The How And Why Of Eye Exams For Pre-Verbal Babies


"Which one is better: this one or this one?" Anyone who has had an eye exam has heard that sentence before. But what about eye exams for babies who can't talk yet? How do eye doctors know when a child needs glasses? When should your baby have an eye exam? Read on to learn the answers to these important questions.

How do you know if your baby needs a comprehensive eye exam?

While the American Academy of Pediatrics recommends routine vision screenings starting at three years of age, your child's pediatrician will check their eyes as a newborn and at around six months. You can certainly elect to take your child to the eye doctor before age three, but what are the indications that you need to schedule a visit sooner?

  • premature birth or problems at delivery, such as low birth weight
  • Down syndrome or other chromosomal defects
  • diabetes or certain other medical conditions
  • delayed motor skills
  • inability to maintain eye contact
  • frequent eye rubbing or blinking
  • poor tracking (eyes don't follow objects)
  • poor eye alignment

What happens at the eye doctor during a baby's examination?

Eye doctors (optometrists and ophthalmologists) try to keep the exams for babies short and quick moving to keep their patients from getting cranky. You should try to schedule your appointment during a time of day when your baby won't be napping or likely to "melt down" due to fatigue or hunger. You'll be able to hold your child on your lap or have the exam done while the child sits in their car seat.

The eye doctor will check for preferential vision to see if your child is favoring one eye over another by blocking each eye one at a time. They will also check to make sure the eyes can converge at the center by holding a toy close to the nose and that they can track without your baby having to move the head.

An initial test to make sure that both eyes are connected with the brain is to hold a prism in front of the eye. The baby's eyes should realign to see around the prism.

Pupil reflexes are tested using a penlight to make sure they are symmetrical. The reflex from the retina in the back of the eye should be the same in both eyes, and there should be no astigmatism (a tiny defect in the curvature of the pupil).

Drops are administered using a small spray nozzle to relax the focusing muscles of the eyes, which are generally very strong in babies. Then, a light is shined in the eyes with a lens held in front of it. The eye doctor will keep holding lenses of increasing power in front of the eye, checking that the movement from the retina is neutralized--a way to tell if your baby needs glasses.

Finally, the doctor will check for cataracts and look at the back of the eye to make sure there are no tumors and that the retinal blood vessels and optic nerves look normal.

What if your child needs glasses?

If the exam reveals that your child needs glasses, today's optical shops have many pediatric designs to choose from. You will be able to find ultra soft, nonbreakable glasses with a strap on the back to keep them on your baby's head. There are also models that take into account the slightly different facial features of children with Down syndrome, so they fit across their small noses and shorter temples.

Since so much of a child's learning depends on their vision, it's imperative to make sure a vision problem isn't keeping your child from developing. The early childhood years are a time of particularly rapid connections being formed between the eyes and the brain. Make sure your child's eyes are healthy with an eye exam, at a location like Envision Eyecare - Dr. Erika Duggan and Dr. Marilyn Lehrner, and don't worry if your baby can't speak yet.


8 June 2015

Take Your Health Into Your Own Hands

My name is Katie Langer. For a long time, I was bed ridden and I felt like I had no control over my life. I simply went along with what was instructed by my doctor and I didn't ask questions. It wasn't that my doctor wasn't willing to work with me, but I preferred to simply not think about the illness I was suffering from. I didn't realize that some of the symptoms I was suffering from were side effects of my medication and were not normal. After communicating more with my doctor, I was able to alleviate my symptoms. Since then, I've taken an interest in patient-doctor relationships and how to improve them.