Focusing On Early Childhood Eye Exams



#LetsTalkThursday gives us as Eye Care Professionals, an opportunity to focus on important topics every Thursday. Today as a kick off to our #EyeCareAboutSchool month we will be looking at Early Childhood Eye Exams and why they are so important for school-aged children.


In Ontario, all children up to the age of 20 are entitled to a yearly eye exam under OHIP.

The Canadian Optometrists Association recommends that :

  • Infants and Toddlers should undergo their first exam between 6 to 9 months of age

  • Preschool aged children should undergo at least one exam between 2 to 5 years of age

  • School aged Children should undergo an exam annually from ages 6 to 19

Unfortunately, only 1 in 10 children have their eyes tested before entering into school. This is problematic as children's vision continues to develop until age eight, and if certain visual issues are not addressed early on they could lead to permanent vision loss.

There are more easily identifiable problems, like strabismus (cross eyed) where one or both eyes are visibly turned inwards or outwards. Strabismus occurs when the eye muscles are pointing the eyes in the wrong direction. Ambylopia (lazy eye), on the other hand does not necessarily present obviously. Amblyopia occurs when there is decreased vision in one or both eyes and there will be a lack of stimulation in the nerve pathways. In the case of amblyopia, the brain will favour one eye's image over the other. One eye compensates for the weaker eye and the brain will eventually "turn-off" the visual pathways for the under responsive eye.


The possibility of vision loss is not the only reason to have your child's eyes tested each year.

If a child is struggling with classroom work or acting out in class often a teacher will recommend a behavioral evaluation, however adding a trip to behavioral optometrist might be a good place to start to rule out any undetected vision issues.

Children who have symptoms of ADD/ADHD may, in fact, have vision difficulties. Every year studies are being conducted not only on how vision difficulties affect children with ADD/ADHD, but also how many children with vision difficulties are being misdiagnosed with ADD/ADHD. "Children with vision problems were nearly twice as likely to have been diagnosed with ADHD, compared to those who hadn't." (American Optometric Association)

Many of the symptoms of ADD/ADHD are linked to convergence insufficiency, tunnel vision, and focusing/tracking disorders. According to Vision For Life, a vision therapy clinic located in Glen Carbon, IL., many of the symptoms of ADD/ADHD present similarly in :

Convergence Insufficiency (CI)

  • Affects about 20% of the population

  • Trouble converging the eyes together for near work such as reading and homework

  • Causes discomfort when doing near work, and the patient can usually only concentrate for a short time before becoming fidgety

  • A high number of patients diagnosed with ADHD actually have CI instead, which is treatable with vision therapy.

Tunnel Vision

  • Restricted peripheral or “side” vision

  • When reading, someone with tunnel vision can focus only on one word at a time and cannot scan ahead to the next word or track across the page.

  • Near work such as reading and homework is frustrating, time-consuming and often leads to inattentiveness and hyperactivity.

  • Studies have proven there is a high incidence of tunnel vision in persons diagnosed with ADHD.

  • In most cases, vision therapy can widen the field of vision.

Focusing – Eye Teamwork – and Tracking Disorders

  • Many people unknowingly have these problems and subconsciously compensate.

  • Any one or all of them together will produce symptoms that are mistaken for ADHD.

  • Trouble focusing causes a child to become agitated and avoid near work.

  • Poor eye teaming forces one eye to do most of the work, and it becomes overwhelming for the child.

  • Tracking disorders react much the same way as tunnel vision above.


How will a parent know that their child needs an eye exam?

Because it is available to every child, an annual eye exam is the best preventative measure for vision loss. A new eye exam might be in order if you find that your child is starting to:

  • Squint and rub their eyes

  • Hold objects, books, and electronics abnormally close to their face

  • Lose interest in activities that are distance based

  • school performance decreasing when there was no issue before


When it comes to vision, when in doubt check them out!

See you next Thursday!




Sources:

https://opto.ca/health-library/frequency-of-eye-examinations

https://www.aoa.org/news/clinical-eye-care/spotting-the-link-between-vision-problems-and-adhd#:~:text=Children%20with%20vision%20problems%20were,vision%20problems%E2%80%94perhaps%2C%20Dr.

https://www.healthlinkbc.ca/healthlinkbc-files/elementary-children-vision

https://aapos.org/glossary/amblyopia

https://visionforlifeworks.com/blog/2014/09/30/really-adhd-treatable-vision-problem/