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START IN INFANCY Lifetime of Good Eye Health
By Dr. DeAnn M. Fitzgerald, O.D.
As eye care professionals, we are always asked, when should I have my child’s eye examined? Here are some guidelines.
When? We recommend a first eye exam at age 6 months. The American Optometric Association believes so strongly that a child’s eyes should be examined in the first year that it has instituted a program called InfantSee. This is a free eye exam for babies, up to 12 months of age. We participate in this free program and have examined many infants. Children should be seen again at age 3, and again before starting school, usually at age 5.
Why? If there is a serious health issue (congenital cataracts, retinoblastoma or lazy eye), this is the time to take care of it. This is especially important for children with a family history of hereditary eye diseases, strabismus or a lazy eye, or a child born prematurely. At age 3, the child has met many developmental milestones and reading is just around the corner. This is the age when it is critical to diagnose the need for glasses. At age 5, the child is ready for school. Make sure that his or her vision is clear and that the eye muscle coordination is where it needs to be to learn properly. Great amounts of uncorrected hyperopia (farsightedness) will cause headaches, eye strain and the avoidance of reading or near activities.
Tips: Try to schedule the exam when the child is well rested, calm and happy. Avoid nap and meal times. Take along a written list of concerns or questions.
How? Many times parents think that their child is too young to have an eye exam. But there are many
objective tests that can be done to determine if there is a large refractive error or need for glasses. At your child's eye exam, you should expect the eye doctor to use eye drops. These drops not only let us examine the health of the eyes but also determine the need for glasses.
Conditions we look for:
Hyperopia or farsightedness is a defect of vision caused by an eye that is too short or when the lens cannot become round enough, causing an inability to focus on near objects. It is normal for children to have some farsightedness because their eyes are still growing. It is also quite probable that children with a large degree of hyperopia can change their focus enough to make objects clear. This is why so many children can pass vision screenings and have a high refractive error. Children who have high hyperopia will naturally "accommodate" and make their vision clear. This, however, is hard work and causes headaches, irritability and often avoidance of reading or near work. A great degree of hyperopia is often a cause of the eyes turning in, or esotropia.
Myopia or nearsightedness is a refractive defect of the eye in which distance objects are blurred. With
myopia, the eyeball is too long or the cornea is too steep so images are focused in front of the retina. Vision screenings generally find myopia.
Astigmatism is a refractive condition in which the front of the eye, the cornea, is irregularly shaped. Instead of being a perfect sphere, it is more like an egg, causing blurring at distance and close up. This can be corrected with glasses or contact lenses.
Amblyopia or lazy eye is a disorder of the eye that is characterized by poor or indistinct vision in an eye that is otherwise physically normal. Common causes include an eye turn, unequal prescriptions between the two eyes or a congenital cataract. Anisometropia is a condition where there is unequal refractive power between the two eyes. One eye may require no prescription, while the other eye has a great degree of nearsightedness or farsightedness. This can lead to amblyopia.
Strabismus is a condition in which one or both eyes are turned. The eye or eyes can be turned in (esotropia) or turned out (exotropia). This deviation causes double vision or diplopia. One eye, usually the straight eye, is favored and the deviated eye is “turned off.†When the affected eye is turned off, this results in amblyopia or a lazy eye. Strabismus can be constant or intermittent, very noticeable (cosmetic) or not noticeable at all. Patients with a constant strabismus will not have normal depth perception.
Congenital cataract is a clouding of the lens of the eye, present from birth. A cataract makes vision very dim or blurred or can even blind a person.
Retinoblastoma is a malignant congenital tumor of the back lining of the eye or the retina. This can occur from birth to age 5 and is highly curable if treated early.
What can be done? Treatment is often easy. Most commonly, glasses can be prescribed. If a lazy eye is found, glasses may be prescribed, muscle surgery may be needed or a patch for the good eye may be prescribed. Patching the dominant eye strengthens a weak or lazy eye that has been turned off by the brain because of a foggy image. This foggy image can be improved with glasses. The patch forces the brain to use the lazy eye so that vision develops properly.
Often, children with these ocular conditions need to be followed more closely than yearly. We may ask to see your child every few months to check for improvement of visual acuity. Please call our office at
319-366-3500 with questions or to schedule an exam.
Allergies and the Itchy, Burning, Red Eye
Do you suffer from seasonal allergies? Do your eyes start to water and itch with the first warm week of spring? Does this make wearing contact lenses difficult and your over the counter medications just don't cut it?
According to the National Institute of Allergy and Infectious Diseases, more than 50 million people in the U.S. suffer from allergies. Allergies are the 6th leading cause of on going, chronic diseases for Americans. While allergies, especially seasonal allergies are rarely life threatening, they are very inconvenient and cause significant discomfort, diminishing quality of life.
Older over the counter allergy medications like Benadryl or Dimetapp can help in the short term. However, they come with unwanted side effects such as drowsiness, dry eyes and dry mouth.
Newer antihistamines like Claratin, Zyrtec and Allegra are more effective with far less systemic side effects. These "second generation" medications do not penetrate the central nervous system as much as the older over the counter medications. Therefore, the side effects of dry eyes, mouth and drowsiness are reduced.
While oral antihistamines are beneficial, many allergy patients can find increased relief with a prescription eye drop. Many of these eye drops are new to the market and are much more effective than any drop available before. There are also different classes of drop, so that if one prescription doesn't work, your eye care professional can select a different drop with a completely different mechanism of action. This wider selection of eye drops makes solving the itchy red eye easier and more effective than ever before.
Some trade names of the drops include Patanol, Optivar, Elestat, Alrex and Alomide. Dr. Fitzgerald and Dr. Miller are knowledgeable in the management and treatment of ocular allergies. They can successfully treat your itchy, red, burning eyes and keep you in your contact lenses this allergy season. Call today for an appointment if you have found yourself rubbing your eyes, putting up with irritation, or have stopped wearing your contact lenses due to allergies.
