children eye exam

Your Comprehensive Eye Exam

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A comprehensive eye exam includes a number of tests and procedures to examine and evaluate the health of your eyes and the quality of your vision. These tests range from simple ones, like having you read an eye chart, to complex tests, such as using a high-powered lens to examine the health of the tissues inside of your eyes.

Here are some tests you are likely to encounter during a routine comprehensive eye exam:

Retinoscopy

This test helps your doctor get a good approximation of your eyeglasses prescription. For retinoscopy, the room lights are dimmed and an instrument containing wheels of lenses (called a phoropter) is positioned in front of your eyes. You will be asked to look at an object across the room (usually the big “E” on the wall chart or screen) while your doctor shines a light from a hand-held instrument into your eyes from arm’s length and flips different lenses in front of your eyes.

Based on the way the light reflects from your eye during this procedure, your doctor can get a very good idea of what your eyeglasses prescription should be. This test is especially useful for children and non-verbal patients who are unable to accurately answer the doctor’s questions.

With the widespread use of automated instruments to help determine eyeglass prescriptions today, many doctors forgo performing retinoscopy during comprehensive eye exams. However, this test can provide valuable information about the clarity of the internal lens and other media inside the eye. So doctors who no longer perform this test routinely may still use it when examining someone who may be at risk of cataracts or other internal eye problems.

Refraction

This is the test your doctor uses to determine your exact eyeglasses prescription. During a refraction, the doctor puts the phoropter in front of your eyes and shows you a series of lens choices. He or she will then ask you which of the two lenses in each choice (“1 or 2,” “A or B,” for example) make the letters on the wall chart look clearer.

Based on your answers, your doctor will determine the amount of nearsightedness, farsightedness and/or astigmatism you have, and the eyeglass lenses required to correct these vision problems (which are called refractive errors).

Autorefractors and aberrometers

Your eye doctor also may use an autorefractor or aberrometer to help determine your glasses prescription. With both devices, a chin rest stabilizes your head while you typically look at a pinpoint of light or other image.

An autorefractor evaluates the way an image is focused on the retina, where vision processing takes place, without the need for you to say anything. This makes autorefractors especially useful when examining young children or people who may have difficulty with a regular (“subjective”) refraction. Automated refractions and subjective refractions are often used together during a comprehensive exam to determine your eyeglasses prescription.

An aberrometer uses advanced wavefront technology to detect even obscure vision errors based on the way light travels through your eye.

Cover test

While there are many ways for your eye doctor to check how your eyes work together, the cover test is the simplest and most common.

During a cover test, the eye doctor will have you focus on a small object at distance and will then cover each of your eyes alternately while you stare at the target. As they do this, eye doctors observe how much each eye has to move when uncovered to pick up the fixation target. The test is then repeated as you focus on a near object.

Cover tests can detect even very subtle misalignments that can interfere with your eyes working together properly (binocular vision) and cause amblyopia or “lazy eye.”

Slit-lamp examination

The slit lamp is an instrument that the eye doctor uses to examine the health of your eyes. Also called a biomicroscope, the slit lamp gives your doctor a highly magnified view of the structures of the eye, including the lens behind the pupil, in order to thoroughly evaluate them for signs of infection or disease.

The slit lamp is basically an illuminated binocular microscope that’s mounted on a table and includes a chin rest and head band to position the patient’s head properly. With the help of hand-held lenses, your doctor can also use the slit lamp to examine the retina (the light-sensitive inner lining of the back of the eye.)

Tonometry (glaucoma testing)

Tonometry is the name for a variety of tests that can be performed to determine the pressure inside the eye. Elevated internal eye pressure can cause glaucoma, which is vision loss due to damage to the sensitive optic nerve in the back of the eye.

The most common method used for tonometry is the “air puff” test – where an automated instrument discharges a small burst of air to the surface of your eye. Based on your eye’s resistance to the puff of air, the machine calculates the pressure inside your eye – called your intraocular pressure (IOP).

Though the test itself can be startling, nothing but air touches your eye during this measurement and there’s no risk of eye injury from the air puff test.

Another popular way to measure eye pressure is with an instrument called an applanation tonometer, which is usually attached to a slit lamp. For this test, a yellow eye drop is placed on your eyes. Your eyes will feel slightly heavy when the drops start working. This is not a dilating drop – it is simply a numbing agent combined with a yellow dye. Then the doctor will have you stare straight ahead in the slit lamp while he or she gently rests the bright-blue glowing probe of the tonometer on the front of each eye and manually measures the intraocular pressure.

Like the air puff test, applanation tonometry is painless and takes just a few seconds.

Since glaucoma is often the result of an increase of pressure inside the eye, these are important tests for ensuring the long-term health of your eyes.

