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Do You See What I See?
Diagnosing Vision Problems in Toddlers By Tamar K. Weiss
ormed again, and the physician will carry out an occlusion of each eye separately. In this test, the physician will place a patch or a hand over each eye in turn and see how the baby reacts. If the baby has a weak eye, he or she will presumably show some sign of discomfort or annoyance when the stronger eye is covered, limiting vision. At this age a "fixation and following" test is also performed: the physician places a toy or image several inches from the baby's face and moves it in different directions in an effort to notice whether the baby is able to fixate on and follow the image.
The next series of vision screenings is performed at approximately 3 years of age. Again the red reflex and corneal light reflexes are tested, and a "visual acuity" test will also be carried out, where the child uses each eye separately to identify pictures and "E"s facing in different directions difficult even for toddlers with no vision problems. Dr. Krantman stresses that it is very important that the child be made aware that no matter how he or she performs on these tests, it is OK there should be no pressure involved. The parents and physician should make equally sure that the child does not peek while taking this exam.
These examinations, recommended and endorsed by the AAO and AAP, are carried out at well baby checkups, assuming that the child has normal vision from one series of tests to the next. If at any point any irregularities are noticed, the physician will most likely advise the parents to make an appointment with an opthalmologist.
There are certain warning signs that a parent or caregiver can look for. Dr. Michael Redmond, a pediatric opthalmologist, speaking on behalf of the American Academy of Opthalmology, notes that "most parents are quite observant as to whether or not their children seem to be seeing as they expect," but parents should ask themselves:
- Does your toddler have straight eyes and straight head position when looking at things?
- Is there uncontrolled eye jiggling?
- Does your toddler exhibit unusual light sensitivity?
- Are your toddler's pupils clear and not white?
- Do the eyes tear frequently?
