Did you know that eye exams start as early as day 1 of a baby's life? Vision is a key part of our ability to interact with the world, and as health care providers, we take vision screening very seriously. Before leaving the hospital, your baby will have had his or her eyes checked by the pediatrician and hospital team at least once. Your care team checks that there are no obvious abnormalities in the appearance of your baby's eyes. After leaving the hospital, your pediatrician or family practitioner then becomes the main health care professional to regularly examine your baby's eyes as part of each well-child visit. If there are any concerns, your pediatrician or family practitioner may refer you to a pediatric ophthalmologist (an eye doctor with an MD) for a closer look.
What is a pediatric ophthalmologist?
A pediatric ophthalmologist is a trained medical and surgical doctor who specializes in vision problems that affect children. In the United States, a pediatric ophthalmologist is a doctor who has completed college, medical school, a 1-year internship, 3-years of comprehensive ophthalmology training (also known as residency), and a 1-2 year fellowship specifically in pediatric ophthalmology and strabismus.
Pediatric ophthalmologists are experts in treating different eye conditions that affect children. This includes if a child has an eye misalignment (also known as 'strabismus' or 'squint'). Treatments include glasses, patching, and medications to help a child's visual system develop. Treatments may also involve complex eye surgery, which pediatric ophthalmologists are qualified to perform. Many doctors, including other ophthalmologists who do not work extensively with children, will refer their pediatric patients to a pediatric ophthalmologist for treatment because of the unique needs children have for their care. Pediatric ophthalmologists also commonly manage adults who have eye movement disorders because of their expertise in strabismus.
Here are examples of eye conditions that pediatric ophthalmologists manage and treat:
Examples of eye misalignment (strabismus).
What is normal vision?
From birth until about 2 months of age, babies may only blink to light. They will start to look at faces and start to track around 2 to 3 months of age.
From 4 months of age and onward, eye coordination continues to improve. Babies gets better at tracking objects with their eyes. Their ability to look and grasp for objects develops. During this time, babies also begin to develop depth perception. Before 4 months of age, it can be normal to have occasional crossing or drifting out of the eyes as a baby is learning to use both eyes together. By 4-6 months of age, babies should be able to use both eyes together without crossing or drifting out of the eyes. Eye-hand-body coordination develops quickly thereafter as a baby learns to crawl and then walk.
By age 3, a child should be able to read the majority of symbols on the 20/50 line of a vision chart.*
By age 4, a child should be able to read the majority of symbols on the 20/40 line.*
By age 5, a child should be able to read the majority of symbols on the 20/32 line or better.*
When should my baby be seen by a specialist for an eye exam?
Here are some situations when it may be worth considering a visit to the pediatric ophthalmologist:
If you have any of the above concerns about your baby's eyes, please talk to your pediatrician or family practitioner about getting a referral.
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