Summary

These are the most common tests performed during a standard comprehensive eye exam. Depending on your particular needs, your doctor may perform additional tests or schedule them to be performed at a later date.

Performance Eyecare is the place for children’s glasses

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With the kids going back to school, it’s time to bring them in for an eye exam and pick out any necessary eyewear to help him or her succeed this school year.

We understand kids can be picky about what they want to wear, but we’re confident your child will find the perfect pair of glasses at Performance Eyecare.

Here are the five trends in children’s eyewear:

  1. Designers have taken cool and classic designs that work for adults and scaled them down for kids. Don’t be surprised if your child wants eyeglasses that look a lot like yours.
  2. Branded or licensed eyewear lines grab a child’s attention. Fisher-Price, Hush Puppies, Stride Rite, Disney and Marvel Comics appeal to kids of all ages, but especially to very young children. Lines related to extreme sports (X-Games), basketball (Nike, Converse) and other sports are very popular with slightly older kids.
  3. Spring hinges, strong and flexible frame materials and impact-resistant polycarbonate or Trivex lenses all help protect your child’s eyes — as well as your financial investment in his or her eyewear.
  4. Don’t forget about sunglasses for kids. Protecting your child’s eyes from the sun’s harmful UV rays may lower the risk of adult eye problems like cataracts later in life.
  5. Photochromic lenses made of impact-resistant polycarbonate are an excellent choice for kids who spend a lot of time outdoors. Clip-on sunglasses (or newer versions that magnetically attach to eyeglasses) also are good choices.
  6. For the child who is fast becoming a teenager, eyewear fashion is increasingly important. Designer eyeglass frames from Guess?, Calvin Klein and others are very appealing to “tweens.” Also popular are frames branded with apparel and accessories names such as Esprit, Nine West and Banana Republic, as well as celebrity brands like Hilary Duff and Thalia eyewear collections.

Visit Performance Eyecare for eye exams

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Did you know August is National Eye Exam month? It’s a nice reminder as we get ready to send the kids back to school that eye health is important learning for children, and even for adults.

The Vision Council of America states that 12.2 million Americans need vision correction, but don’t use any. Also, almost 50 percent of parents with children under 12 years old have never taken their children to an eye care professional.

Here are five reasons why you should have an eye exam this month:

1. Save a headache

You might need to visit an eye care doctor if you have unexplained and constant headaches. The stress you’re putting your eyes through could be the cause.

2. Perform well in school

This is vital as one out of four children is believed to have vision problems, which could explain why your child’s grades are slipping. Children won’t always speak up so it’s on you to do the right thing and take your child to get his or her eyes examined.

3. Determine prescription

Like everything, your eyes change. Visiting an eye care professional such as the one you’ll find at Perfomance Eyecare, you can change your prescription so you can see better.

4. Detect eye conditions

An eye doctor is able to spot early onset signs of various health conditions such as diabetes, high blood pressure, glaucoma and high cholesterol.

5. Prevent conditions

As if the previous four reasons weren’t enough, you can stop eye conditions. Many eye diseases, such as macular degeneration or cataracts, don’t have symptoms. Early detection is extremely important to prevent serious damage.

At Performance Eyecare, we test for glaucoma without the dreaded air puff. Your eye doctor instills an eye drop and determines your eye pressure while looking with the microscope. There is no pain and this method is much more accurate than blowing air into your eye.

Performance Eyecare carries contacts for ‘hard-to-fit’ eyes

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eye doctor in Swansea IL & St. Louis

Not everyone is an ideal candidate for contact lenses. If you have one or more of the following conditions, contact lens wear may be more difficult:

  • astigmatism
  • dry eyes
  • presbyopia
  • giant papillary conjunctivitis (GPC)
  • keratoconus
  • post-refractive surgery (such as LASIK)

But “difficult” doesn’t mean impossible. Often, people with these conditions can wear contacts quite successfully. Let’s take a closer look at each situation – and possible contact lens solutions.

Contact lenses for astigmatism

Astigmatism is a very common condition where the curvature of the front of the eye isn’t round, but is instead shaped more like a football or an egg. This means one curve is steeper or flatter than the curve 90 degrees away. Astigmatism won’t keep you from wearing contact lenses – it just means you need a different kind of lens.

Lenses specially designed to correct astigmatism are called “toric” lenses. Most toric lenses are soft lenses. Toric soft lenses have different corrective powers in different lens meridians, and design elements to keep the lens from rotating on the eye (so the varying corrective powers are aligned properly in front of the different meridians of the cornea).

In some cases, toric soft lenses may rotate too much on the eye, causing blur. If this happens, different brands that have different anti-rotation designs can be tried. If soft lens rotation continues to be a problem, gas permeable (GP) lenses (with or without a toric design) can also correct astigmatism.

