The InfantSEE assessment offers early detection of potential eye and vision problems as a complement to the eye screening conducted in a pediatric well-care visit. A comprehensive assessment between the ages of 6 months and 12 months is recommended to determine healthy development of vision. Risk factors for many eye conditions, including Amblyopia (often referred to as Lazy eye), muscle imbalances, and some ocular diseases, have no signs or symptoms and may not be detected in a well-baby check-up. Such pediatrician visits include care and services performed by all personnel and last an average of 22.1 minutes, which is ample time for screening and detecting potential large-scope health problems. However, significant risk factors for eye and vision disorders are not detectable by base-level infant eye screening, and even early retinoblastoma, the seventh most common pediatric cancer, is detected more than 80 percent of the time outside the doctor’s office by a family member or friend.

 

Although infants cannot speak, optometrists have the clinical education, training and experience, as well as the instruments and resources, to provide non-invasive eye and vision assessments for any non-verbal patients such as infants. Additionally, volunteer InfantSEE optometrists have access to additional AOA training in working effectively with babies – and parents.

During the assessment, parents might hold the baby on their laps or on a lap pillow and might also assist by holding targets or toys to hold the baby’s attention. Optometrists will gauge the babies’ comfort levels with specific techniques and adjust them as necessary, but will typically evaluate visual acuity, refraction, motility, alignment, binocularity and overall eye health. As detailed below, these tests will determine signs of strabismus, amblyopia or diseases of the eye.

Following the assessment, in addition to sharing findings with the parents, the optometrist may send summary information to the infant’s pediatrician, family physician or other appropriate practitioners reporting and explaining any significant condition diagnosed in the course of the assessment.

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Glass lenses should be avoided in children because they are more likely to break. Plastic or polycarbonate lenses are lighter and safer but they scratch more easily. The lenses must be made with a scratch-resistant hard coating. Some high power prescriptions can result in thick lenses and your optometrist or optician may advise you on modifying a lens to make it more cosmetically acceptable. High density/thinner materials can be used and the edges of the lenses can be thinned to improve the appearance.

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Additional excerpted writings from Patricia S. Lemer, M.Ed., NCC, Executive Director, Developmental Delay Registry

Eyesight vs. Vision

Eyesight and vision are not synonymous. Eyesight is the sharpness of the image seen by the eye. Vision is the ability to focus on and comprehend that which is seen. Research has shown that while most children with special needs do not have eyesight problems, many have visual dysfunction. If a child has motor delays, vestibular difficulties, or health problems, vision is often compromised.

The American Optometric Association (AOA) recommends that children have vision examinations by six months. A good eye doctor can test many aspects of function at this young age and quickly effect changes with intervention.

Most school vision screenings check only eyesight, and only at twenty feet, not at reading distance. They rarely tell us whether a child has a clear image at nearpoint or how the eyes work together. The only information they provide is whether a child can see the blackboard. Many vision problems thus go undetected when parents have false security and brag, "My kid's eyes are 20/20!"

Vision is Learned

Vision, like reading, mathematics, and language, is learned. Giving meaning to what is seen begins at birth. In the developmental hierarchy, infants move without purpose, while their eyes learn how to work as a team, to sustain focus. Toddlers use movement to drive vision, such as shaking a rattle for its sound before looking at it. Finally, children can visualize without movement. Thus, for children to be successful in school, vision must purposefully direct their actions.

Vision Lays the Foundation for Language & Relationships

Vision plays a major role in language and social-emotional development. Children with language delays, attention deficits, pervasive developmental disorders and autism all have inefficient visual systems. If a toddler is not speaking or relating to others, a vision evaluation is essential.

A developmental optometrist can prescribe therapeutic and pleasurable activities to be done at home, during floor time, occupational and language therapy, or at day care. Combining the visual system with touch, movement, audition and social experiences benefits all areas. Begin Where They Are, a workbook designed by vision therapists and available through the DDR, has good ideas for pre-verbal children and toddlers.

The Developmental Delay Registry is a not-for-profit organization whose mission is to educate parents and professionals supporting children with developmental delays about healthy options for treating the whole child.

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