Children’s Eyes by Three Years Old
Peter S. Schwartz, MD
The American Academy of
Pediatrics recommends that all children have their eyes screened by the time
they are three years old. This screening should be performed by an
ophthalmologist, who is a medical doctor that specializes in diagnosing and
treating eye and vision problems. These pediatric guidelines include all
children, including those who are healthy, with no obvious visual or physical
The emphasis on early
ophthalmologic screening is very important. The vision center of the brain
develops from the time of birth through the sixth or seventh year
of life. When a child suffers from poor vision during these critical early
years of development, the brain is not stimulated to “learn” to see. Left
undiagnosed and uncorrected, impaired vision during these first few years can
lead to poor vision that is permanent. Amblyopia,
sometimes known as lazy eye, is correctable as a child, but typically cannot be
corrected past the age of seven or eight.
early an age can vision problems be detected?
A pediatric ophthalmologist can
examine a newborn child and determine whether the child will need glasses or if
there is another eye problem present. Even premature babies should be examined
while still in the hospital. Certainly when parents or siblings of the baby
wear glasses, or have any family history of eye problems, it’s a good idea to
have the baby screened sooner rather than later.
are the most common pediatric eye problems?
Most kids with vision problems
just need glasses, either to correct refractive errors (near or far sightedness
or astigmatism) or to address eye muscle disorders.
Another common pediatric eye problem is a wandering, or crossed eye. Known as strabismus, this can occur for many
reasons. Poor vision from refractive errors, pediatric cataracts, or problems
with the brain controlling the eye muscles are some examples.
Amblyopia, which we discussed
earlier, can be associated with almost any disorder that compromises the
vision. It may be associated with wandering eyes, or other obvious signs of eye
disease. However, it may be hidden to even an attentive parent or
It’s also not uncommon for young children to suffer trauma to the eye from accidents;
these injuries should be addressed immediately.
How are problems like lazy eye and crossed eyes treated?
In treating amblyopia or strabismus we are striving to teach the brain to see out of both
eyes together and to achieve a satisfactory cosmetic result. Sometimes these
conditions can be successfully treated with a combination of glasses,
exercises, eye drops, and an eye patch to help the weaker eye work harder.
Often, however, surgery is required to achieve goals of treatment. These are
same-day surgery procedures performed at Cayuga Medical Center’s Surgicare on
the Convenient Care Campus in Ithaca. Kids undergoing this surgery are
typically back at school in a couple of days.
there is no family history of vision problems and no obvious vision problem, do
I still need to have my child screened?
Yes, you should have your
child’s vision screened. Amblyopia is
not always obvious even to a watchful parent; the signs can be very subtle.
Your child’s eyes may be aligning well and there may still be a vision deficit.
You might notice that your child is clumsy, and this may well be due to the
fact that he or she is simply not be seeing well.
Routine eye exams for healthy, normal kids can go a long way to ensuring better
vision for the rest of their lives.
Schwartz is board certified in ophthalmology and is fellowship trained in
pediatric ophthalmology. He is a member of the medical staff of Cayuga Medical
Center and treats both pediatric and adult patients. His practice is located at
2333 Triphammer Road in Ithaca and he can be reached
at (607) 266-7600. Dr. Schwartz graduated with distinction from Cornell in an
accelerated three-and-a-half-year program and went on to the Mount Sinai School
of Medicine in New York, where he also graduated with honors and was inducted
into Alpha Omega Alpha Medical Honor Society. Following his ophthalmology
residency at Mount Sinai Hospital, Dr. Schwartz went to Children’s Hospital of
Michigan for a fellowship in pediatric ophthalmology. He also served on the teaching
faculties of two of the country’s premier teaching hospitals, the New York Eye
and Ear Infirmary and Mount Sinai Medical Center, where medical residents in
specialty training honored him with a number of teaching awards.