Your Guide to Kids' Eye Care

Your Guide to Kids' Eye Care

Raise your hand if you've ever told your child to eat his carrots because they're good for his eyes.

We thought so.

"80% of our processing, the way we understand the world, is vision," says Joel Warshowsky, O.D., F.A.A.O., F.C.O.V.D. a behavioral and developmental optometrist. "If our vision is off, we’re off."


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So ... are carrots really enough? Since August is children's eye health month, we set out to answer that question and to figure out how we can best care for our children's eyes.

Where do we start? Right here:

When Should Children Visit the Eye Doctor?
The American Optometric Association recommends having your child's eyes checked at six months if everything seems normal--meaning you don't notice signs like excessive tearing, red eyelids or extreme sensitivity to light, and if there isn't a family history of eye problems. If everything continues to be normal, your child's next visit should be at age 3, then every two years after that.

For more on helping your child's eyes develop appropriately, find age-specific recommendations here.

Are School Eye Checks Enough?

According to Dr. Warshowsky, they are not. "Definitely go to an eye doctor outside of school," he said. Annual vision screening in schools--which some schools don't even do, so check with yours if you're interested--usually only detect 20-30% of eye problems, and the earlier problems are caught, the fewer repercussions kids will have in the future. (More on that below.)

Additionally, standard school eye testing doesn't include checking for things like tracking and focusing skills, the components that can really affect young kids.

Can Eye Problems Lead to Other Problems?

Behavioral Optometry, in which Dr. Warshowsky specializes, is an entire field of study dedicated to the idea that vision is a developed system, and that delays in the development can be reversed through therapy, in turn correcting outside issues that could be related to the delays, like learning disabilities or behavioral problems. 

Vision can derive meaning, like what words on a page mean, or direct action, like how to get from the classroom to the school bus, Dr. Warshowsky explains. If your eyes don't work correctly, your ability to understand meaning or to perform physically is compromised--so you might not understand the pages of that book, or you might bump into things.


Dr. Warshowsky compares undiagnosed vision problems to looking into a distorted fun house mirror: It's fine at first, but at some point you get frustrated, especially when you are young and don't quite understand what's happening. "These kids want to get out," he says, "so they start acting out. They can’t rely on what their vision is telling them, so they become insecure and anxious, which can snowball into larger behavioral problems."

When Is My Child Old Enough for Contact Lenses?

"Certain conditions demand contacts," says Dr. Warshowsky, "like having a high prescription at a young age, or being born with cataracts. For children who don’t need contacts, it’s up to the parents to determine when the child is ready."

Since properly used contacts won't hurt the eye, signs of readiness include: Will your child keep his or her hands clean when handling the contacts, change lenses regularly and take them out every night? Improper care of contacts can lead to infection, so once you feel that your child is responsible enough to care for his or her eyes appropriately, contacts are fine.

What Are the Warning Signs That My Child Might Be Having Eye Problems?

Besides obvious complaints about not being able to see the board at school or the clock on the wall, Dr. Warshowsky cites poor coordination, sitting very close to the TV past age 5 and trouble learning to read or write as indicators of eye issues. Also be on the lookout for eyes that turn inward or outward independently of each other, which could indicate a common disorder called convergence insufficiency, which can affect your child's learning but is not tested for in schools. If you notice this happening, head to the optometrist.

Are There Specific Behaviors That Are Good or Bad for the Eyes?

Sitting too close to the TV or not eating enough carrots aren't the culprits for poor eyesight, says Dr. Warshowsky. Straining the eyes with unequal light (such as reading in the dark or using a backlit tablet in the dark) is a bigger issue--according to Dr. Warshowsky, studies show that when vision is blurred, it stresses the focusing system.

As for farsightedness, that's wholly genetic.

Dr. Warshowsky points out, however, that in children's developing eyes, nearsightedness can sometimes be corrected with the right prescription--meaning a weaker prescription that actually trains the eyes to work harder at focusing. "The way an eye doctor prescribes glasses will either make a prescription stronger or weaker," the doctor explains. "Parents should be aware those options are available and speak to their child's doctor."

What If I Can't Afford Eye Care for My Child?

For most people, vision insurance is supplemental to regular insurance, and the type of eye exam your child has, as well as whether or not it will be covered, is determined by the reason for the visit or the main complaint. The difference between "routine" vision exams and "medical" eye exams tends to be the diagnosis. Routine exams generally produce diagnoses like astigmatism, or farsightedness, while medical exams produce diagnoses like conjunctivities.

While each insurance plan will differ, most companies handle the two types of exams differently. Sometimes medical eye exams are covered, while routine exams may not be. Many vision plans also provide coverage for glasses and contacts, or at least give some kind of discount.

If eye insurance is out of the question, there are a handful of resources that help parents provide proper eye care for their children.The following are some examples from All About Vision:

  • InfantSEE: A national public health program that provides a one-time eye exam to children ages 6-12 months, independent of parents income or insurance coverage. For more information, visit their website.
  • The Children's Health Insurance Program (CHIP): Provides low-cost health insurance coverage for children in families who earn too much income to qualify for Medicaid, but can't afford to purchase private health insurance. For more information, visit their website.
  • Sight for Students: Provides free exams and glasses to students of low-income or uninsured families. For more information, visit their website.
  • New Eyes for the Needy: This volunteer organization purchases new eyeglasses for poor children and adults in the United States and recycles donated glasses for people in developing countries. For more information, visit their website.

Pssst! Got their eyes under control? Then you may want to turn your attention to their pearly whites. Read everything you need to know about children's dental care here.


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