Seeing Eye to Eye

Written by: Lianne Castelino

Published: Oct 24, 2010

How Well Can Your Child See?  How can parents help their children prepare for a trip to the optometrist?  What should the child expect?

This is a guest article by Dr. Catherine Chiarelli, Pediatric Optometrist, Member of the Ontario Asociation of Optometrists.

A comprehensive eye examination includes assessment of vision at distance and near, refractive error (nearsightedness, farsightedness, astigmatism), eye co-ordination / focusing and eye health.

Your child will be asked to name (or point to, or match) letters, numbers or pictures at near and far distances. This usually is done with both eyes open and then again with one eye at a time.  Your child also may be asked to look through different glasses, including 3D glasses, and to report what he/she sees.  Older children will look through a phoroptor which looks like a giant eye mask with many lenses and knobs that is used to determine eyeglass prescriptions.  Lights will be used to look into your child’s eyes to examine them.

Sometimes eyedrops are used to dilate the pupils first, so that a more thorough assessment can be made.

For very young children, it is advisable to schedule an examination at a time of day when your child is usually awake and alert.  Bring one of your child’s toys or another familiar item to the exam, to comfort your child if he/she becomes anxious or upset.

What are some warning signs parents can be on the lookout for that their child might have a vision problem?

Your child may have a vision problem if he/she:

•        squints or tilts/turns head when looking at things

•        has one eye turned in or out

•        has headaches, dizziness, nausea, motion sickness

•        has watery or crusty eyes

•        has red or swollen eyelids

•        rubs eyes frequently

•        has a short attention span for detailed / close work

•        frequently loses place while reading

•        writes/ prints with irregular sizing, spacing

•        becomes easily frustrated with visual tasks

•        has learning difficulties

•        has risk factors for vision problems:

•        exposure to maternal infections (ex – rubella, toxoplasmosis) before birth

•        premature birth

•        complications during delivery (ex – long labour, oxygen deprivation)

•        childhood illnesses (ex – high fever)

•        genetic conditions (ex – Down Syndrome)

•        cerebral palsy

•        hearingimpairment

•        family history of high refractive error, strabismus, amblyopia

What eye related conditions are common / not common in young children?

The incidence of vision problems in preschoolers is 10%; this increases to 25% in older children.  Children with risk factors (as identified above) have a much higher incidence of vision problems – up to 80-90%.

Potential vision problems in children include refractive errors, strabismus (turned eye), colour vision deficiency (found in 8% of boys), blocked tear duct, conjunctivitis (pink eye), ocular allergies, and congenital eye diseases or abnormalities.

The most common cause of permanent vision loss in children is AMBLYOPIA (lazy eye), which may occur
when vision problems are not identified and corrected soon enough.  The most critical period for vision
development is from birth to 4 years – therefore comprehensive eye care is important from an early age.

Why is it so important a child should have their eyes checked before going to school?

Eighty percent (80%) of what children learn in early years is acquired through the visual processing of information.  Vision impacts upon the development of:

•        Gross and fine motor skills

•        Language skills

•        Interaction and social skills

•        Behavior, concentration

•        Learning skills

•        Athletic ability

A child whose vision problems are identified and corrected before starting school has the best chance to develop to his/her full potential.

 Eye See…Eye Learn

In the school year ending in 2009, only 25% of children between the ages of five and nine received an eye exam by an optometrist and only 7% under the age of four. Due to these troubling statistics, the Ontario Association of Optometrists started the Eye See…Eye Learn program in Ontario which had its roots in Alberta. The Eye See…Eye Learn program offers OHIP-insured eye exams to junior kindergarten children and free eyeglasses, if the child requires them. The program is currently running in Halton, Hamilton Wentworth, Peel, and Windsor Essex. To find participating Eye See..Eye Learn optometrist or for more information on the program visit




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