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pediatric eye doctor examines 6-year-old girl

Pediatric Optometry

Pediatric optometry is the branch of medicine that deals with the examination, diagnosis and treatment of children's eyes. Pediatric optometrists are specially trained to treat visual disorders in children.

Why see a pediatric eye doctor?

This subspecialty of optometry requires many years of additional study. Eye doctors within this field must have four years of college and four years of doctoral-level study, plus residency training in the field.

The American Optometric Association (AOA) recommends that children have their eyes examined at 6 months of age, again between the ages of 3 and 5 and every two years during the school years. If a family physician or pediatrician detects problems, he or she may refer the child sooner. Specifically trained to diagnose developmental vision problems, a pediatric optometrist can quickly treat any problems that are discovered.

Therapy may include fitting the child for glasses or contact lenses or therapeutic exercises designed to strengthen a child's vision.

Because vision affects behavior and performance, proper vision therapy can enhance and improve vision as well as behavior. This can significantly improve a child's ability to learn and pursue other activities.

Children who encounter vision problems may show signs of difficulty, which include squinting or frowning, excessive blinking or rubbing eyes frequently. If eyes turn in or out or if the child closes or covers one eye, this could indicate a problem. Even if a school-aged child passes an initial eye chart exam, he or she should see an eye doctor if a change in academic performance occurs or if he or she tires easily during school.

Children at a higher risk of eye and vision problems include those born prematurely or who had a low birth weight as well as those with a family history of eye problems. If the mother had an infection while pregnant or had a difficult or assisted labor, the odds of eye problems increase.

Finding a specialist could involve asking for a referral or doing your own research. Check Angie's List's member reviews online and ask questions before making an appointment to make sure you are seeing a physician that will suit your child's needs.

Pediatric eye exams

Even children who are too young to talk can have their eyes examined. The eye doctor will check the child's eye muscle movements, make sure no disease is present and look for alignment problems. 

The optometrist will observe visual behavior. Dilating the eye allows the doctor to view the eye's structure and look for any abnormalities of the retina or optic nerve. During an exam, the eye doctor will also check the physical condition of the child's eyes, which includes the eye's overall health and refractive status, meaning the need for lens correction in nearsightedness, farsightedness or astigmatism. The need for glasses or pediatric contacts is rare for babies, but early correction can prevent future problems.

After a basic exam, pediatric optometrists also perform tests to check visual skills to see how efficiently the child's vision allows him or her to function. The eye doctor tests and evaluates color vision and depth perception as well.

Vision, eyesight and development

Vision and eyesight are not exactly the same. Whereas vision is the ability to focus and make sense of what's seen, eyesight refers to the clarity of the image. That said, eyesight is not the only concern of pediatric optometry. Visual dysfunction can play a role in developmental delays. Eyesight may be fine, but the way images are processed may not be. Children with motor delays or other special needs and health issues should be checked for visual dysfunction.

Social and emotional development is also related to vision. Children who suffer from autism, developmental disorders and attention deficits, for example, should have a vision evaluation.

Pediatric optometrists can administer several tests to diagnose vision problems. Binocularity refers to how the eyes interact and maintain single vision without sliding out of alignment, as with crossed eyes. Oculomotility refers to the ability to aim and control eyes. This is especially important when reading, for which the eyes must be able to smoothly move across the page.

The American Optometric Association estimates that nearly 25 percent of school-age children have vision problems, and disabled children exhibit an incidence rate of vision anomalies at least twice as high as other children.

According to the Journal of Behavioral Optometry, 80 percent of all learning is obtained through vision during a child's first 12 years.