September 16, 2020
Why routine eye exams are critical for academic success
New York, NY— Did you know that over 5 million children in the U.S. struggle to learn because of an undiagnosed vision problem? Eye care is a crucial part of a child’s development at every stage, especially for detecting problems that may hinder learning and everyday function. As kids head back to school this year, eye exams are more important than ever since many children will be shifting their focus from the classroom Smartboard to the home computer screen during this time of Covid-19.
“With more learning taking place in front of a computer or on a digital device, an increase in screen time can place additional stress on developing eyes,” says Deborah Amster, OD, Chief of Pediatric Services at the SUNY College of Optometry University Eye Center (UEC). “It is essential to have your child’s vision checked regularly.”
Launched in April 2020, the 5,000 square foot, state-of-the-art Barbara Saltzman Center for Pediatric Eye Care at the UEC in midtown Manhattan features eight inviting new exam rooms, a specialized children’s optical for eyeglass dispensing, and a waiting room for sensory-sensitive children (called a Chill Room). It also offers a family-friendly waiting area with limited interactive activities, a consultation room for interdisciplinary care, and a special equipment testing room. The center is dedicated to accommodating the growing need for basic and advanced pediatric eye care within the UEC, including focused care and programs for infants, children with special needs, myopia management (nearsightedness), and medical conditions that impact eye health.
“What sets us apart is that we can spend more time with our patients in this uniquely crafted environment for children, with the most up to date technology, in a collaborative setting for learning since we are a teaching facility,” says Dr. Amster.
Common eye problems
According to the American Optometric Association, children should receive their first eye exam between six to 12 months of life, followed by an exam at least once between the ages of three and five. At school age, an eye exam should be conducted yearly.
“The reason for an annual exam is that a child’s eyes can change over time with growth and visual demands,” explains Dr. Amster. “For example, some vision problems like nearsightedness (myopia) or eye-focusing-at-near, which includes activities such as reading, that were not present early on in development may appear when the child is older.”
In addition to nearsightedness, an eye condition marked by blurry distance vision, other common eye problems in children are:
- Farsightedness—the inability to see clearly up close.
- Astigmatism—the inability to see clearly in the distance or up close.
- Eye coordination problems—the inability to coordinate the eyes together effectively.
- Eye focusing problems—the inability to easily refocus the eyes or maintain clear focus.
- Eye-tracking—the inability to move the eyes smoothly from one point to another
- Amblyopia (lazy eye)—decreased vision in one or both eyes, typically due to a significant difference in refractive status/prescription (farsightedness, nearsightedness, or astigmatism) between the eyes or a high prescription in one or both eyes, or a constantly misaligned eye.
- Strabismus (eye turn)—an eye that turns inward, outward, or up/down.
Other difficulties related to visual processing that may affect learning and warrant further evaluation include difficulty with the following skills:
- Visual form perception—the ability to discriminate the difference in size, shape, or form.
- Visual memory—the ability to remember and understand what is seen.
- Visual-motor integration—the ability to process and reproduce visual images by writing or drawing.
- Laterality and directionality— left/right awareness on self and external space (orientation of letters)
“If your child does have an eye problem, your provider may recommend more frequent follow-ups,” says Dr. Amster.
What to look for
As a parent or teacher, if you notice a child struggling with learning, concentration, play, and socializing, it may be related to a vision problem. According to Dr. Amster, some signs and symptoms to be aware of include:
- Blurred vision or squinting
- Headaches
- Tired eyes
- Rubbing eyes frequently
- Closing or covering an eye
- Double vision or words that appear to move/overlap
- An eye that turns in or out
- Skipping words, losing place while reading, uses finger to keep the place
- Misreading words
- Difficulty with reading comprehension or recalling what was read
- Reversal of letters or words
- Lack of interest in or avoidance of reading
- Short attention span
- Poor hand-eye coordination
“Some signs and symptoms that warrant an immediate visit to the eye doctor would include the sudden loss of vision, pain or severe redness in the eyes, and sudden onset double-vision,” adds Dr. Amster.
What to expect
If your child needs to see an eye doctor for the first time, it is helpful to know what to expect and how to prepare your child for the eye exam at the Pediatric Eye Center, especially as we continue to address the health crisis.
