Northwest Health | SUMMER 2010 By Virginia Smyth

It's never too soon to see if your child is seeing well.

Lucas Ng was just 1 year old when he had his first appointment with Grace Cinciripini, MD, a pediatric ophthalmologist with Group Health Physicians. He'd been referred to Dr. Cinciripini at our Bellevue Medical Center because of a benign skin condition that, in rare instances, can involve the eye and cause blindness.

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Dr. Cinciripini ruled out that possibility, but she did find that Lucas was very nearsighted in one eye and slightly farsighted in the other — a serious condition that can lead to amblyopia, commonly referred to as lazy eye. Between 2 percent and 4 percent of all children are affected by this condition in which one eye is weaker than the other. To correct it, children must be diagnosed at a young age. "If not treated, the condition becomes irreversible and can result in permanent vision loss," says Dr. Cinciripini.

While grateful the condition was caught early, Hoi Ho, Lucas' mother, says the treatment proved challenging. It was difficult to find eyeglass frames that fit, and not surprisingly, Lucas wasn't excited about wearing them. Ditto the eye patch. But his mother's persistence paid off. "Now, with the help of his glasses, his ability to see in both eyes is equal," she says.

Early Eye Care

Children are routinely screened for eye problems during well-child visits that begin soon after birth. Eye issues might be detected during these visits, or a parent may notice that something doesn't seem right — especially in a very young, pre-verbal child. Symptoms that may suggest an eye problem include frequent eye rubbing; extreme light sensitivity; poor focusing and visual tracking; excessive tearing; eyes that look mismatched, crossed, or that don't move together; and pupils that are not the same size or that are white instead of black.

"If a parent has any concern — if the eye doesn't look right or if they feel the child isn't seeing well — they should discuss it with their pediatrician or family doctor," advises Dr. Cinciripini. Even if a parent doesn't notice a problem, a vision screening with the child's doctor is important prior to starting school, notes Philip Paros, OD, an optometrist at our Capitol Hill Campus in Seattle. "We want to rule out any eyesight issues and give the child the best possible advantage at school," he says.

If your family physician or pediatrician does detect a problem, your child will be referred to a specialist, either an optometrist who does basic eye exams and can prescribe glasses, or an ophthalmologist who deals with more serious concerns that may require advanced treatment and surgery.

Contact Lenses

Children with nearsightedness or astigmatism are usually prescribed eyeglasses. As the child matures, the question of whether glasses can be exchanged for contact lenses will come up. Contacts are usually not recommended until children are willing to take on the responsibility of taking care of their eyes, says Michael Lee, MD, an ophthalmologist at Bellevue Medical Center. For some children, that could be at age 12; for others, it might be much later.