Eyecare for Children

Infant's VisionYour baby has a whole lifetime to see and learn.  But did you know your baby also has to learn to see?  When babies are born, their visual systems are not fully developed.  In order for vision to develop normally, both eyes have to be used and seeing clearly.  As a parent, there are many things that you can do to help your baby’s vision develop properly.

At about six months of age, you should take your baby to a pediatric optometrist or opthalmologist for his or her first eye examination. They will check for excessive or unequal amounts of focussing errors such as nearsightedness, farsightedness, and astigmatism.  Misalignment of the eyes, eye movement disorders, as well as other eye health problems will also be checked for.  While not common, these problems need to be identified early on and corrected in order to ensure your child's vision develops properly.

Unless you notice a need, or your child’s eye doctor advises you otherwise, your child’s next eye exam should be around age three, and then again before he or she enters school.

Your baby should begin to follow moving objects with the eyes and reach for things, first by chance and later more accurately, as hand-eye coordination and depth perception begin to develop.  Measures that can help:

  • Use a nightlight or other dim lamp in your baby's room
  • Change the crib's position frequently and your child's position in it
  • Keep reach-and-touch toys within your baby's focus, about eight to twelve inches
  • Talk to your baby as you walk around the room
  • Alternate right and left sides with each feeding
  • Hang a mobile above and outside the crib

Your baby should begin to turn from side to side and use his or her arms and legs.  Eye movement and eye/body coordination skills should develop further and both eyes should focus equally.

  • Enable your baby to explore different shapes and textures with his or her fingers
  • Give your baby the freedom to crawl and explore
  • Hang objects across the crib
  • Play "patty cake" and "peek-a-boo" with your baby

Your baby should be mobile now, crawling and pulling himself or herself up.  He or she will begin to use both eyes together, judge distances, and grasp and throw objects with greater precision.  To support development, don't encourage early walking.  Crawling is important in developing eye-hand-foot-body coordination.  Give your baby stacking and take-apart toys and provide objects your baby can touch, hold, and see at the same time.

Your child's eye-hand coordination and depth perception will continue to develop and he or she will begin to understand abstract terms.  Things you can do:

  • Encourage walking
  • Provide building blocks, simple puzzles and balls to play with
  • Provide opportunities to climb and explore indoors and out

There are many other affectionate and loving ways in which you can aid your baby's vision development.  Use your creativity and imagination.  Ask your eye care professional to suggest other specific activities.

Recommended Link

All About Vision: Children's Vision Care Information

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Pre-School Vision

During infant and toddler years, your child is developing many visual skills.  In the preschool years, this process continues, as your child develops visually guided eye-hand-body coordination, fine motor skills, and the visual motor skills necessary to learn to read.

Preschool Vision

As a parent, you should watch for signs that may indicate a vision development problem, including:

  • A short attention span for the child's age
  • Difficulty with eye-hand-body coordination in ball playing and bike riding
  • Avoidance of coloring and puzzles and other detailed activities

There are everyday things that you can do at home to help your preschooler's vision develop.  These activities include:

  • Reading aloud to your child and letting him or her see what you are reading
  • Providing a chalkboard, finger paints, and different shaped blocks and showing your child how to use them in imaginative play
  • Providing safe opportunities to use playground equipment like a jungle gym and balance beam
  • Allowing time for interacting with other children and for playing independently

Your child should have a thorough eye examination to make sure your preschooler's vision is developing properly and there is no evidence of eye disease.  If needed, your doctor can prescribe treatment including glasses and/or vision therapy to correct a vision development problem.  Several tips to make your child's eye examination a positive experience:

  • Make an appointment early in the day
  • Allow about one hour
  • Talk about the examination in advance and encourage your child's questions
  • Explain the examination in your child's terms, comparing the E eye chart to a puzzle and the instruments to tiny flashlights and a kaleidoscope

Unless recommended otherwise, your child's next eye examination should be at age five.  By comparing test results of the two examinations, your eye doctor can tell how well your child's vision is developing for the next major step....the school years.

