Screenings help detect eye problems early

Experts recommend routine eye screening in all infants before they leave the hospital and at all well-child visits.

Pediatricians look for abnormalities in the reflex of the eye, the alignment of the two eyes and how well a child responds visually to light or to objects. If your child's physician suspects a problem, he or she will refer you to a pediatric ophthalmologist for a complete eye exam.

Common pediatric eye problems include strabismus (misaligned eyes, typically crossed eyes), amblyopia or "lazy eye" (in which one eye has weaker vision than the other), and refractive errors (the need for glasses to see clearly).

You can help your pediatrician monitor your child's eye health by pointing out any crossing or drifting of the eyes you may see, says Susan M. Culican, M.D., assistant professor of ophthalmology and visual sciences at Washington University School of Medicine in St. Louis and a pediatric ophthalmologist at St. Louis Children's Hospital.

"Many parents notice eye misalignment or different-colored pupils in photos of their children," she says. "If you have any question, be sure to take the photos with you to your appointment with your pediatrician or eye-care professional."

Older children will often have eye screenings in preschool or elementary school. These exams can draw attention to children with more subtle eye problems than can be detected in infancy, when the children cannot tell you what they see. If your child fails a school vision screening, contact your pediatrician.

Children with behavioral or learning disabilities should also have a vision-screening exam as soon as possible once the disability is discovered, Culican says.

"Many conditions that result in learning difficulties are associated with higher rates of eye problems that can further hamper a child's ability to learn," says Culican. "Prompt intervention will help to optimize a child's ability to do his or her best work."

Culican says parents and their child's pediatrician should work together to make sure the child's eyes are working the way they should, but parents also need to protect their child's eyes.

"Racquet sports such as handball, racquetball and squash should never be played without protective eyewear," she said. "Older children who are allowed to use fireworks should wear something to shield their eyes and should always be supervised by an adult."

BB guns and paintball guns can lead to serious eye injury, including loss of eye. They should never be aimed at the face and should be used only in supervised arenas with appropriate eyewear.

Washington University School of Medicine's full-time and volunteer faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Children's hospitals. The School of Medicine is one of the leading medical research, teaching and patient care institutions in the nation, currently ranked fourth in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Children's hospitals, the School of Medicine is linked to BJC HealthCare.