That is a good question but that all depends on what is diagnosed. Let’s go briefly over some of the most common diagnosis.
Refractive errors:
Hyperopia (Far sightedness)
What is interesting is that a certain amount of refractive error in a child is actually normal. When a child is born, most babies tend to be
hyperopic or far sighted. This means that the eye is not strong enough to focus the light onto the retina without focusing or the assistance of a lens. This will make both the distance and near images blurry. A child tends to outgrow this in time. However, a highly
hyperopic baby may need additional correction to prevent visual developmental delays and
amblyopia (will discuss later).
Myopia (N
ear sightedness)
This is the most common refractive error diagnosed in babies. Myopia or near sightedness is when the eye’s optics are too strong which causes the eye to focus the light before the retina. No amount of focusing will be able to make a myopic image clear. Myopic babies will see clearly up close, but blurry in the distance. As the nearsightedness increases, the range at which a baby can see up close decreases. In babies, because of the nature of their everyday environment being within a few feet or so, a mild myopic prescription is acceptable without correction. However, if there is a high myopia present, a corrective lens is optimal to prevent visual developmental delays.
Astigmatism
Astigmatism is one of the most confusing things to understand, in a nutshell it is a disruption in the way light normally enters into the eye. With astigmatism there is a different shape of the front surface of the eye, which causes a disruption of the image. Typically, crisp vision is correlated to a spherical front surface (like a baseball), but with an astigmatic eye, the front surface is not spherical, but cylindrical, (like a football). Babies will tend to show slight astigmatism when born, but if the astigmatism is large enough or in an area that is not typical, correction is again recommended to avoid visual developmental delays.
Other Visual Conditions:
Strabismus
Maybe you know the phrase “lazy eye”. A strabismus is when one eye of the child is turned either in toward the nose or out toward the side of the head. The best way to make sure that your child does not have this condition is to bring him or her to your optometrist for an eye exam. If a strabismus is discovered, two things can be done, either prism or surgery, depending on your child’s severity of strabismus.
This is an example of esotropia
Nystagmus
Nystagmus is unique that the eyes move in a pattern. With nystagmus, you will see the eyes wiggle, oscillate or shift from one side to the other. Nystagmus can be a result of cause poor vision and can be associated with poor wiring to the eye muscles. This is found in a condition known as albinism. If the nystagmus is present after 3 months of age, contact your pediatrician. Visual development is important between 3 and 4 months, at this point the pediatrician will actively search for the cause of nystagmus.
This video is an example of pendular nystagmus, one type of nystagmus that can be diagnosed.
Amblyopia
Amblyopia is a reduced visual function in one eye or both eyes due to a lack of development into the brain. One of the most common ways that amblyopia develops is when there is a significant difference in refractive error between the two eyes (ex. one eye can see 20/20, the other only can see 20/400 because of myopia, hyperopia or astigmatism). The brain essentially gives up trying to look through the blurry eye and a permanent and life effecting reduction in vision can occur if not cared for.
Amblyopia can also occur in both eyes (less frequent) when there is enough of a refractive error in both eyes that the target can not be made clear both at near or far (ex. absolute hyperopia or high astigmatism). The brain does not have the ability to make the images clear, so it does not bother to develop the connections necessary to do so.
Other causes that cause a difference in visual acutity include cataracts (congenital or acquired), nystagmus, strabismus or other visually disturbing conditions.
Now, what about treatment? If amblyogenic factors are present, the optometrist will then start a treatment regime geared toward your child's condition. It may include patches, glasses and/or drops that are geared toward a restoration of normal vision and interaction between the two eyes.
Retinoblastoma
Retinoblastoma is a rare type of ocular cancer found in infants and children. Retinoblastoma has an occurrence of 1 in 15 000 to 20 000 births. This is a life threatening cancer that needs to be removed at first detection. One way to see a more advanced case of retinoblastoma is to look at a photo of your child. If one eye is more white than the other, then you should have their eyes examined as soon as possible. When an optometrist makes a diagnosis of retinoblastoma, he or she will refer to a surgical specialist immediately.
