Children’s eye exams at D’Ambrosio Eye Care are a routine part of our Pediatric Ophthalmology practice. Pediatric Ophthalmology is a subspecialty area that deals with problems common to or seen exclusively in the pediatric or children’s age group. Children’s eyes and vision are different than adult’s eyes and vision. The brain cells that control our vision are not fully developed, or mature, when we are born. These cells develop throughout the first decade of life. Because of the immaturity of a child’s visual system, disorders that may have little effect on an adult’s ability to see can have a profound and life-long effect on a child’s vision. Poor vision due to inadequate stimulation of these brain cells, amblyopia, is a common cause of loss of vision in this age group. Some disorders are only seen in children. Some disorders, such as certain types of tumors, may be found in both children and adults, but may have different effects when they occur in children.

The Pediatric Eye Exam

During the pediatric eye exam your child will typically have the following testing:

Visual Acuity

Your child’s vision will be checked. This is possible even in children who do not speak yet. For older children, picture charts, letter games and letter recognition can be used.

Eye Alignment or Muscle Balance

Various methods are used to test the alignment of the eyes and make sure the muscles, which move the eye, are functioning normally. This may be done using light reflexes or alternately covering each eye to make sure that they do not move from the straight ahead position.

Binocular Vision

These tests are used to make sure that the eyes are not only aligned correctly, but that the brain is using them together as well. If the eyes are properly aligned, it does not always follow that the brain is using them together.  Proper eye alignment is important for the development of depth perception, or the ability to see objects in 3D.

Refraction

Refraction is used to measure the “power” of the eye. It determines if your child is nearsighted, farsighted or has astigmatism. This can be done in infants where they cannot cooperate to tell us how well they are seeing. A special light is placed into their eyes and the light is moved back and forth. The light enters the eye and “bounces” back to the examiner. The way the light behaves as it comes back out through the child’s eye can be used to determine the refractive power of the eye. To obtain accurate measurements in young children, the focusing power of the eye must first be neutralized. This is done by placing drops into the eye to dilate the pupil and eliminate their focusing mechanism. These drops often take 30-60 minutes to work.

Fundus Examination

We use specialized instruments, often worn on the head, to look into the back of your child’s eye. The retinal blood vessels and the optic nerve, an extension of the brain, can be seen. Because this is an area where blood vessels and portions of the brain can be seen, it is very valuable in helping to diagnose many disorders that can affect the entire body.

Once the examination is complete, your child may be prescribed glasses. Treatment for other problems may also be addressed. If your child received drops, he/she may experience blurry vision until their effect has resolved which can be anywhere from three to 24 hours. The duration of this effect is dependent on the type of drop used, the color of his/her eyes and the refractive power of the eyes.