Dry eyes can make contact lens wear difficult and cause a number of symptoms, including:

  • a gritty, dry feeling
  • feeling as if something is in your eye
  • a burning sensation
  • eye redness (especially later in the day)
  • blurred vision

If you have dry eyes, the first step is to treat the condition. This can be done a number of ways, including artificial tears, medicated eye drops, nutritional supplements, and a doctor-performed procedure called punctal occlusion to close ducts in your eyelids that drain tears away from your eyes.

Once the dry eye condition is treated and symptoms are reduced or eliminated, contact lenses can be tried. Certain soft contact lens materials work better than others for dry eyes. Also, GP lenses are sometimes better than soft lenses if there’s a concern about dry eyes since these lenses don’t dry out the way soft lenses can.

Replacing your contacts more frequently and reducing your wearing time each day (or removing them for specific tasks, such as computer work) can also reduce dry eye symptoms when wearing contacts.

Contact lenses for giant papillary conjunctivitis (GPC)

Giant papillary conjunctivitis (GPC) is an inflammatory reaction on the inner surface of the eyelids. One cause of GPC is protein deposits on soft contact lenses. (These deposits are from components of your tear film that stick to your lenses and become chemically altered.)

Usually, changing to a one-day disposable soft lens will solve this problem, since you just throw these lenses away at the end of the day before protein deposits can accumulate on them. Gas permeable lenses are also often a good solution, as protein deposits don’t adhere as easily to GP lenses, and lens deposits on GP lenses are more easily removed with daily cleaning.

In some cases of GPC, a medicated eye drop may be required to reduce the inflammation before you can resume wearing contact lenses.

Contact lenses for presbyopia

Presbyopia is the normal loss of focusing ability up close when you reach your 40s.

Today, there are many designs of bifocal and multifocal contact lenses to correct presbyopia. Another option for presbyopia is monovision. This is wearing a contact lens in one eye for distance vision and a lens in the other eye that has a modified power for near vision.

During your contact lens fitting we can help you decide whether bifocal/multifocal contact lenses or monovision is best for you.

Contact lenses for keratoconus

Keratoconus is a relatively uncommon eye condition where the cornea becomes thinner and bulges forward. The term “keratoconus” comes from the Greek terms for cornea (“kerato”) and cone-shaped (“conus”). The exact cause of keratoconus remains unknown, but it appears that oxidative damage from free radicals plays a role.

Gas permeable contact lenses are the treatment option of choice for mild and moderate keratoconus. Because they are rigid, GP lenses can help contain the shape of the cornea to prevent further bulging of the cornea. They also can correct vision problems caused by keratoconus that cannot be corrected with eyeglasses or soft contacts.

In some cases, a soft contact lens is worn under the GP lens for greater comfort. This technique is called “piggybacking.” Another option for some patients is a hybrid contact lens that has a GP center, surrounded by a soft “skirt”.Contact lenses after corrective eye surgery

More than one million Americans each year have LASIK surgery to correct their eyesight. Sometimes, vision problems remain after surgery that can’t be corrected with eyeglasses or a second surgical procedure. In these cases, gas permeable contact lenses can often restore visual acuity and eliminate problems like glare and halos at night.

GP lenses are also used to correct vision problems after corneal transplant surgery, including irregular astigmatism that cannot be corrected with eyeglasses.

GP lenses prescribed after LASIK and corneal transplants sometimes have a special design called a “reverse geometry” design to better conform to the altered shape of the cornea. The back surface of these lenses is flatter in the center and steeper in the periphery. (This is the opposite of a normal GP lens design, which is steeper in the center and flattens in the periphery.)

Problem-solving contact lens fittings cost more

Fitting contact lenses to correct or treat any of the above conditions will generally take much more time than a regular contact lens fitting. These “hard-to-fit” cases usually require a series of office visits and multiple pairs of trial lenses before the final contact lens prescription can be determined. Also, the lenses required for these conditions are usually more costly than regular soft contact lenses. Therefore, fees for these fittings are higher than fees for regular contact lens fittings. Call our office for details.

Find out if you can wear contact lenses

If you are interested in wearing contact lenses, call our office to schedule a consultation. Even if you’ve been told you’re not a good candidate for contacts because you have one of the above conditions or for some other reason, we may be able to help you wear contact lenses safely and successfully.

Choosing the right glasses for your child

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Just the thought of buying eyeglasses for your child can make you want to pull your hair out. First, there is the initial selection to consider. Second, you must consider what your child is willing to wear. Third, which eyeglasses will be the most durable?

Then there is the pressure from your child, who is likely more worried about what the other kids might say and if their glasses look cool to others.