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School-Age Vision

A good education for your child means good schools, good teachers, and good vision.  Your child's eyes are constantly in use in the classroom and at play.  So when a child's visual system is not functioning properly, learning and participation in activities will suffer.  The basic vision skills needed for school use are:

  • Near Vision: The ability to see clearly and comfortably at 10-13 inches
  • Distance Vision: The ability to see clearly and comfortably beyond arm's reach
  • Binocular coordination: The ability to use both eyes together
  • Eye movement skills: The ability to aim the eyes accurately, move them smoothly across a page, and shift them quickly and accurately from one object to another
  • Focusing skills: The ability to keep both eyes accurately focused at the proper distance to see clearly and to change focus quickly
  • Peripheral awareness: The ability to be aware of things located to the side while looking straight ahead
  • Eye/hand coordination: The ability to use the eyes and hands together accurately

If any of these vision skills are lacking or not functioning properly, your child will have to work harder.  This can lead to headaches, fatigue, and other eyestrain problems.  As a parent, be alert for symptoms that may indicate your child has a vision or School-Age Visionvisual processing problem.  Be sure to tell your optometrist if your child frequently:

  • Loses their place while reading
  • Avoids close work
  • Holds reading material closer than normal
  • Tends to rub their eyes
  • Has headaches
  • Turns or tilts head to use one eye only
  • Makes frequent reversals when reading or writing
  • Uses finger to maintain place when reading
  • Omits or confuses small words when reading
  • Consistently performs below potential

Since vision changes can occur without you or your child noticing them, your child should visit the optometrist at least every two years, or more frequently, if specific problems or risk factors exist.  If needed, the doctor can prescribe treatment including eyeglasses, contact lenses, or vision therapy.  Remember, a school vision screening or pediatrician's screening is not a substitute for a thorough eye examination.

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Protective Eyewear

Please don't overlook the importance of safety eyewear when playing sports.  Each year, hundreds of men, women, and children are injured when playing sports.  To help prevent sports eye injuries, children as well as adults should use protective athletic eyewear whether or not a prescription is needed.  Any injuries to the eyes or head should be evaluated immediately at a hospital emergency room or by an eye care professional.

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Children & Contact Lenses

The important thing for parents and their children who wear contact lenses to remember is that contacts are prescribed medical devices and are not a cosmetic accessory.  Contact lenses worn by children can build self confidence especially if the child is active in sports or not happy with wearing glasses.  Lenses need to be properly fitted to the eye and it is extremely important that the lenses be properly cleaned and worn according to the instruction of the optometrist.  Sight threatening eye infections can result from improper use and care of the lenses. 

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Eyecare Over 40

PresbyopiaAs people reach their mid 40s, a condition called presbyopia can set in.  Presbyopia is the loss of ability to focus at near as we age.  Needing to hold things further away or needing more light to read are typical symptoms.  Wearing bifocals, progressive lenses, or reading glasses are common ways to remedy this condition.  Contact lenses are also available to correct presbyopia.

Presbyopia is a natural consequence of getting older and there is no cure.  Even if a person has never had vision problems before, he or she will still develop presbyopia.  While symptoms can present suddenly, presbyopia usually occurs over a period of time.  

Single vision or single focus reading glasses are the simplest way to correct the blur and strain caused by presbyopia.  They provide a large reading area, are widely available, and are usually the least expensive option to correct near vision problems.  The main disadvantage is that reading glasses only allow clear vision for close distances so they have to be removed when looking further away.  Some individuals also do not like the cosmetic appearance of wearing reading glasses.

Recommended Link:
All About Vision: Reading Glasses

For many presbyopes, lined bifocal or trifocal glasses are a good option.  They allow clear vision at far, intermediate (trifocal), and near distances without having to take the glasses on and off throughout the day.  The top section is for far, the middle section (trifocal) is for intermediate, and the bottom segment is for reading.  Each area is well delineated so it is relatively easy to access the section of the lens needed for the distance one is viewing.  Many individuals, however, do not like the cosmetic appearance of the visible lines.  Some also find the abrupt change in power between each section visually uncomfortable.

