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Does My Child Have a Lazy Eye?

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SAN FRANCISCO, March 19 /PRNewswire/ -- "Lazy Eye" is a common term for an eye that is not working properly. The eye may turn in, or wander out (or up) and not line up correctly with the other eye, as if it were being lazy. "Lazy eye" also refers to an eye that does not see as well as the other eye. The American Association for Pediatric Ophthalmology and Strabismus (AAPOS) can help parents understand how specialists identify poor vision in the eyes of an infant or young child.

In amblyopia (one kind of lazy eye) the brain connections for vision are better in one eye than the other. This common condition affects one out of every 45 children. In the past, a child's amblyopia often was not detected until age five or six in school vision checks. Unfortunately, by then the child was usually too old to treat amblyopia and to improve vision.

Some children have one eye that is "in focus" and one that is "out of focus." This abnormality results from uncorrected farsightedness (hyperopia), nearsightedness (myopia) or astigmatism in one eye. Sometimes the out of focus eye drifts in or out; parents will notice this misalignment and have the child examined. Often the out of focus eye remains in alignment with the better eye, and the parent or pediatrician has no way to suspect a problem. A specialist such as a pediatric ophthalmologist, trained to examine infants and very young children, will be able to detect and treat the problem.

A pediatric ophthalmologist is an Eye MD (an eye physician and surgeon) who specializes in caring for children. A pediatric ophthalmologist has graduated from medical school and has completed a three or four-year ophthalmology residency training program in all aspects of eye disease. In addition, pediatric ophthalmologists receive further training in a fellowship programs dedicated to the study of eye diseases and disorders of children's eyes.

There are several tests to detect amblyopia in young children, including picture chart vision, photorefraction and complete eye exam. By age three most children can be tested at home with a picture chart or home vision test. Prevent Blindness provides both the picture chart and home vision test for parents. It is very important to perform a home screening exam carefully, because many children with amblyopia have "passed" the test by peeking or memorizing the chart leaving their eye problems undetected.

A second technique used to help detect a difference in vision of the eyes of young children is called photoscreening or photorefraction. Both techniques use high-tech, hand held devices that shine a light into the eyes. The returning reflection must be analyzed. These instruments require skilled interpretation by a technician or physician to decide if one or both eyes are out of focus.

Parents can opt for a complete eye exam for their child soon after birth, especially if there is a family history of eye problems. Premature infants may require an exam at age four to six weeks to detect possible changes in the retina (the blood vessels in the back of the eye). A family history of an eye disease beginning in early childhood, such as cataracts or retinoblastoma (the most common malignant eye tumor in children), calls for an exam in the first two months of life or immediately if a white pupil is noted. Children with a family history of amblyopia or eye muscle problems should have an eye exam between 6 and 12 months of age.

The best time for a complete eye exam for a child with both eyes lined up, who appears to see normally and has no family history of early eye problems, is between three and four years of age. A child does NOT have to be able to read a picture chart in order to have a complete eye exam. Pediatric ophthalmologists have many other ways to detect problems in the eyes of infants and children.

An eye exam for children with no vision problems may seem like an unnecessary expense. If a child has amblyopia, sight can, in most cases, only be restored during a critical period in early childhood -- usually birth to about age four -- the most important years in visual development.

Visit the AAPOS website or call AAPOS at 415-561-8505. The American Association for Pediatric Ophthalmology and Strabismus was established in 1974. Its Eye MD (ophthalmologist) members specialize in providing medical and surgical eye care to children and to adults with strabismus. AAPOS provides education to members and future members, other health care providers, and the public.

SOURCE American Association for Pediatric Ophthalmology

 

 

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