What can my baby really see?
Vision actually begins at birth. Studies indicate that newborns can distinguish contrasting colors and moving patterns, and may respond visually to the mother’s face. From here, vision begins developing rapidly. Clear focusing on objects begins by six weeks of age and fully matures around four months. The most critical period for development of the visual system is from birth to age 3 years. However, the vision system continues to experience tremendous change up to age seven.
Childhood represents the most destructive time for eyeglasses! Children’s frames must be exceedingly durable, safe, attractive, fit correctly and comfortably. Higher quality component parts and a greater degree of difficulty is required to make a frame for a child that can last until outgrown.
Most adult eyewear functions to help the person see while wearing the glasses. Childhood represents the only time eyeglasses can have a positive effect on visual outcome. Quite simply, eyewear for children must perform better and last longer.
While vision coverage can benefit adults, coverage for children is less complete. Children are examined more frequently, outgrow the frames, and have prescription changes more frequently than typically allowed by more carriers. Vision insurance typically covers about 50% of the costs incurred only about 50% of the time.
Sometimes, medical insurance will cover eyeglasses. It is strongly suggested that parents, especially parents of very young children for whom glasses have been prescribed to treat an associated eye condition, submit a claim through their medical carrier. The claim will probably be denied at least once and may go to arbitration. However, once approved, coverage will be much more inclusive and allow the more frequent Rx changes needed to treat the condition.
Because of the liberal replacement policy at A Child’s View, we have not found any replacement insurance to be cost-effective. There is typically a deductible for each part that is replaced and this deductible when added to the annual premium far exceeds the replacement fee charged at A Child’s View. Although replacement insurance may be worthwhile if the glasses are lost, we replace glasses less for loss than any other reason!
All children should receive a newborn eye evaluation. An infant can be checked for congenital cataracts, tumors, pupillary reactions, shape and size of the cornea (the clear covering at the front of the eye), eye movements, and more.
The next eye examination is often recommended at six months of age. By this time, vision is adequate to include more sophisticated testing. After the newborn and six month examinations, the child is checked at age three years, followed by both a preschool and a school-age examination. Once a child has reached elementary school age, eye examinations are recommended every one or two years.
Even if the pediatrician has not found a problem or the child’s symptoms are deemed normal, any time a parent suspects a vision abnormality—especially if the child is considered “at risk”, the child should be checked by a pediatric eye specialist. By erring on the side of caution, little is lost and much can be gained.
A school screening and a screening done by the pediatrician during routine “well-baby” checks are important and vital tools. However, neither are substitutes for thorough eye examinations conducted by a pediatric ophthalmologist or pediatric optometrist. Since the visual system is most sensitive from birth to age 7 years, waiting for a school vision evaluation may be too late to treat strabismus during this sensitive period. Serious ocular-medical diseases also can be present with relative innocuous symptoms.
Children at risk for eye problems include children with developmental difficulties, those with familial ties to vision problems, those born prematurely or with low birth weight, children with HIV or diabetes and other whole body diseases. (Whole body diseases are those that affect the organs and tissues throughout the body.)
The choice of an ophthalmologist or optometrist is a personal one. According to Patricia Lemer, M.Ed., “Both types of eye doctors examine and prescribe glasses, diagnose and treat eye disease, and can evaluate how well a person uses the eyes together. However, each profession is unique.” (1)
The American Association for Pediatric Ophthalmology and Strabismus explains that “Pediatric ophthalmologists are medical and surgical doctors who specialize in the eye problems of children. In particular, vision develops in the brain until about age 9 years and can be affected by eyes that are not straight or do not focus correctly. A child can grow up with good vision in each eye if these problems are caught early, treated and maintained.” (2)
In their clinical guideline, the American Optometric Association offers that “Doctors of optometry are independent primary health providers who examine, diagnose, treat, and manage diseases and disorders of the visual system, the eye, and associated structures as well as diagnose related systemic conditions.” (3). Optometrists who specialize in pediatrics are highly regarded for their ability to integrate vision and visual development.
Insurance coverage may be another factor in determining which type of doctor to see. Check with your adult provider for referrals and suggestions and check with your insurance carrier for coverage. It is always more lucrative to file a claim with your medical carrier instead of your vision provider. Vision coverage, which may be effective for adults, typically covers about 50% of the costs incurred only 50% of the time.
- Experts, More Ophthalmology & Optometry Questions (2009) at: http://en.allexperts.com/q/Ophthalmology-Optometry-979/difference-optomotrist-opthalmologist.htm.
- American Association for Pediatric Ophthalmology and Strabismus, Understanding The Difference Between Eyecare Professionals, (San Francisco, CA: Children’s Eye Foundation, 2009), at http://www.aapos.org/displaycommon.cfm?an=3.
- Optometric Clinical Practice Guideline, Pediatric Eye And Vision Examination (St. Louis, MO: American Optometric Association, 2002).
Strabismus is a generic term indicating that the eyes do not point in precisely the same direction. Its cause is unknown. Strabismus is present in about 4% of the population
Amblyopia, commonly known as lazy eye, is a condition of reduced sight, usually in one eye, resulting from poor visual stimulation during the first few years of life. It affects 2-4% of the population. Amblyopia is responsible for loss of vision in more children than any other form of ocular disease.
All forms of strabismus threaten visual function and cannot be outgrown
Go to www.WillMyChildActuallyWearTheseGlasses.com to find the most complete text on children’s glasses ever written for the parent.
Parents can judge adequate thickness by feeling the lenses at the thinnest point. For farsighted children, this usually is along the temporal (outer) edge of the glasses. For nearsighted children, this usually is the center of the lens. At its thinnest, the lens should not exceed the thickness of the frame. This rule does not apply to children who are prescribed prism in their lenses. Since the thickness of a lens is controlled at its thinnest point, the subsequent thickness is an effect of the child’s size, the frame selected and the prescription itself.
Since children’s eyes are particularly vulnerable to the sun’s UV radiation, they need to wear good quality sunglasses. Better quality lenses with higher UV absorbing properties, in both prescription and non-prescription form, should be placed on children in their infancy and should continue to be worn into adulthood. As Bill Sardi, President of Eye Communications, wrote, “Whereas the cornea and lens of the human eye can be surgically replaced, there is, as yet, so such thing as a retinal transplant. Only two retinas are issued per newborn, and they have to last a lifetime” .
 B. Sardi, “Sunlight and Your Baby’s Eyes,” public health information pamphlet (Monrovia, CA: Eye Communications, 1989).
Eye injuries are the leading cause of blindness in children and sports is the leading cause of eye injuries in school-age children. Of the 100,000 sports-related eye injuries occurring each year, it is estimated that the frequency and severity of these injuries could be reduced by 90% with the use of protective eyewear. Sports glasses should be worn whenever a child is actively engaged in an organized or recreational sport, when riding a bicycle, and during physical education at school.
Sport glasses will never be as comfortable as regular (dress) glasses because they must fit snugly causing the child to feel “hot and sweaty.” Most parents have to insist the glasses be worn. Once a child has been stitched up in the emergency room or has suffered through the treatment for a broken nose, he will be more willing to wear the sport glasses. But, what a way to learn! No sport glasses? No sport.
Go to www.WillMyChildActuallyWearTheseGlasses.com to find the most complete text on children’s glasses ever written for the parent!