We’ve seen how stressful this process can be. Don’t worry, we’re here to help make it a lot smoother for everyone involved.

As noted by Liz DeFranco of AllAboutVision.com, there are other variables to this journey such as what kind of glasses are needed (near- or farsighted) and how often will they be worn.

Here are DeFranco’s 10 items to consider when buying kids’ eyewear.

1. Lens Thickness

It’s important to consult with the optician about the eyeglass prescription before looking at frames. Stronger lenses are likely going to be thick, so it is important to keep the frames as small as possible to reduce the final lens thickness.

2. Fashion

Sadly, other kids might comment with either nice compliments or unnecessary jokes about your child’s eyeglasses. It is important your child is comfortable with his/her new specs so don’t let them choose ones that you think might be a cause for concern with other kids later.

The goal is to get your child to wear the glasses.

3. Plastic or Metal

Children’s frames are made of either plastic or metal. Boys’ frames have double bridges while girls’ frames have single frames, which can also be unisex.

Plastic frames in the past were considered a better choice for children because they were more durable, less likely to be bent or broken, lighter in weight and less expensive.

Now manufacturers are creating metal frames to incorporate these features as well.

Also, ask for hypoallergenic materials if your child has shown sensitivity to certain substances, such as nickel.

4. Proper Bridge Fit

Children’s noses aren’t fully developed which makes this a tough part of the consideration process. They don’t have a bridge to prevent plastic frames from sliding down, but metal frames are usually made with adjustable nose pads to fit everyone’s bridge.

5. Temple Style

Temples that wrap all the way around the back of the ear, called “cable temples,” help keep glasses from sliding down or falling off your child’s face completely.

Another option is a strap that goes around the head.

6. Spring Hinges

A nice feature to look for is temples with spring hinges because kids aren’t always careful when they put on or take off glasses. Spring hinges can prevent the need for frequent adjustments to be made to the glasses.

7. Lens Material

Children’s lenses should be made of polycarbonate or a material called Trivex because the lightweight materials are more impact-resistant than other lens materials. They are also lighter in weight, have built-in protection from damaging UV rays, and are scratch-resistant coated by the manufacturer.

The least desirable material is glass. It must be treated for impact resistance, but it still shatters when it breaks which can be hazardous to the eye.

8. Sports Eyewear

If your kid plays sports, a proper sports goggle with polycarbonate lenses will provide the best protection against an eye injury. These goggles also must be fitted properly.

9. Warranties

If your child is a toddler or a first-time wearer, opt for a warranty if it’s offered. Not all warranty plans are the same, but it can be useful in case the eyewear needs to be replaced or fixed.

10. Backup Pair

It’s always good to have a backup pair of glasses because kids aren’t always the gentlest being to their belongings. Another pair might be best especially for those with strong prescriptions and wouldn’t be able to function without their glasses.

Ask your optician if special discounts apply for second pairs, especially if they’re purchased at the same time as the primary pair.

Performance Eyecare conducts stress-free eye exams

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Performance EyeCare STL Eye Examination

We understand the word “exam” can add some unnecessary stress to your life, so we wanted to share with you what a routine comprehensive eye exam usually consists of:

As noted by Gary Heiting, OD, and Jennifer Palombi, OD, the following is what makes up a routine eye exam:

Visual Acuity Test

This measures the sharpness of your vision and it’s usually performed with a projected eye chart to measure the distance visual acuity. It also consists of a small, handheld acuity chart to measure your near vision as well.

Color Blindness Test

This test can check your color vision as well as alert your eye doctor to any possible eye health problems that may affect your color vision.

Cover Test

During this test, your eye doctor will have you focus on a small object across the room and will then cover each of your eyes alternately while you stare at the target. The doctor then assesses whether the uncovered eye must move to pick up the fixation target, which could indicate strabismus or a more subtle binocular vision problem that could cause eye strain or amblyopia, known as “lazy eye.”

Retinoscopy

Your eye doctor may perform this test early in the eye exam to obtain an approximation of your eyeglass prescription.

In retinoscopy, the room lights will be dimmed and you will be given a large target (usually the big “E” on the chart) to fixate on. As you stare at the “E,” your eye doctor will shine a light at your eye and flip lenses in a machine in front of your eyes.

Refraction

During a refraction, the doctor puts the instrument called a phoropter in front of your eyes and shows you a series of lens choices. He or she will then ask you which of the two lenses in each choice looks clearer.

Based on your answers, your eye doctor will continue to fine-tune the lens power until reaching a final eyeglass prescription.

Autorefractors and Aberrometers

An autorefractor, like a manual refraction, determines the lens power required to accurately focus light on your retina. Autorefractors are especially useful in certain cases such as evaluating young children who may not sit still, pay attention or interact with the eye doctor adequately for an accurate manual refraction.

