20/20



Whether it’s being able to catch a baseball, succeed at school or read a favorite book, good vision is critical to a child’s health, development and well-being. That’s why it’s important to have your child’s eyes checked regularly by his or her doctor, as many eye conditions and vision problems can be corrected if detected early.

 

Q: I’m expecting my first child in a couple of months. When should we take our child to the doctor for his or her first eye exam?

A: Newborn babies have their eyes assessed for the first time in the hospital nursery. Your pediatrician will then include a screening examination of your child’s eyes and vision at each well-child visit. If any difficulties emerge, he or she will be retested or referred to an eye doctor (either an ophthalmologist or optometrist) for a more detailed examination.

 

Q: My 3-year-old son has just been diagnosed with “lazy eye.” What is this condition and how is it treated?

A: “Lazy eye,” also known as amblyopia, is a loss of vision that results when the brain tunes out information sent by one eye. It happens due to the way vision develops in children. When babies are born, their vision is very blurry. To develop 20/20 vision, babies must be exposed to a clear and steady light source. But if the image from either eye is not sharp when it reaches the brain, or if it’s diminished while the other eye continues to see normally, the brain will focus on the better eye. The brain will slow down development of vision for the eye that sends the fuzzy images, and over time, it will learn to see blurry with the eye sending the fuzzy picture.


Generally, there are three types of lazy eye. The easiest to spot is a misalignment of the eyes known as strabismus. This means that both eyes do not look at the same thing simultaneously. Near- or far-sightedness can also cause lazy eye. So can a physical blockage to light, such as that from a cataract or droopy eyelid.


The good news is that with timely and proper medical intervention, lazy eye is treatable. Treatment typically begins with the underlying cause of blurry vision, which may involve glasses or contact lenses. Sometimes an eye patch is used to block vision from the eye upon which the brain has been relying. Without signals from the favored eye, the brain is forced to use the other eye, and this restarts the process of forming the neural connections necessary for clear vision.


If eye misalignment, a cataract or a droopy eyelid is blocking your son’s vision, surgery may be necessary. 

 

Q: My 9-year-old daughter is having problems keeping up at school. Could they have to do with vision?

A: Because children rarely complain about not being able to see well, it’s important to have their eyes checked regularly to detect problems. Your daughter’s vision can affect her ability to learn, and if she needs them, a pair of glasses can help her see better. Teachers often notice the red flags before parents do, and can tell you whether your daughter squints when reading the board or asks to be moved to the front of the class. Make sure you also consider other causes for your daughter’s difficulties, including social issues, dyslexia or a learning disability.

 

Q: My 6-year-old son is having trouble distinguishing certain colors. Could he be colorblind?

A: Colorblindness, or more accurately color deficiency, means that certain color-sensitive cells in the retina (the nerve layer at the back of the eye) don’t sense color normally. Most people can see some color. Color deficiency affects boys, and is often a genetic condition inherited from the male family members on the mother’s side. You may have noticed that your son has difficulty distinguishing shades of red and green – the most common type of color deficiency. A test can confirm it. Depending on the severity of the condition, your son’s color deficiency will have little effect on his future life choices, although a few occupations do require perfect color vision.

 

Omondi Nyong’o, M.D., is a board-certified pediatric ophthalmologist with a special interest in childhood vision at the Palo Alto Medical Foundation’s Palo Alto and Fremont centers. Advice is not intended to take the place of an exam or diagnosis by a physician.

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