Eye Care in Children - Ophthalmologist, optometrist or an Optician - Health Education - DesiMD Healthcare - India

Eye Care in Children

Dr.Renu Grover profile Authored by Dr.Renu Grover on 18 Jul 2014 - 15:53.


Getting a child's eye examined is important, but difficult to say when or if the child should get an eye exam done. However if the child is taken for a general well-check-up, sometime useful information about the child's eye health comes to the fore. Let's find out more about the child eye-care from Dr. Renu Grover, MBBS, MS (Ophthalmology), FICO, FESA, Consultant at Center for Sight Hospital, New Delhi.

When should the child get the first eye examination done?

The first eye examination of the child may be performed by a paediatrician in early infancy when the child visits for a regular check-up. The external eye examination and a red reflex test is an easy test performed by the paediatrician. The first eye examination for vision screening should be done at the age of 4-5 years or at school entry age. If the child has a family history of vision problems, the child must be taken for a proper eye examination from an ophthalmologist.

What are the tests that the child may undergo?

The child must undergo the following:

  • Vision testing
  • Refraction (if required)
  • Test for eye movements and squint
  • Intraocular pressure
  • Fundus (retina) examination

Who should a child go to,for an eye exam,to an ophthalmologist,an optometrist or an optician?

For vision screening, the first contact of the child may be with an optometrist, who if required, may refer the child to an ophthalmologist. To clarify, the jobs of an optometrist, ophthalmologist and an optician are different and significant:

  • Optometrist
    An optometrist is a health care professional who can provide complete eye exams, prescribe corrective lenses, diagnose common eye disorders, and treat selected eye diseases. They do not treat more complex eye problems or perform surgery.
  • Ophthalmologist
    An ophthalmologist is a medical doctor who provides eye care, such as complete eye exams, prescribes corrective lenses, diagnoses and treats eye diseases and performs eye surgery.
  • Optician
    An optician assembles fits and sells eye glasses.

    What are the common eye problems seen among children?

The common eye problems seen among children include:

  • Refractive errors occur when the eye is slightly not in shape and causes blurry vision. They are of 3 types:

o    Long sighted: or hyperopia, is poor near-vision and is usually treated with glasses.

o    Short sighted: also known as myopia or poor distance vision. Short sight is usually treated with glasses.

o    Astigmatism: is an abnormal curve of the front surface of the eye and is treated with glasses.

  • Lazy eye (Amblyopia): This is poor vision in an eye, sometimes also called as Lazy Eye. If not treated in childhood, amblyopia can lead to permanent vision loss.
  • Squint : Misalignment of eyes
  • Infections like conjunctivitis, stye (a small lump inside/outside the eyelid), cellulitis (bacterial skin infection)
  • Tear duct blockage
  • Trauma, such as corneal abrasions
  • Ptosis, also known as Heavy Eyelid. 

    What are the possible symptoms of vision problem in children?

The child is usually unable to verbalize that he is seeing less. Some symptoms that the parents might notice are:

  • Bumping into furniture and walls
  • Holding objects too close to their nose to see
  • Rubbing eyes a lot, frequent squinting
  • Using one eye and closing the other
  • Not focussing the eyes together
  • Unable to see the writing on the board in the class etc.

    What can be expected during an eye exam?

The complete eye examination may require dilatation of the pupils, i.e. eye drops are put in the eye 3 times before completing the examination. This process may require about an hour. There are various types of test that are done some of them are:

  • Visual acuity testing: Using an eye chart, the examiner asks the child to read numerous lines of characters to test each eye separately.
  • Inspection of the eye: the eyes and eyelids are inspected, examines the various eye muscle movements, and the pupils and the reflection of light from the back of the eye.
  • Ophthalmoscope: In children, the back of the eye is examined.
  • Can all the problems be treated?

The child may be suffering from certain developmental anomalies of the eye or some retinal problems which may be hereditary and may not be possible to treat. However, the symptoms can be managed.

What are the tips to follow if the child needs to wear glasses?

The parents need to be told the following:

  • The child should wear glasses all the time ,and not just for reading or watching television.
  • The frame should be comfortable and well-fitting and not sliding down the child's nose,so that he sees through the glass and not over it.
  • The child should undergo regular eye examinations at least one a year.

Children's eye exams are extremely important for overall health of the child and therefore should not be ignored or taken casually.

*Disclaimer: This is not medical advice. The content is for educational purposes only. Please contact your doctor for any health care issues.