Slit-Lamp Examination

The slit lamp, also called a biomicroscope, allows your eye doctor to get a highly magnified view of the structures of your eye to thoroughly evaluate your eye health and detect any signs of infection or disease.

During this test, your doctor will have you place your chin on the chin rest of the slit lamp and will then shine the lamp’s light at your eye. The doctor looks through a set of oculars (much like a microscope in a science lab) and examines each part of your eye in turn.

He or she will first examine the structures of the front of your eye (lids, cornea, conjunctiva, iris, etc.). Then, with the help of a special high-powered lens, your doctor will view the inside of your eye (retina, optic nerve, macula and more).

The Glaucoma Test

A common glaucoma test is the “puff-of-air” test, technically known as non-contact tonometry, or NCT. (This test was immortalized on the hit TV show Friends, when Rachel couldn’t sit still for it.)

For NCT, the test begins with you putting your chin on the machine’s chin rest. While you look at a light inside the machine, the doctor or a trained assistant will puff a small burst of air at your open eye. It is completely painless, and the tonometer does not touch your eye.

At Performance Eyecare, we do not use the air puff. Instead, our doctors instills an eye drop and determines your eye pressure while looking with the microscope. There is no pain and this method is much more accurate than blowing air into your eye.

Pupil Dilation

To obtain a better view of the eye’s internal structures, your eye doctor instills dilating drops to enlarge your pupils. Dilating drops usually take about 20 to 30 minutes to start working. When your pupils are dilated, you will be sensitive to light (because more light is getting into your eye) and you may notice difficulty focusing on objects up close. These effects can last for up to several hours, depending on the strength of the drop used.

Once the drops have taken effect, your eye doctor will use various instruments to look inside your eyes. You should bring sunglasses with you to your eye exam, to minimize glare and light sensitivity on the way home. If you forget to bring sunglasses, the staff usually will give you a disposable pair.

Visual Field Test

In some cases, your eye doctor may want to check for the possible presence of blind spots (scotomas) in your peripheral or “side” vision by performing a visual field test. These types of blind spots can originate from eye diseases such as glaucoma.

Analysis of blind spots also may help identify specific areas of brain damage caused by a stroke or tumor.

Sunglasses for Kids

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Children may not be as interested as adults are in wearing sunglasses as a fashion accessory. But because kids spend so much time outdoors in direct sunlight, they need sun protection even more than adults.

In fact, some experts say we get up to 80% of our lifetime exposure to solar ultraviolet (UV) radiation by the time we’re 18 years old.

Many styles available

You should have no trouble finding sunglasses your child will enjoy wearing. Children’s sunglasses are available in a wide variety of styles and sizes. And virtually any children’s frame can be transformed into sunglasses by adding prescription or non-prescription sun lenses.

Metal frames are very popular for children’s sunglasses because of their durability. Wraparound styles like those worn by adults are also popular in scaled-down versions for kids. Because they fit closer to the face than traditional frame styles, wraparound sunglasses provide superior UV protection not only for your child’s eyes, but for the delicate skin around their eyes as well.

Choose lenses with 100% UV protection

The most important thing when choosing children’s sunglasses is to make sure the lenses block 100% of the sun’s ultraviolet (UV) rays. The harmful effects of UV radiation are cumulative over our lifetime. By limiting your youngster’s exposure to UV rays during childhood, you may be decreasing their risk of cataracts and other eye problems when they become adults.

Polycarbonate lenses are great for kids’ sunglasses because they have 100% UV protection built-in, and they are lighter and much more impact-resistant than lenses made of other materials. And they can be tinted to nearly any shade.

Photochromic polycarbonate lenses are a good choice for kids who need prescription eyewear. These lenses darken automatically when exposed to the sun’s UV rays, and then quickly return to a clear state indoors – so one pair of eyeglasses does the job of two! They also provide 100% UV protection.

Don’t forget the accessories!

To protect your investment in your child’s sunglasses, purchase a durable, hard-shell carry case for them. Also, make sure your son or daughter knows how to clean and care for their eyewear. Getting sunglass cords (commonly called “retainers”) is also a good idea. These are attached to the temples of the frame so your child can remove their sunglasses and the eyewear will stay with them – hanging from their neck instead of getting misplaced.

Learning-Related Vision Problems

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There’s no question that good vision is important for learning. Experts say more than 80% of what your child is taught in school is presented to them visually.

To make sure your child has the visual skills they need for school, the first step is to make sure your child has 20/20 eyesight. You’ll want to ensure any nearsightedness, farsightedness and/or astigmatism is fully corrected with glasses or contact lenses. But there are other, less obvious learning-related vision problems you should know about as well.

