The Children's Optometrist

Vision and eye health is critical in children

The children's optometrist must be mindful of the special considerations that apply to very young patients.  Visual problems that are missed in childhood can grow, multiply and become permanent and serious as a patient matures.  Simply stated, it is difficult to function in a visual world if your visual system is not functioning.  For these reasons, It is critical to diagnose and treat vision problems early in life.  No one should be forced to go through life held back by a treatable vision problem or visual disorder.

A 2011 study published in the journal, Pediatrics, found that in addition to refractive errors such as myopia and astigmatism, ocular disorders like strabismus and amblyopia that occur in infants, toddlers, and children may present lifelong problems for the child. Children that become adults with these conditions must adapt and compensate for them. Moreover, vision problems that were present in childhood may continue to plague the patient into adulthood, affecting overall health, self-perception, educational attainment, job choices, and a number of other social factors.

It is critical to catch and treat vision problems in childhood

Dr. Randhawa is often thought of as a children's optometrist.  Most of her vision therapy patients are children because most ocular-motor and perceptual disorders are caught in childhood.  At least, we hope that they are caught in childhood.  This is one of the reasons that optometrists recommend that children see an eye doctor every year.

In fact, childhood is a critical time for human visual development.  The human visual system is completely developed by the age of seven or eight.  If a child has visual problems in this critical developmental period, they may, tragically, be stuck with these disorders and suffer serious consequences for their entire life.  An example is amblyopia (commonly known as lazy eye) in which one eye does not see well or at all.

Amblyopia is best treated at an early age. However, recent research into neuroplasticity holds out some hope for teenagers and adults who were not diagnosed in childhood. However, even if older people are successfully treated, being forced to life with being blind in one eye during childhood can have serous consequences on their development, affecting their ability to learn, read, play sports, drive and many other basic human activities.

Children can't tell you that they have a vision problem

Children can often be seriously impacted by "ordinary" vision problems like myopia and hyperopia (nearsightedness and farsightedness). The impact of these problems is amplified because children cannot know that they have a vision problem and that they are not seeing normally. They have always seen that way and they think that every one else sees that way too.

Every optometrist can tell you a heart-warming story of a five or six year-old child who sees his mother's face for the first time in the exam room. Here is Doctor Randhawa tell the story of such a child that she examined:

 

A child's inability to communicate or even know about her vision problem is the reason why it is so important to see your optometrist every year to make sure that a child's eyes are developing properly and that she is seeing well enough to accomplish all the learning that must occur for proper human development. Remember that 80% of our learning comes via our visual system. As parents and eye doctors, we need to make sure that the visual system is working properly.

Proper vision care is often hampered by the system

Many parents are lulled into a sense of false security by school vision screenings. Those screenings only test if a child can read the eye chart clearly. They do not look for eye diseases, do not check to see if the eyes are moving properly or working together as a team, they do not seek do diagnose vision problems such as convergence insufficiency, visual information processing deficits, accommodation problems, and many others.

 

 

Doctors who are not vision specialists often mistake vision problems for ADHD, learning disabilities or psychiatric problems

It is also easy for doctors who are not vision specialists to jump to conclusions. That is why many children are placed into special educational programs, therapy sessions or even medicated for ADHD when they have an undiagnosed vision problem. Read the following articles to learn more:

 

 

 

Vision therapy is an effective treatment for adults with convergence insufficiency

I82 percent of teachers report an improvement in children following vision therapy

Hinkley S,Schoone E, Ondersma B. Perceptions of Elementary Teachers about Vision and Learning and Vision Therapy. J Behav Optom 22;3-9, 2011.

Vision therapy and adults with convegence insufficiency

"A 2011 study published in the journal, Pediatrics, found that in addition to refractive errors that can be corrected with glasses such as myopia and astigmatism, ocular disorders like strabismus (eye-turn, cross eyes) and amblyopia (lazy eye) that occur in infants, toddlers, and children may present lifelong problems for the child.

Children who become adults with these conditions must adapt and compensate for them. Moreover, vision problems that were present in childhood may continue to plague the patient into adulthood, affecting overall health, self-perception, educational attainment, job choices, and a number of other social factors.

Basically, people with these disorders find it very difficult to do things that people with healthy vision take for granted, like effortlessly understanding visual learning. The fact that 80% of classroom learning happens through our visual system means a child with lazy eye, for example, is at a significant disadvantage in school.

The study confirms what we already know about vision disorders and quality of life. A person's life can be needlessly limited if a treatable vision disorder is ignored. Amblyopia is rarely evident to parents or teachers and can only be diagnosed during an eye exam. Even the child will not know that she is not seeing as well as others. That is why all children should have an annual eye exam. In British Columbia the provincial health plan covers visits to an optometrist up to the age of 18 so there is really no reason why a child needs to have their potential needlessly limited.

In our society there is no reason for people to grow up with strabismus or amblyopia. Yet, tragically, it is still too frequent." 

Childhood vision disorders lead to adult problems,See for Life, June 13, 2011

Vision therapy is an effective treatment for adults with convergence insufficiency

How to choose a children's optometrist - See for Life
Apr 19, 2012
Vancouver paediatric optometrist advises parents on how to choose a children's optometrist. Kids have special eye care needs and a kid's vision specialist can meet them.

 

You need over 17 visual skills to succeed in life and school.  Seeing clearly is just one of them.  Deficiencies in the other cannot be fixed with glasses, lenses or surgery.

In order for children to learn well, they need to see well. Parents may not realize there is more to good vision than 20/20 and that there are conditions that vision screenings can miss. Two optometrists conducted a visual experiment where common visual problems known to affect learning in kids are simulated in 4 adult teachers, and their experience and reaction are discussed.