WHY ROUTINE EYE EXAMS ARE IMPORTANT FOR SCHOOL SUCCESS

The Center for Pediatric Eye Care at the University Eye Center keeps kids focused on learning

New York, NY— Did you know that over 5 million children in the U.S. struggle to learn because of an undiagnosed vision problem? As kids ready for school this year, eye exams are more important than ever as children shift their focus from their home computer screen to the classroom Smartboard.

“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 University Eye Center (UEC). “It is essential to have your child’s vision checked regularly.”

Launched in 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 exam rooms, a specialized children’s optical for eyeglass dispensing, and a waiting room for sensory-sensitive children (called a Chill Room). The center accommodates the growing need for basic and advanced pediatric eye care at 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 in kids

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.”

Dr. Amster pointed to recent study that suggests home confinement due to COVID-19 may be associated with an increase in myopia in children aged 6-8 years. In fact, the prevalence of myopia increased 1.4 to 3 times in 2020 compared with the previous 5 years.  “Younger children’s eyesight may be more sensitive to environmental changes than older children given that they are in an important period for the development of myopia,” says Dr. Amster. 

In addition to myopia, 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. 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 

The pediatric exam will include a battery of tests to examine several areas of vision, says Dr. Amster. These include:

  • 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 using drops to widen (dilate) the pupil allows the doctor to see the retina and optic nerve at the back of the eye. Although a scary part of the exam for some 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.  

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. At the UEC, our commitment is to the patient’s well-being and comfort to achieve the best results for healthy vision,” stresses Dr. Amster.

To schedule an appointment or for more information about the Center for Pediatric Eye Care Center at the UEC, offering services for patients of all ages, visit sunyopt.edu or call 212-938-4001. Telehealth is available upon request. Referrals are also accepted and welcomed.

Updated: August 5, 2021

Organization contact: Adrienne Stoller, communications@sunyopt.edu, 212-938-5607

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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