Childhood eye exams, vision screenings, are an efficient way to identify children with impairments in vision or children who are suffering from eye disorders that could lead to vision impairments. This method allows the physician to refer his or her patient to the correct pediatric ophthalmologist and optometrists for further investigation and treatment.
Childhood Eye Exams – Pediatric Vision Screening
Depending on the age of the child and the experience of the examiner, different childhood eye exams may be used to assess a child’s vision. Vision screening methods include:
Inspection of the Eye, Pupils and Red Reflex
Inspection of the eye, pupils and red reflex entails shining a flashlight into the child’s eyes to inspect for abnormalities of shape or structure including abnormalities in the shape of the pupil. In healthy eyes, the pupil constricts (becomes smaller) in bright light and dilates (becomes larger) in the dark. If they are healthy, both pupils are the same size. An ophthalmoscope is used to test the red reflex in the eye, which is a reflection from the lining of the eye (retina) and is the cause of ‘red-eye’ in photographs. The red reflex should be equally bright in both eyes.
Photo Screening (auto refractor, objective screening, and instrument-based screening) is a form of vision screening for children that uses a special camera to determine how well a child can see. It can be used in place of the visual acuity-based screening with an eye chart. This technique uses the red reflex to identify a number of eye problems. Its advantage with young children is that the process is quick and thorough. In the most modern photo screeners, immediate information can be extracted about the eye condition.
Corneal Light Reflex Testing
The Corneal Light Reflex Testing is carried out using only a penlight. The child focuses on the penlight and as he/she does so, the ophthalmologist is able to assess the position of the light reflection from the front surface of the eye (cornea). The test requires a child to look directly into the light, which can be difficult with very young patients. When the eye is normal, the corneal reflex (light reflection) is in sharp focus and centered in both pupils. If the test comes back abnormal, the corneal light reflex will appear blurry and unclear or off-center.
Cover Testing for Strabismus
Cover testing is a method to detect strabismus, the misalignment of the eyes. A child will focus on a target as the examiner covers each eye sequentially to check for a shift in the alignment of the eyes. This test requires cooperation of a child, meaning that it is best used with children 3 years and older by an experienced examiner.
Subjective Visual AcuityTesting
Subjective screening requires participation from a child to identify images or letters on the visual acuity charts. This examination is also only recommended for children aged 3 and over. This method tests the acuity (sharpness) in vision of children by use of an eye chart. Most adult eye charts can be used in older children, but for younger children, shapes or pictures can be used in place of letters. The ophthalmologist will test each eye separately to measure individual acuity.
Eye Problems Detectable with Vision Screening
The primary goal in pediatric vision screening is to detect children suffering from or at risk of amblyopia. Amblyopia is an ocular condition in which the nerve pathways between the brain and the eye are not properly stimulated and the brain favors one eye over the other. Amblyopia can cause permanent visual impairment if not treated early on in childhood.
Other problems that a vision screening can detect are:
- Strabismus (eye misalignment)
- Ptosis (drooping eyelid)
- Myopia (near sightedness)
- Hyperopia (far sightedness)
Vision screening can also detect some of the more serious conditions like tumors or neurological diseases.
Vision examinations should start early in life and continue through the school years. Appropriate vision care at an early age is vital to giving your child the visual skills he or she needs to perform well in school. Similar to taking a child for regular wellness-physicals, parents should also be scheduling comprehensive eye exams. Families searching for expert, full-service pediatric ophthalmological care need look no further than Dr. Ann Ranelle, Dr. Kacy Pate and the team at Fort Worth Eye Associates.
If you would like to learn more about childhood eye exams and vision screening by our pediatric eye specialists, please call our Fort Worth office at 817-732-5593 or our Weatherford office at 817-341-1600.
For children's eyeglasses and contact lenses prescriptions visit our full-service optical shop, Camp Bowie Optique (817-732-9307), which is conveniently located in the Fort Worth office building of Fort Worth Eye Associates.