What can I do to ensure that my baby's eyes and vision are properly monitored and cared for?

By the BabyCenter editorial staff, from: http://www.babycenter.com/refcap/baby/babydevelopment/1437477.html

As a parent, your first strategy should be to make sure your baby's eyes are checked thoroughly at regular doctor visits. If you're not satisfied, talk with your child's doctor. And if you're still not happy with the level of care, by all means get a second opinion from someone you trust, whether that's a pediatrician, an ophthalmologist, or an optometrist. Between visits, monitor your baby's developing vision at home, and if you think something might be wrong, have it checked out. For pointers on what to look for, see our list of warning signs that there might be a problem with your child's eyes.

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What happens during an Eye Exam at a well-baby visit, and how can I tell whether the doctor is doing a thorough job?

By the BabyCenter editorial staff, from: http://www.babycenter.com/refcap/baby/babydevelopment/1437477.html

At all well-baby visits, your child's doctor should check the structure and alignment of your baby's eyes, his ability to move them correctly, and for signs of congenital eye conditions or other problems. Here's what to watch for to make sure the doctor's doing a thorough job:
? Your baby's family eye history is noted.
? Using a penlight, the doctor examines the outside of your baby's eyes, including the eyelids and the eyeball. She checks to see that the pupils are the same size and that the lids don't droop. She looks for discharge and other signs of infection, allergy, disease, or blocked tear ducts. She looks at the position of your baby's eyes, lids, and lashes.
? The doctor checks your baby's eye movement by watching his ability to fix on an object (like a toy) and follow it as she moves it into different positions. She'll do this with each eye, and with both eyes together.
? The doctor watches how your baby responds to an object with each eye. If both eyes don't respond equally, or if your baby has a strong preference for one eye, it could signal a problem.
? The doctor observes how your baby's eyes react to changes in light. In a darkened room (to make the eyes dilate), she'll use a lighted instrument called an ophthalmoscope to look for a red reflex in each eye and in both eyes at once. An abnormal reaction to light could be a red flag for eye problems like cataracts (clouding of the lens of the eye) or tumors.

Most doctors are trained to screen children for eye problems, but some are more comfortable (and better trained at) examining eyes than others. A good pediatrician or family doctor will refer you to a specialist if she thinks she's unable to adequately screen or if she notices a potential problem.

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What is amblyopia?

By the BabyCenter editorial staff, from: http://www.babycenter.com/refcap/baby/babyills/babyeyes/10890.html

Amblyopia (also called Lazy eye) develops when the brain shuts off or suppresses vision in one eye. This can happen if your baby's eyes are misaligned or if he can't see as well with one eye because of nearsightedness, farsightedness, astigmatism, or something that's blocking clear vision in that eye, like a cataract or a drooping eyelid. About 3 to 6 percent of children under the age of 6 develop amblyopia. Treatment is most successful before age 5 or 6, although recent research shows that even older children may recover their vision. If ignored, though, amblyopia can result in permanent vision loss.

How to recognize amblyopia

Identifying the problem isn't easy because children can get along fine using only one eye. The less-used eye may look perfectly normal, even though your baby isn't using it to see. Your child's doctor should routinely test for amblyopia (as well as strabismus) by checking the eyes independently and together. But pediatric ophthalmologist James Ruben, a member of the AAP section on ophthalmology, says it's also a good idea for you to occasionally test the vision in your child's eyes at home.

Testing for amblyopia at home.

Here's a simple way to get an idea of whether your baby's eyes are both pulling their weight:

While your baby is interested in an object ? a toy bear that you dance in front of him, for example ? cover one of his eyes (it helps to have a partner for this). See if he follows the object with his uncovered eye as you move it. Then cover the other eye and see if he follows the object just as well ? and as far.

It's a little tricky to test a baby, who may lose interest or become distracted before your informal test is over. But if one eye seems weaker, try testing it again another time ? maybe starting with the other eye first.

If your baby seems to be able to see better with one eye than the other, schedule an appointment with either your child's doctor for a vision screening test or an ophthalmologist, who can diagnose and treat the problem.

What can be done to treat amblyopia?

The first step is to address any underlying problem ? by correcting the astigmatism or nearsightedness with glasses or removing a cataract with surgery, for example. Once that's taken care of, the goal is to encourage your child's brain to connect with the weaker eye, eventually improving its ability to see.

Glasses don't help to improve this eye-brain connection. In fact, one sign of the condition is that your baby's vision is still worse in one eye when he's wearing the correct glasses. That's because glasses work to help the eye focus ? like a camera lens ? but if the brain isn't communicating well with that eye, there won't be a clear picture. Instead, your doctor will probably recommend covering your baby's stronger eye with a patch or using eyedrops once a day to blur the vision in that eye, either of which will force the brain to use the weaker eye. This process could take weeks, months, or even years.

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