Importance of annual vision screening in children

09 June 2022

Stephanie Vasquez, MD. Pediatric Ophthalmology, Strabismus and Pediatric Cataract Specialist

Every year, most schools ask parents of students for a pediatric ophthalmologic evaluation as part of the enrollment requirements, and this is done with the objective of detecting if there is any vision problem typical of childhood.

Pediatricians also recommend that parents take their children for an eye exam because early childhood is a time when vision problems that may not be addressed in adolescence and adulthood can be treated. These are good measures to be able to timely identify problems that children may have with their vision and have the opportunity to treat them successfully.

But we cannot leave this responsibility to schools, teachers or pediatricians, parents should also be interested in the visual health of our children, and attentive to any warning signs of a vision problem. A timely eye exam is essential for preventive eye care, especially in families with a history of vision problems or eye disease.

It is important to take infants and children for a pediatric ophthalmologic evaluation because there are many silent eye pathologies that do not present symptoms or any type of manifestation, and that could only be diagnosed if the ophthalmopediatrician examines them. In addition, it is very difficult for a baby to manifest that he/she has a visual difficulty or for a pre-verbal toddler to express that he/she does not see well. You don't have to wait until they learn to talk before they can complain about something regarding their vision or eyes.

Understanding the importance of being attentive to these signs that children may manifest, we will mention some relevant warning signs:

• Not making steady eye contact with an object or when spoken to.
• Frequent rubbing or squeezing of the eyes.
• Constant or very marked blinking.
• Eyes that look strange in photos (dull despite the flash or deviated).
• Red or watery eyes.
• Constant tearing of only one eye.
• High sensitivity to light when turned on at night or when exposed to the sun.
• Not being able to read the blackboard unless squinting or sitting closer.
• Watching television very closely or almost glued to the screen.
• Writing with your head sideways or with your face too close to the paper.
• Confusing handwriting or getting lost in reading.

Many times a child may have difficulty learning, be very distracted or unable to concentrate, not want to cooperate in learning to read, or not show interest in class. This does not necessarily mean that the child has attention deficit, is lazy or just wants to play, it could be that he/she has some defect in focusing the sight and, if he/she does not see well, he/she cannot have a proper learning. These and many other signs should make parents react and motivate them to take their children for an ophthalmologic checkup.

In the consultation with the pediatric ophthalmologist, the examination is performed in different ways, depending on the age of the child and also on his cooperation during the consultation: some will need to read or identify objects and/or images; they could measure the position of their eyes; they could be tested for glasses, see the reflection of light in the back of the eye; in some cases the pupils are dilated or special drops are used to determine if there is a need for glasses or other treatment.

For all these reasons, the recommendation is to perform routine ophthalmologic checkups every year, whether or not there is any discomfort, in order to detect in a timely manner any visual problem that may have an implication in the good visual-brain development of the child or in his or her adequate academic performance.