The eyes have it, but when they aren’t working correctly they can set your child up for a lifetime of misery. Finding a problem with the eyes early is key to repairing weaknesses that could lead to blindness later on. Vision screenings and, more importantly, comprehensive eye exams, should be on parents’ radars as public school begins next week.

“You talk about buying notebooks, pencils and papers, but don’t forget to check (their) eyes,” says optometrist Janet Leasher, the director of community outreach at Nova Southeastern University’s College of Optometry in Davie, Fla.

According to a December 2003 study of 1,846 children 6 and younger conducted by Vision Service Plan, a nationwide eye-care benefits provider, seven out of 10 youngsters had never had an eye exam. Only two in 10 had exams before their first birthday.

These figures worry the American Optometrist Association, which suggests that children receive their first eye exam by an ophthalmologist, optometrist or family doctor at 6 months and then at age 3 and every two years after that if everything is normal.

Children that young can’t read the traditional “big E” eye chart adults use, of course, but doctors can analyze their eyes using picture symbols and machines.

Some elementary schools offer free eye screenings beginning with kindergarten, while some states, such as Kentucky, have made these exams mandatory.

Gloria Bustetter is a pre-K teacher at North Miami’s Holy Family school and a mother of three. She has seen students needlessly placed into learning disability classes when the problem wasn’t their ability to comprehend the lessons but, rather, problems with vision, which can go beyond simply nearsightedness or farsightedness.

Some children have misaligned eyes, a k a strabismus; tracking problems; and amblyopia or lazy eye, the leading cause of treatable blindness in children.

The problem came home when Bustetter’s middle son Daniel, now 8, started falling behind despite high test scores.

“He’s had problems as far back as I can remember,” Bustetter says. “When he started to read he couldn’t remember his letters and we did a series of traditional and nontraditional tests to try and find out what the problem was.” The fear was that this bright child would eventually give up in frustration as his peers progressed more easily and more rapidly. A thorough eye exam finally determined that Daniel suffered a tracking problem, like a faulty stylus on a record player.

He couldn’t follow a line on the page from left to right, up and down, properly. Vision therapy through Nova corrected the problem.

“It’s been a lifesaver,” mom says. Daniel is now entering third grade at St. Rose Catholic School in Miami Shores and reading at the fourth- or fifth-grade level, she says. “When I see him reading a book, I’m happy.”

Another reason to test children and catch eye problems early: P.E. class. Children often suffer low self-esteem when they can’t catch or throw a ball. No kid wants to be picked last on a team, but vision problems stymie the eye-hand coordination required for sports.

Be careful, though.

“Screenings can pick up things ahead of time, but a lot of times screenings miss things,” says Deborah Amster, an attending optometrist in the Specialty Pediatrics Binocular Clinic at Nova Southeastern University in North Miami Beach. “Some will check distance vision and if they see a 20/20 acuity, they will stop there and give a false sense of security. Most of what (children) take in while learning, 80 percent, is through vision, and a lot of that will be what they see up close. A comprehensive eye exam would be careful to check for color vision, depth perception, focusing, eye team skills” (how well the eyes work in tandem).

Tests are important because you can’t rely on children to alert you to a vision problem. When was the last time your child asked, “Mom, how come all the trees look like big green blob lollipops?”

“Children don’t realize what normal is,” Amster says. “They assume everyone sees everything the way they see it.”



RECOMMENDATIONS

The American Academy of Ophthalmology recommends vision screening for all children starting at age 3. Infants should also be checked for eye problems during regular pediatric appointments.

Visual screeners should test for amblyopia (lazy eye), the leading cause of treatable blindness in children. Also, test for strabismus (misaligned eyes), ptosis (drooping of the upper eyelid), color deficiency and refractive error (near or farsightedness and astigmatism).

Risk factors include:

-A family history of lazy eye, misaligned eyes or other genetic or metabolic disorders.

-Parents or siblings who wore glasses since childhood.

-Low birth weight and/or premature birth.

-Developmental or neurological conditions such as cerebral palsy or Down Syndrome.

-A failed vision screening test performed by the primary care physician or school nurse.

Warning signs parents should look for in their children according to Vision Service Plan, a nationwide eye care benefits provider:

-Excessive eye blinking and/or watering.

-Squinting to see distant objects.

-Headaches.

TIPS

-Avoid toys with sharp, protruding or projectile parts.

-Protect eyes during sports by using appropriate protective eyewear.

For more information visit the American Academy of Ophthalmology’s site at www.aao.org or Vision Service Plan at www.vsp.com.

Resources for families in need include Parents Active for Vision Education at 1-800-728-3988 or www.pavevision.org.



(c) 2004, The Miami Herald.

Visit The Miami Herald Web edition on the World Wide Web at http://www.herald.com/

Distributed by Knight Ridder/Tribune Information Services.

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PHOTOS (from KRT Photo Service, 202-383-6099):

AP-NY-08-13-04 0617EDT



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