes? to miss, at what age is there a tendency to decrease vision – this and other important points are discussed by Olena Varga, a leading specialist in the children's department of the Excimer ophthalmology center.

Olena Varga

Leading specialist of the children's department of the Excimer center, doctor of the highest category, member of the Association of Pediatric Ophthalmologists of Ukraine, specialist in orthokeratological treatment.

Depending on age and risk factors, including heredity, a complete eye examination should be performed at least once a year. The older the child gets, the more often he should visit an ophthalmologist. This is due to both the development of speech, when the baby can already interact with a specialist and answer his questions, and the increase in visual load during school years and the appearance of certain problems. It is a preventive examination that allows you to detect eye diseases and vision impairment in a timely manner and prescribe effective treatment or correction.

If problems with the visual system are ignored, this will have a negative impact on the child's overall development and relationships - with peers, adults, and the world around them.

The most important periods of professional examinations

After birth

In the maternity hospital, the baby is examined by a neonatologist, and if any abnormalities are detected, by an ophthalmologist. 

What is being researched:

• the presence of damage to the retina of the eye - retinopathy, which is characteristic of premature babies or those born with low birth weight (up to 2,5 kg). It is important to treat the disease to prevent blindness;
• pupil reaction to light;
• Congenital defects of the eye or its appendages: underdevelopment of the eyeball - anophthalmos, abnormal size of one or both eyes - microphthalmos, cataracts, glaucoma, etc.

Is visual acuity checked for infants? This study is relative: babies acquire the ability to see gradually, because from birth they have very poor eyesight. That is why it is so important for parents to check the child's reaction to light, then to a toy (fixation of the gaze on large or bright objects) over time. In order not to worry about cataracts, you can take a photo of the baby with a flash - if the pupils in the photo are black or red, then everything is fine, but white ones are a reason to see an ophthalmologist unscheduled.

First year

In addition to the above screening:

• checking eyeball movement;
• detection of strabismus;
• examination of the anterior and posterior segments of the eye.

What can bother a baby? It happens that the tear duct becomes blocked, especially in the first weeks after birth. Usually the child is shown to the pediatrician, who prescribes drops. If they do not help within a few weeks, this is a reason to contact an ophthalmologist.

At 1-3 years 

From the 12th to the 36th month, the same examination is performed as in the first year of life. At this age, the child is actively exploring the world, picking up everything and touching his face. This can cause inflammation - usually the family doctor prescribes eye drops for treatment. But it should be noted that redness of the eyes is a sign not only of conjunctivitis, but also of astigmatism or severe farsightedness. 

Did you know that a certain degree of farsightedness from birth is the norm for babies? As a child grows, the eyeball also grows, so farsightedness gradually decreases and almost disappears by the age of 6. If a child has no reserve of farsightedness, this indicates a tendency to myopia (short-sightedness).

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At 3-5 years old

The child is already able to express his opinion and complete tasks when requested, so the specialist can finally check visual acuity using the chart.

What is important at this age: 

• prepare the young patient in advance for a visit to the ophthalmologist so that the specialist can conduct the appointment productively;
• pay attention to whether the child squints at home when watching pictures or cartoons, rubs his eyes, or looks closely, because these are all signs of impaired vision;
• Do not overload the child's visual system with small details and close-up games for the sake of early development (assembling Lego, learning letters, drawing with a pencil).

At this age, ophthalmologists detect the problem of “lazy eye” (amblyopia) and uncompensated strabismus. Both conditions must be treated.

From 5 to 16 years

Starting at age 5, eyes should be examined every year, and more often if there are ophthalmological problems. 

Be sure to undergo a thorough check:

• before school at age 6 to determine readiness for learning and possible limitations regarding visual load;
• after the end of grade 1 to monitor visual acuity. Due to unusual and heavy strain on the eyes, children may see significantly worse at the end of the school year. In this case, the ophthalmologist prescribes correction with glasses or lenses or hardware treatment;
• in the transitional period, at 10-11 years old – for girls and 12-13 – for boys. During puberty, the eyeball grows actively, which can cause the development of myopia. If over the summer a teenager has grown up like a spruce, it is better to visit an ophthalmologist more often – twice a year.

How to recognize that a child has vision problems

The whole difficulty and a common mistake of parents is that the baby does not complain about poor eyesight. After all, he may not know about it, he has nothing to compare it to, and in some cases he does not yet know how to formulate his complaints.

What you should definitely pay attention to:

• the child blinks frequently, trying to compensate for vision problems, in particular myopia or astigmatism;
• Many people complain that their eyes get tired after watching TV, drawing, or reading;
• one eye is squinting – this may be a sign of amblyopia or improper focusing of vision;
• tilts head low when reading or writing, which indicates problems with eye coordination, focusing, myopia;
• often makes mistakes when reading and writing due to errors in visual perception;
• eyes react painfully to bright light;
• there are difficulties with coordination of movements – the child is unable to move deftly or keep balance;
• redness, itching, dry eyes, or tearing;
• Headaches can indicate vision problems, it is not always a neurological disease.

What affects vision impairment in children?

There are both congenital and acquired factors. The main factors are as follows:

• prematurity;
• complicated pregnancy and childbirth;
• heredity: congenital glaucoma, cataracts, optic nerve atrophy, retinal dystrophy, myopia, strabismus in a family member;
• excessive visual strain and violation of the correct distance to the object of observation;
• past infectious diseases;
• a diet poor in vitamins and minerals; 
• visual hygiene disorders: poor lighting, improper organization of the workplace;
• impaired blood circulation in the eye area, including due to incorrect posture;
• lack of sleep;
• chronic stress and fatigue;
• head and eye injuries.

What vision disorders can an ophthalmologist detect?

The most common problems:

• inability to distinguish colors – color blindness;
• decreased vision in one eye – amblyopia; 
• Strabismus – conjunctival, paralytic, convergent, divergent, vertical, monolateral, alternating;
• poor vision at a distance – myopia;
• inability to focus on objects that are close - farsightedness;
• Blurred image at different distances due to astigmatism.

Therefore, preventive examinations by a specialized specialist, attentive attention to the baby's complaints, and timely treatment and correction will help not only preserve vision, but also influence the child's development and successful learning.