Your Child's Vision

About 50 percent of children with vision problems are not properly treated according to the Vision Council of America. One of the reasons is that vision tests and vision screening exams are no longer provided by many schools.

Good vision is important for all of us. In children, good vision is essential for proper physical and educational growth.

Having An Eye Exam

The American Academy of Ophthalmology recommends that all infants be screened by six months of age by a pediatrician, family doctor or ophthalmologist. Once a child starts school, he/she should have a comprehensive eye exam at least every two years.

If you detect signs of a vision problem or have questions about the health of your child’s eyes, you should see your physician or eyecare professional. No child is too young for an eye exam.

Amblyopia

Amblyopia, or lazy eye, is a condition where there is an unequal vision between the eyes despite the use of glasses or other corrective measures. Your child’s eyes develop at different rates and this leads to differences in how each eye focuses or unequal vision. The eye with the weaker vision sometimes wanders, which is why amblyopia is commonly known as lazy eye. It is the leading cause of unilateral vision loss in children and young adults. It can be caused by many vision problems, such as ocular misalignment or cloudiness in the line of vision due to cataracts.

In some children with amblyopia, one eye wanders or does not move with the other eye. In other children, there may be no visual symptoms and young children may not complain about poor vision making amblyopia hard to detect. Some conditions that can suggest amblyopia include:

• Eyes that do not move together in the same direction

• Eyes that do not fix on the same point

• Crying or complaining when one eye is covered

• Squinting or tilting the head to look at something

• Cloudiness in the black center of the eye

• An upper eyelid that droops and covers most of the eye.

Amblyopia is reversible by patching the better-seeing eye or by blurring its vision using prescription eye drops.

Strabismus

Strabismus is a condition in which the eye muscles fail to coordinate, leading to double vision and poor depth perception. Sometimes the child’s eye will point outward or inward. Intermittent strabismus can be caused by fatigue or stress and is a temporary condition that can be treated with rest and relaxation. If the condition does not go away, you should see your pediatrician or ophthalmologist. When the condition occurs all the time, it is called constant strabismus.

The most common visible signs of strabismus are:

• Eyes that do not look in the same direction at the same time

• Eyes that do not move together

• Squinting or closing one eye in bright sunlight

• Tilting or turning of the head to look at an object

• Bumping into things because of limited depth perception.

A child who develops strabismus between the ages of seven and ten may have double vision as well.

Astigmatism

Astigmatism is when the lens or cornea of the eye takes on an oval shape instead of being round. This makes it difficulty for your child’s eyes to focus and your child’s vision will be blurred at any distance. It is a very common condition in that most people have some degree of astigmatism. Larger amounts of astigmatism can cause not only blurred and distorted vision, but eye discomfort and headaches as well.

Children may experience difficulty focusing on printed words and lines, headaches and eye strain or tired eyes. Usually, your ophthalmologist will prescribe corrected lenses, either eyeglasses or contact lenses, to correct the condition.

Benefits Under Your Coverage

Your Service Benefit Plan coverage does not provide benefits for routine eye exams. Benefits are only available if the eye exam is related to a specific medical condition.

Under both options, benefits are provided for the nonsurgical treatment of amblyopia and strabismus in children from birth through age 12. In addition, both options cover the surgical correction of amblyopia and strabismus.

Please refer to Sections 5(a) and 5(b) in the 2008 Service Benefit Plan brochure for more information about how these covered services are paid.

Written by Paula Spurway, Blue Cross and Blue Shield Association. References include the 2008 Service Benefit Plan brochure; www.webmd.com under children’s health; www.strabismus.org; and the web site for the American Optometric Association www.aoa.org.