No-line multifocal or progressive lenses are designed to address these issues.  Since there are no visible lines, it is cosmetically more acceptable and the transition from far to near is graduated and smoother.  As with any multifocal glasses, line or no lines, there is always a period of adjustment with new wearers who have to learn to use them properly.  Small head movements are often needed in order to access the portion of the lens that is needed for the distance that is being viewed.  Over time, these head movements become more natural and finding the "sweet spots" in the lenses easier. 

Recommended Link:
All About Vision: Bifocals

Individuals who normally wear contact lenses often prefer not to wear reading glasses when they become presbyopic.  Several contact lens options are available for presbyopia.

Monovision Contact Lenses
Monovision is a method of fitting one eye with a contact lens for far vision and the other eye for near vision.  There is often a period of adjustment when someone is trying monovision contact lenses for the first time.  Your visual system has to learn to use one eye or the other for what it needs to see.  It works best for individuals who have a varied work day, performing tasks that are both far and near.  Someone who spends the whole day reading or working in front of a computer or someone who drives alot may not be a good candidate for monovision.  Monovision can make driving less safe since only one eye sees far distances clearly.  Long hours in front of the computer will likely cause eyestrain as only one eye is being used for near.

Multifocal Contact Lenses
Multifocal contact lenses have progressive-like optics that allow patients to see well at far, intermediate, and near distances.  They are available as soft lenses, disposables, as well as rigid gas permeable lenses.  Their obvious advantage over monovision is that both eyes are being used at the same time for all distances.  Individuals trying them for the first time should expect to go through an adaptation period. 

While many patients can successfully wear monovision or multifocal contact lenses, it is important to have realistic expectations with these lenses.  Multifocal contact lens technology is still evolving and improving every year.  However, they do not provide "perfect" vision at all distances.  Fitting them requires finding the right balance between far, intermediate, and near vision and this balance differs for each patient.  For example, someone who never drives but spends a good portion of their day at their desk will be better off having the contact lenses prescribed to favor near vision.  Distance vision is often less clear as a result. 

Individuals should also realize that while these presbyopic contact lenses will reduce the need for reading glasses, it will not completely eliminate it.  There will be times when reading glasses will be necessary such as for fine print or when the lighting is dim.  Eyes also become drier as we get older.  Presbyopic individuals often find that their contact lenses have become less comfortable and are unable to wear them for long hours.  Trying new lens materials, using eye drops, and wearing glasses even for part of the day can help alleviate dry eye symptoms.

Annual eye exams are recommended after age 40.  In addition to the continuing changes in vision due to presbyopia, the risk for developing certain eye diseases such as Glaucoma increases after age 40 especially for individuals with a family history.  High Blood Pressure and Diabetes, which can potentially affect the eyes, may also manifest after the age of 40 so routine check ups with your general physician are also important. 

Recommended Link:

All About Vision: Monovision
All About Vision: Bifocal Contacts

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Eyecare Over 60

The changes in your vision due to presbyopia that started in your 40's generally stabilizes in your 60's.  You may notice that your eyeglass prescription does not need to be changed as often.  However, annual or more frequent eye exams are recommended as the risk for eye diseases greatly increases over age 60.  Cataracts may develop to a point where it affects vision and surgery may be needed.  Dry eye symptoms may worsen with age and may need more aggressive therapy.  Glaucoma and Macular Degeneration in individuals with high risk factors may begin to manifest.  Diabetics who, by this age, may have had the disease for ten to twenty years may show signs of retinopathy.  Treatment and/or frequent follow ups to monitor these conditions may be needed.  As with all eye diseases, early detection is the key to preserving vision.  

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Office Details

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25 West 43rd Street, Suite #316
New York, NY 10036
Tel: (212) 852-4880  Fax: (212) 320-0368


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