3 Good Reasons To Bring Your Child to the Eye Doctor

Boy with glasses reading from E-reader
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Many people wait to call the optometrist when they experience blurred vision. Unfortunately, many of us do the same with our children. We are prompted to schedule an eye exam when our child fails a vision screening at the pediatrician's office or at school, or at the child's first complaint of blurry vision. However, children can experience binocular vision problems with or without blurred vision.

In fact, optometrists and ophthalmologists don’t really use blurry vision to judge children who suffer from vision problems. While they take blurred vision seriously when a child complains, they also look at many other factors when examining children. Binocular vision problems occur when the visual system fails to use both eyes together with accuracy. Sometimes these problems can occur without a frank complaint of blurry vision, neither far away or up close.

The following are three good reasons to take your child to the eye doctor for a checkup to check for problems that don't necessarily involve blurred vision as the primary complaint.

Latent Hyperopia

Hyperopia or hypermetropia is farsightedness. Latent farsightedness is a term used to describe when farsightedness is masked (when the focusing muscles are being used to increase the eye's focusing power). Farsightedness can be tricky. Some children and even some young adults can actually be quite farsighted without ever complaining of blurred vision.

Children have such powerful focusing systems that they can focus extra hard to compensate for great amounts of farsightedness. They manage to make their vision clear, but only by focusing or accommodating. Someone that has latent farsightedness may have to focus twice as hard as someone who does not. Instead of complaining of headaches or blurry vision, children who have uncorrected hyperopia may quit reading or act out in class and get in trouble.

Myopia or nearsightedness is different. Generally, at some distance, nearsighted kids complain that they can’t see certain things out at a distance, particularly the chalk board at school. Nowadays, many schools actually have computer aided screens in lieu of chalk boards to aid in student education. Doctors and parents need to be careful with those too, because when nearsightedness occurs slowly, children do not see the change in vision. Unless severely nearsighted, most nearsighted people have clear vision at a close range, so at least most things near to them appear clear.

Just as farsighted children can be significantly farsighted and can compensate by focusing extra hard, nearsighted children may not complain of blurred vision. Other symptoms such as headaches could be present but a child will not usually admit, “I see blurry.” Doctors can determine how much farsightedness to correct by instilling special dilating drops that not only increase the size of the pupil but also temporarily paralyze the focusing muscle so the entire amount of farsightedness can be measured. This will tell the doctor exactly how much correction to prescribe in the spectacle or contact lens prescription.

Convergence Insufficiency (CI)

Convergence insufficiency is the name given to a condition in which a person cannot converge the eyes inward while focusing on a target at a close range. The eyes normally turn inward or converge and increase in focusing power when viewing something at a close range when the visual system is normal. The systems that control the inward turning of the eye muscles and the muscle inside the eye that causes the eye to focus or accommodate are closely related.

Children who have convergence insufficiency find it difficult to fuse the two images together when looking at a new object. One eye may drift outward when they attempt to focus on a nearby word or object. They may be able to focus just fine, but the eye muscles have a very difficult time turning inward. When they are not able to converge their eyes easily and accurately, children may have eye strain, double vision, headaches, difficulty concentrating, dizziness or motion sickness.

Researchers have also discovered a correlation between convergence insufficiency and attention deficit hyperactivity disorder (ADHD). As a result, convergence insufficiency can not only create reading and comprehension difficulties in school, but they can be a clue to other disorders such as ADHD.

Treating Convergence Insufficiency

Treatment of convergence insufficiency varies depending on the severity of the condition. Although glasses may need to be prescribed, convergence insufficiency is often treated with vision therapy. Vision therapy consists of certain exercises or computer-aided vision exercises that may either be performed at work or at home to strengthen the eye muscles that allow us to turn the eyes inward.

Studies show that therapy performed in the doctor’s office rather than at home have better results. Remarkably, these muscles can be strengthened and trained quite well. Symptoms seem to improve in most people after four weeks of exercises or computer aided therapy.

Convergence Excess

Convergence excess is a term used to describe another eye muscle imbalance in which the eyes tend to cross inward too much when looking at an object at a close distance. This is caused by some type of mismatch between the eyes and the brain. The system must work harder to maintain the alignment of the eyes than it needs to. In some cases, people who suffer from convergence excess see double. Because our brains do not like seeing double, the brain begins to suppress one of the images when double vision occurs. Convergence excess can affect one or both eyes.

When the eyes cross in, it is said to be an esotropia. If a child has the tendency for the eyes to cross in but can keep them straight most of the time, it is called an esophoria. An esophoria is sort of a latent esotropia. The eyes can control it most of the time, but if one or both eyes actually cross in, it is labeled an esotropia. Symptoms of esophoria are occasional double vision, eye fatigue, headaches, pulling sensation around the eyes, head tilting, or excessive blinking.

Treating Convergence Excess

When a child with convergence excess reads, writes, or works on a computer, they often complain of dizziness. Treatment for convergence excess also consists of vision therapy exercises or vision training. Although many patients are successful with vision training, it is a bit harder to control than if you had convergence insufficiency. It is easier to train the eyes to turn in more, but more difficult to train your eyes to move out.

Often times, eyeglasses work well for this condition. When the eyes focus, it triggers more convergence. In a person with convergence excess, this causes the eyes to turn in more. With eyeglasses, the focusing effort is reduced as well as the convergence signal. Prism can also be prescribed. Prisms move the image a certain direction so that the eye does not have to move as much. The prism can allow the eyes to be in a certain angle or position where they feel most comfortable. Prism can be added to your eyeglass prescription.

A Word From Verywell

Many things can cause eye strain in children. However, these problems won't always get a parent's attention because they don't always cause blurred vision. Even when kids experience blurred vision, they may not know how to articulate it clearly to their parents. They may even think that the way they see the world is completely normal. It is a good idea to schedule a comprehensive eye examination with an optometrist or ophthalmologist to check for these conditions as children enter preschool.

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