Good vision is more than 20/20 visual acuity

Your child can have “20/20” eyesight and still have vision problems that can affect their learning and classroom performance. Visual acuity (how well your child can see letters on a wall chart) is just one aspect of good vision, and it’s not even the most important one. Many nearsighted kids may have trouble seeing the board in class, but they read well and excel in school.

Other important visual skills needed for learning include:

  • Eye movement skills – How smoothly and accurately your child can move their eyes across a printed page in a textbook.
  • Eye focusing abilities – How well they can change focus from far to near and back again (for copying information from the board, for example).
  • Eye teaming skills – How well your child’s eyes work together as a synchronized team (to converge for proper eye alignment for reading, for example).
  • Binocular vision skills – How well your child’s eyes can blend visual images from both eyes into a single, three-dimensional image.
  • Visual perceptual skills – How well your child can identify and understand what they see, judge its importance, and associate it with previous visual information stored in their brain.
  • Visual-motor integration – The quality of your child’s eye-hand coordination, which is important not only for sports, but also for legible handwriting and the ability to efficiently copy written information from a book or chalkboard.
  • Deficiencies in any of these important visual skills can significantly affect your child’s learning ability and school performance.

Many kids have vision problems that affect learning

Many kids have undetected learning-related vision problems. According to the College of Optometrists in Vision Development (COVD), one study indicates 13% of children between the ages of 9 and 13 suffer from moderate to severe convergence insufficiency (an eye teaming problem that can affect reading performance). The study also concluded as many as one in four school-age children may have at least one learning-related vision problem.

Signs and symptoms of learning-related vision problems

There are many signs and symptoms of learning-related vision disorders, including:

  • Blurred distance or near vision, particularly after reading or other close work
  • Frequent headaches or eye strain
  • Difficulty changing focus from distance to near and back
  • Double vision, especially during or after reading
  • Avoidance of reading
  • Easily distracted when reading
  • Poor reading comprehension
  • Loss of place, repetition, and/or omission of words while reading
  • Letter and word reversals
  • Poor handwriting
  • Hyperactivity or impulsiveness during class
  • Poor overall school performance

If your child exhibits one or more of these signs or symptoms and is having problems in school, call us to schedule a comprehensive children’s vision exam.

Comprehensive children’s vision exam

A children’s vision exam includes tests performed in a routine eye exam, plus additional tests to detect learning-related vision problems. These extra tests may include an assessment of eye focusing, eye teaming, and eye movement abilities. Also, depending on the type of problems your child is having, we may recommend other testing, either in our office or with a children’s vision and/or vision development specialist.

Vision therapy

If it turns out your child has a learning-related vision problem that cannot be corrected with regular glasses or contact lenses, then special reading glasses or vision therapy may help. Vision therapy is a program of eye exercises and other activities specifically tailored for each patient to improve their vision skills.

Vision and learning disabilities

A child who is struggling in school could have a learning-related vision problem, a learning disability or both. Vision therapy is a treatment for vision problems; it does not correct a learning disability. However, children with learning disabilities may also have vision problems that are contributing to their difficulties in the classroom.

After your child’s comprehensive vision exam, we will advise you about whether a program of vision therapy would be helpful. If we don’t provide the services we believe your child needs, we will refer you to a children’s vision specialist or education/learning specialist who does.

Minimize Stress To Keep Your Eyes Healthy

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Big project due? Bills need to be paid? Trying to find a job? These are a few things that can cause stress. That stress can cause other problems to your health including your eyes.

Life can be hectic as we try to best manage our tasks in an orderly fashion, but sometimes the anxiety takes control of us and our body. Hypertension, or constant high blood pressure, can put us at a higher risk of Retinal Vein Occlusion (RVO). This disease affects about four out of 1000 people and is considered a “heart attack or stroke selectively affecting the retina.”

This can lead to blurred vision or total loss of vision if not treated.

Our eyes are the most sensitive part of our body which is why stress easily affects our vision. High blood pressure obviously affects the heart and it also damages the vessels that supply blood to our eyes. This damage is in the form of clots.

How Can I Prevent Stress-Related Issues?

The best way to treat this problem is to address your stress. It’s important for us to understand the physical damage that can be done to our eyes. Finding ways to cope with our stress will lead to less anxiety and keep our eyes and the rest of our body healthy.

Technology has also helped with controlling the damage done to our eyes due to stress. These new treatments include injections, lasers and surgery. It’s important to get your blood pressure checked regularly to help prevent RVO from affecting you and your eyes.

If you’ve noticed your vision is becoming more blurred, please schedule an appointment to see one of our eye doctors at Performance Eyecare. It’s important to understand why your vision is blurred and to address it immediately.

It’s also important to seek other help if you are under uncontrollable stress whether it be from the workplace or your everyday life.