Following strict COVID-19 guidelines as established by state public health officials and the American Optometric Association, safety protocols and requirements at the Center feature reduced capacity, temperature checks and screening, face coverings at all times, frequent hand washing and sanitization of equipment, and safeguarded exams. Signage is posted throughout the building as a reminder about health, safety, and social distancing protocols. Plexiglass shields are present for the patient and provider protection in the lobby and at all front desk/receptionist areas.
“We are taking all the necessary safety precautions before and during the exam. Children and parents will be required to complete a screening questionnaire before their visit and have temperature checks in the facility’s lobby. If guests arrive without a face covering, we do provide masks, including some fun Disney masks for our young patients,” explains Dr. Amster. “In turn, you can expect to see our doctors and staff wearing surgical masks and either face shields or goggles, as well as using instrument shields as physical barriers during examinations, testing procedures, and when taking measurements in the eyewear center.”
Before the exam starts, you will be asked about your child’s history, including general health, family history, activities, eye problems, and other medical issues. If your child is old enough, the doctor will probably talk with them to help the child feel more comfortable.
The pediatric exam will include a battery of tests to examine the following areas of vision:
- Vision (visual acuity) to determine how well your child sees at different distances using a standard eye chart with letters, or shapes for younger patients.
- Depth perception which includes a test using 3-D glasses to identify pictures that are seen or not seen. The exam can be done without the use of glasses if the child is apprehensive.
- Color vision using a test that requires the child to identify shapes on colored plates.
- Pupils to check how your child’s eyes respond to light. The doctor will shine a bright light in each eye to see if the pupil reacts normally.
- Eye movement and coordination to see how well a child follows a target in different directions using a small letter/picture or toy, as well as the child’s ability to pull in or converge their eyes. Side or peripheral vision is also assessed.
Refraction is the part of an eye exam that determines how well your child sees at different distances and will help determine if your child needs glasses. In older children, the exam is done using a phoropter, a testing device that uses different lenses to assess a refractive error and eyeglass prescription if necessary. Retinoscopy is another method that involves shining a light into the patient’s eye to observe the retina’s reflection to determine the prescription. “It is an approach that can objectively find a prescription particularly for patients who are young, have a difficult time communicating, or have special needs,” explains Dr. Amster.
A final part of the exam includes a check for eye disease, which involves pupil dilation. This procedure, which uses drops to widen (dilate) the pupil, allows the doctor to see the retina and optic nerve at the back of the eye. Although sometimes a scary part of the exam for kids (and adults), says Dr. Amster, dilation is an important procedure that allows the doctor to check for eye disease and obtain an accurate prescription measurement.
“To help kids prepare for the exam and decrease anxiety, we are working on creating social stories that will provide the child with a pictorial and narrative description showing what to expect from start to finish in advance of the eye exam.”
Depending on the child and circumstances, parents can rest assured the eye exam may not have to be completed all in one visit. “Some parents opt to split the examination into two separate visits to make it easier for the child and all involved. Our commitment is to the patient’s well-being and comfort to achieve the best results for healthy vision,” stresses Dr. Amster.
Telehealth is available for urgent care matters and upon request. To schedule an appointment or more information about the Pediatric Eye Care Center at the UEC, visit www.sunyopt.edu or call 212-938-4001. Referrals are also accepted and welcomed.
Organization contact: Adrienne Stoller, communications@sunyopt.edu, 212-938-5600
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About SUNY Optometry
Founded in 1971 and located in New York City, the State University of New York College of Optometry is a leader in education, research, and patient care, offering the Doctor of Optometry degree as well as MS and PhD degrees in vision science. The College conducts a robust program of basic, translational, and clinical research and has 65 affiliated clinical training sites as well as an on-site clinic, the University Eye Center. SUNY Optometry is regionally accredited by the Commission on Higher Education of the Middle States Association of Colleges and Secondary Schools; its four-year professional degree program and residency programs are accredited by the Accreditation Council on Optometric Education of the American Optometric Association. All classrooms, research facilities and the University Eye Center, which is one of the largest optometric outpatient facilities in the nation, are located on 42nd Street in midtown Manhattan. To learn more about SUNY Optometry, visit www.sunyopt.edu