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Six months not too young for first eye exam.

Byline: BIRTH TO THREE By Carol Marusich For The Register-Guard

Why do we need a national program to ensure that infants have their vision and eye health examined during the first year of life? Why is early examination of infants important? Why isn't a simple screening at age 3 during a well-baby check at the pediatrician's office enough?

Vision disorders are the fourth most common disability in the United States and the most prevalent handicapping condition in children, according to a recently published Current Ophthalmology survey.

As many as five percent of preschool children, amounting to nearly four million children nationwide, are estimated to have impaired vision, according to the American Academy of Pediatrics.

The organization also says that of children who receive a late diagnosis of amblyopia (lazy eye), as many as one-third have been screened as preschoolers, but the amblyopia was not detected. Of the children who failed a screening, 50 percent of the parents were still unaware of the screening results two months later.

These statistics clearly demonstrate the problems with vision screenings. You need more than a simple screening, especially with infants and toddlers, when even small irregularities can have a profound impact on development.

Research indicates that a child's brain develops fastest during the first three years of life. Sensitive periods in vision development support the need for early intervention, when many conditions are more responsive to treatment and before additional complications arise. Visual impairment can profoundly affect overall development, not just vision development.

Early detection and prevention are the best approach to infant eye care.

There are many infants who have eye health and vision problems without any family history, predisposing condition or event. These, unfortunately, are the children we often see long after the damage is done, because there was no easily detectable sign of trouble.

Among these problems are the undetected amblyopia with no eye turn; high nearsightedness, farsightedness or astigmatism that no one suspected; and even the small tumor way off to the side in the retina that could not be seen during a screening but could be detected during an eye examination where drops are used to open the pupil wide.

Good vision and eye health care is not just for `grown-ups' and older children. The American Public Health Association encourages comprehensive examination as opposed to just screening. The American Optometric Association advises that a screening does not replace a complete vision and eye health examination. Both recommend that all children have such an examination at the age of 6 months.

The goal of early examination is to prevent vision and eye health conditions that can impede normal child development. Optometrists have the specialized training, equipment and facilities attuned to the needs of this pediatric population and include infants as an integral part of family vision care.

The tools we use to examine infants are different from those used for adults, and are often presented as games. The games we play with our youngest patients give us the vital information that we need to diagnose and treat eye health problems early, thus minimizing the damage.

Through early intervention, we can eliminate refractive amblyopia as a primary cause of vision loss and enhance development.

So, as parents, grandparents, guardians, aunts and uncles, what can we do?

Now that we better understand the need for early vision care, we can advocate for the children in our lives. If our preschoolers and toddlers have not yet been examined, make the necessary arrangements to do so.

For those little ones ages 6 months to 1, I encourage you to take advantage of the national InfantSEE program that provides an assessment at no charge for all infants in this age group. Here in Oregon, contact the Oregon Optometric Physicians Association at to locate a participating optometrist in your area.

Nationally, the American Optometric Association's InfantSEE Web site address is

Working together, we can help all of our children achieve their full potential.

Dr. Carol Marusich practices in Eugene at Lifetime Eye Care and is adjunct faculty for the Pacific University College of Optometry. The opinions expressed in this column are those of the writer. Birth To Three is a nonprofit organization dedicated to strengthening families through parent support and education. For more information about Birth To Three, call 484-5316.
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Title Annotation:Columns
Publication:The Register-Guard (Eugene, OR)
Article Type:Column
Date:Jul 24, 2005
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