Glasses to Aid Kids’ computer vision

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Prevent Computer Vision Syndrome

Did you know October is considered Computer Learning Month? We’re not here to teach you how to use the computer better, but to inform you of computer vision syndrome, especially for children who are likely to use the computer more often.

Take a look at these facts and figures from Gary Heiting, OD and Larry K. Wan, OD:

  • 94 percent of American families with children have a computer in the home with access to the Internet.*
  • The amount of time children ages 8 to 18 devote to entertainment media (including computer and video games) each day has increased from 6.19 hours in 1999 to 7.38 hours in 2009.**
  • In 2009, 29 percent of American children ages 8 to 18 had their own laptop computer, and kids in grades 7 through 12 reported spending an average of more than 90 minutes a day sending or receiving texts on their cell phones.**

Sitting in front of the computer screen stresses a child’s eyes because it forces them to focus and strain a lot more than any other task. This can put them at an even greater risk than adults for developing symptoms of computer vision syndrome.

According to the American Optometric Association (AOA), parents should consider these factors affecting children and computer use:

  • Children may not be aware of how much time they are spending at a computer. They may perform a task on the computer for hours with few breaks. This prolonged activity can cause eye focusing and eye strain problems.
  • Children are very adaptable. They assume that what they see and how they see is normal — even if their vision is problematic. That’s why it is important for parents to monitor the time a child spends working at a computer and make sure they have regular eye exams as directed by their optometrist or ophthalmologist.
  • Children are smaller than adults. Since computer workstations often are arranged for adult use, this can change the viewing angle for young children. Computer users should view the screen slightly downward, at a 15-degree angle. Also, if a child has difficulty reaching the keyboard or placing their feet comfortably on the floor, he or she may experience neck, shoulder and/or back pain.

Here are tips to reduce the risk of computer vision syndrome in children, according to the AOA:

  1. Have your child’s vision checked. Before starting school, every child should have a comprehensive eye exam, including near-point (computer and reading) and distance testing.
  2. Limit the amount of time your child spends at the computer without a break. Encourage kids to take 20-second breaks from the computer every 20 minutes to minimize the development of eye focusing problems and eye irritation. (Some eye doctors call this the “20-20 rule.”)
  3. Check the ergonomics of the workstation. For young and small children, make sure the computer workstation is adjusted to their body size. The recommended distance between the monitor and the eye for children is 18 to 28 inches. Viewing the computer screen closer than 18 inches can strain the eyes.
  4. Check the lighting. To reduce glare, windows and other light sources should not be directly visible when sitting in front of the monitor. Reduce the amount of lighting in the room to match the computer screen.

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Eye Exams for Children

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As a parent, you may wonder whether your pre-schooler has a vision problem or when a first eye exam should be scheduled.

Eye exams for children are extremely important. Experts say 5 to 10% of pre-schoolers and 25% of school-aged children have vision problems. Early identification of a child’s vision problem is crucial because, if left untreated, some childhood vision problems can cause permanent vision loss.

When should kids have their eyes examined?

According to the American Optometric Association (AOA), infants should have their first eye exam at 6 months of age. They should go back to the eye doctor around age 3, then again at about age 5 or 6.

For school-aged children, the AOA recommends an eye exam every two years if no vision correction is required. Children who need eyeglasses or contact lenses should be examined annually.

Early eye exams also are important because children need the following basic visual skills for learning:

  • Near vision
  • Distance vision
  • Eye teaming (binocularity) skills
  • Eye movement skills
  • Focusing skills
  • Peripheral awareness
  • Eye/hand coordination

Scheduling your child’s eye exam

Your family doctor or pediatrician likely will be the first medical professional to examine your child’s eyes. If eye problems are suspected during routine physical examinations, they may refer an optometrist for further evaluation. Eye doctors have specific equipment and training to help them detect and diagnose vision problems.

When scheduling an eye exam, choose a time when your child is usually alert and happy. Specifics of how eye exams are conducted depend on your child’s age, but an exam generally will involve a case history, vision testing, determination of whether eyeglasses are needed, testing of eye alignment, an eye health examination and a consultation with you regarding the findings.

After you’ve made the appointment, you’ll fill out a form all about your child’s health. The health history form will ask about your child’s birth history (also called perinatal history), such as birth weight and whether or not the child was full-term. Your eye doctor also may ask whether complications occurred during the pregnancy or delivery. The form will also inquire about current medications and past or present allergies.

Be sure to tell your eye doctor if your child has a history of prematurity, has delayed motor development, engages in frequent eye rubbing, blinks excessively, fails to maintain eye contact, cannot seem to maintain a gaze while looking at objects, has poor eye tracking skills or has failed a pediatrician or pre-school vision screening.

