We tend to think that a child sees the world as we see it and sometimes we forget that he is learning to see just as surely as he is learning to walk.
At birth a baby's eyes act a bit like a fixed-focus camera the ideal focusing distance being eight inches from the bridge of the nose, which is about the distance a mother will hold her baby when looking at him. Babies vary in how rapidly they become able to focus on objects at a greater distance. By nine days some can focus on an object at two-and-a-half feet; by three months, most can focus on an object five feet away. At about three-and-a-half months when the baby begins to grab objects, he develops the ability to see in'3-D' and is also able to look from near to far and back again.
Eye tests
A small number of children will have been born with or will develop problems which affect their sight. Most children will have their eyes tested by a doctor or health visitor at regular developmental check-ups, although the precise timings may vary between health authorities.
At the six-week postnatal check, the doctor will move an object in front of the eyes to check whether the infant follows it with his gaze in all directions. At seven to nine months, the health visitor normally carries out a developmental check, including eye movements and testing for a squint. The baby will be given different objects to look at and will have small objects, such as a handful of hundreds and thousands, shaken on to the table to check if he will pick them up. At eighteen months to two years, the child normally has another check. This will be repeated at the age of four-and-a-half years, and again at seven in school. The child will be asked to read letters off a board, covering up each eye in turn.
However, many ophthalmic opticians, also known as optometrists people qualified to examine the eyes and prescribe spectacles and contact lenses think that these tests do not always pick up problems, and suggest that parents take their child for free eye tests at regular intervals, especially before they start school. The tests can start at any age.
If they need glasses
Once a child has had an eye test, if they have been prescribed glasses the optometrist will issue a voucher worth 28.70 which can be offset against the cost of a pair of glasses. Many large chains of opticians offer a range of suitable spectacles for children which means that the full cost of frame and lenses comes within this figure. Today there is a wider range of colours and types of frames than in the past.
If the child is very young and needs to wear glasses for most of the day, it is often recommended that they have two pairs, as they frequently get lost or broken.
While most young children do not mind wearing glasses, and are delighted with the improvement of their vision, a few may dislike wearing them at first. If so, the parent or carer can reassure the child that they need only wear the glasses part of the time, and that when they are older they will be able to wear contact lenses. A lot of positive comments about the glasses 'Don't they suit you','What lovely glasses' can help build the child's confidence.
Common problems
'Lazy eye' or amblyopia
This usually results from a misalignment of a child's eyes, or a difference in image quality between the two eyes, with one focusing better than the other. In both cases, one eye becomes dominant and suppresses the image from the other. If this condition persists, one eye may become useless. Treatment is normally to have the child wear a patch over the good eye or, if the child wears glasses, one eyepiece blacked out.
Astigmatism
This results from an irregular shape of the front surface of the cornea the transparent'window' in front of the eye. It can be mild or severe. People who suffer from astigmatism typically see vertical lines more clearly than horizontal ones, or vice versa. Glasses with specially ground lenses are prescribed to improve the sight.
Cataract
This is a clouding of the lens in the eye. Some children may be born with a cataract, or it can be acquired after an injury. Surgery can now be done to replace the lens and restore normal vision.
'Squint' or strabismus
Strabismus exists when one eye does not aim directly at an object of interest to which the other eye is aimed. The eye may point inwards towards the nose (crossed eye) or outward (wall eye). Treatment is with eye exercises to correct the eye muscles and enable the eyes to work together. Surgery may sometimes be necessary. It is important to correct strabismus before the child reaches age of eight, while the eye muscles are more flexible. Again, early eye checks are recommended.
Short-sightedness
In myopia, the eyeball is too long for the eye to focus properly and distant objects appear blurred. The opposite condition is hyperopia or long-sightedness, which is rare in children. Both conditions can be corrected with glasses or contact lenses. Research which suggested that children who sleep with a night-light on were more likely to develop myopia has recently been contradicted by a larger study.
Eye strain
Children who spend too much time reading in poor light or looking at a computer screen may complain of headaches or sore eyes. In other circumstances these may be symptoms of a problem with vision, and the child should have an eye test.
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