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  • Don’t Overlook Possible Eye Disorders in Your Baby or Preschooler

Published on January 16, 2013

Don’t Overlook Possible Eye Disorders in Your Baby or Preschooler


SIOUX FALLS (Jan. 1, 2013) - Because the gift of sight is precious, irreplaceable, and worth protecting, parents should be aware of vision problems and eye disorders which can affect young children, and their future vision.

An estimated one in 20 preschoolers has a serious eye disorder that if not corrected can lead to a lifetime of impaired vision. Most babies have their first eye screening as a newborn in the hospital, when the basic structures and anatomy of the eye are checked for obvious defects.

“During a baby’s first couple months of life, their eyes do a lot of strange things. Their eyes may drift, cross and not appear to focus,” said Joseph Martin, orthoptist with Avera Medical Group Ophthalmology Sioux Falls. An orthoptist is a medical professional who specializes in the diagnosis and non-surgical treatment of neuromuscular eye disorders and conditions that affect the binocular vision system.

Beginning from about 3 months of age to 6 months, the child’s vision system begins to take over. He should begin to look straight at people or objects, track toys, and focus on mom or dad’s face and smile in response. Parents should visit with their pediatrician or family practitioner if the child doesn’t seem to be responding as she should to visual stimuli, if one eye is directed inward or outward, or if the eyes chronically tear or matter. A basic vision check is included in most well-baby check-ups.

Strabismus is the medical term for the condition when the eyes are not aligned – when they do not look in the same direction. Because the two eyes are focusing on different things, the brain is confused and may learn to ignore the image from one eye in order to alleviate double vision.

Amblyopia, often called “lazy eye,” is the condition in which one or both eyes lose the ability to see details. It occurs when the nerve pathway from the eye to the brain does not develop during childhood, because the abnormal eye is sending a blurred image or the wrong image to the brain. Again, the brain is confused and may learn to ignore the image of the weaker eye. Strabismus is the most common cause of amblyopia, and amblyopia accounts for more vision loss in children than all other causes combined.

“A child’s visual system develops from birth to approximately age 9. During this time the brain and eye are making connections and the brain learns to interpret images,” Martin said. “Any condition that affects the clarity of images can halt the development of vision in the affected eye.”

If your child is suspected to have one of these eye disorders, he or she may be referred for ophthalmologic care.

While they can’t read letters on an eye chart or tell what they see or don’t see, even infants can be assessed by eye specialists. “In infants, we assess vision, check eye movement and alignment, and also do a thorough dilated eye exam. When the pupils are dilated, the muscles that focus the eye are temporarily suspended, and we can evaluate the patient for vision correction without them telling us anything,” Martin said.

Children can be fitted for glasses before age 1 if correction is necessary at that age. Flexible frames that are virtually indestructible are often recommended for children under age 5. Children are not often fitted for contact lenses until after age 9, Martin added.

If glasses alone cannot correct vision, other strategies include eye drops or eye patches which occlude vision in the strong eye to strengthen eyesight in the poor eye. Prisms and eye muscle exercises can help eye alignment. “The last thing in the arsenal is surgical intervention,” Martin added.

If your young child sits too close to the TV, that doesn’t necessarily signal a vision problem. “Kids in general love to sit close to the TV. That’s not always indicative of a problem, and it’s not something that will cause a vision problem,” Martin said.

Rather, if your child is squinting, if he cannot see something that others in the family can see such as a clock on the wall, or if she is complaining of a headache or double vision, this may indicate a problem. “If you have a family history of pediatric eye disorders, it’s a good idea to make sure your child is screened early for eye conditions,” Martin added.

Your child may be offered vision screening through school or preschool. Avera screens through Sioux Falls Catholic Schools, Brandon Valley, Hartford and Humboldt and the YWCA preschool. A photoscreener, which is like a hand-held camera, can indicate vision difficulties such as nearsightedness, farsightedness, astigmatism or misalignment in just a few seconds.

To learn more about specialized eye care, go to