Your eye doctor will also want to know about your child’s previous ocular diagnoses and treatments like surgeries and glasses or contact lens wear. Be sure you inform your eye doctor if there is a family history of eye problems requiring vision correction, such as nearsightedness or farsightedness, misaligned eyes (strabismus) or amblyopia (“lazy eye”).

Eye testing for infants

It takes some time for a baby’s vision skills to develop. To assess whether your infant’s eyes are developing normally, your eye doctor may use one or more of the following tests:

  • Tests of pupil responses evaluate whether the eye’s pupil opens and closes properly in the presence or absence of light.
  • “Fixate and follow” testing determines whether your baby can fixate on an object (such as a light) and follow it as it moves. Infants should be able to perform this task quite well by the time they are 3 months old.
  • Preferential looking involves using cards that are blank on one side with stripes on the other side to attract the gaze of an infant to the stripes. In this way, vision capabilities can be assessed.

Eye testing for pre-school children

Pre-school children can have their eyes thoroughly tested even if they don’t yet know the alphabet or are too shy to answer the doctor’s questions. Some common eye tests used specifically for young children include:

  • LEA Symbols for young children are similar to regular eye tests using charts with letters, except that special symbols in these tests include an apple, house, square and circle.
  • Retinoscopy is a test that involves shining a light into the eye to observing how it reflects from the retina (the light-sensitive inner lining of the back of the eye). This test helps eye doctors determine the child’s eyeglass prescription.
  • Random Dot Stereopsis uses dot patterns to determine how well the two eyes work as a team.

Eye and vision problems that affect children

Besides looking for nearsightedness, farsightedness and astigmatism (refractive errors), your eye doctor will be examining your child’s eyes for signs of these eye and vision problems commonly found in young children:

  • Amblyopia. Also commonly called “lazy eye,” this is decreased vision in one or both eyes despite the absence of any eye health problem or damage. Common causes of amblyopia include strabismus (see below) and a significant difference in the refractive errors of the two eyes. Treatment of amblyopia may include patching the dominant eye to strengthen the weaker eye.
  • Strabismus. This is misalignment of the eyes, often caused by a congenital defect in the positioning or strength of muscles that are attached to the eye and which control eye positioning and movement. Left untreated, strabismus can cause amblyopia in the misaligned eye. Depending on its cause and severity, surgery may be required to treat strabismus.
  • Convergence insufficiency. This is the inability to keep the eye comfortably aligned for reading and other near tasks. Convergence insufficiency can often be successfully treated with vision therapy, a specific program of eye exercises.
  • Focusing problems. Children with focusing problems (also called accommodation problems) may have trouble changing focus from distance to near and back again (accommodative infacility) or have problems maintaining adequate focus for reading (accommodative insufficiency). These problems often can be successfully treated with vision therapy.
  • Eye teaming problems. Many eye teaming (binocularity) problems are more subtle than strabismus. Deficiencies in eye teaming skills can cause problems with depth perception and coordination.

Vision and learning

Experts say that 80% of what your child learns in school is presented visually. Undetected vision problems can put them at a significant disadvantage. Be sure to schedule a complete eye exam for your child prior to the start of school.

Get Ready for School with a Trip To Performance Eyecare

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The American Optometric Association (AOA) recommends each child has an eye exam prior to starting kindergarten. All children in Illinois are required to have an eye exam prior to kindergarten.

Did you know that 30 percent of learning disorders are caused by visual problems? According to Gary Heiting, OD of AllAboutVision.com, five to ten percent of preschoolers and 25 percent of school-aged children have vision problems. The key to getting your child off to the right start is early detection of vision issues. This is important because children are more likely to be responsive to treatment than adults.

The AOA recommends school-aged children with no vision correction should have an eye exam every two years. Those children with eyeglasses or contacts need to have an annual eye exam, or as recommended by their optometrist.

How Does Good Vision Help My Child in School?

Good eyesight is critical to learning, because children rely heavily on sign and touch to explore the world around them. They use skills such as near vision, distance vision, binocular coordination, eye movement skills, focusing skills, peripheral awareness and hand-eye coordination.

Your family doctor or pediatrician will likely be the first medical professional to examine your child’s eyes. If eye problems are detected, a referral to an eye doctor is likely to happen.

It’s important to choose a time when he or she is usually wide awake and happy! At Performance Eyecare we have a kid-friendly office with a kid’s corner complete with an African animal mural and toys. We understand children can be anxious when going to any doctor so we try to make it as relaxing and enjoyable as possible for them.

To schedule your child’s appointment, find your local office and select your appointment time here!

For more information on why vision matters when kids go back to school, check out the original article: http://www.allaboutvision.com/eye-exam/children.htm