Studies show that one in every 10 children are at risk for undiagnosed vision problems, yet only 13 percent of mothers with children under the age of 2 say they have taken their babies to an eye care professional for a check-up. Former president Jimmy Carter discovered this fact when one of his grandchildren’s condition for amblyopia went undetected until the boy was in grade school. Carter felt if such care had been available, his grandson’s ailment might have been treated sooner and with less effort.
In 2005, the American Optometric Association (AOA) and The Vision Care Institute launched InfantSEE, a free public health program developed to provide a one-time, comprehensive eye assessment for infants within the first year of life, regardless of a family’s income or access to insurance coverage.
“Every child deserves the best conditions in which to begin life and learning,” notes Glen Steele, chair of the AOA InfantSEE committee and a professor at The Southern College of Optometry (SCO).
“The assessment of social and emotional milestones at 12 months is heavily based upon observations of how the baby uses vision in his surroundings. If vision is not properly functioning, we have seen patients with delays in development.”
The AOA recommends having an eye exam at age 6 months, 3 years, before starting school and then every two years thereafter. Early intervention is the key to successful child development. The program gives new parents the peace of mind that their infant’s vision is developing properly.
Babies are generally fussy when it comes to doctor visits but there’s no cause for concern. “Optometrists have developed instrumentation and techniques to evaluate non-verbal patients,” assures Steele. “From my experience, the only “fussiness” I have noted is when the dilation drops are used and that is because I ask the parent to hold the child still for a few seconds while the drops are administered.”
During a well-baby check-up, pediatricians provide base-level eye screening to detect gross eye abnormalities. The InfantSEE® examination is designed to augment this screening with a more in-depth evaluation of the baby’s visual function and eye health.
“We discuss the importance of visual development in the progression of overall development,” continues Steele. “Information related to what might be expected and what might be a problem between now and the time of the next examination are also discussed with the parent which increases parental involvement with development.”
What doctors find
Steele reports that InfantSEE providers have diagnosed patients with retinoblastoma (eye cancer), congenital cataracts, and other sight and life-threatening conditions. While parents shouldn’t be overly concerned, it is important to receive an early diagnosis so more serious conditions can be caught early and treated.
To spread the word about the program, InfantSEE® is working through a network of organizations including Zero to Three, American Academy of Pediatrics, the Association of Maternal and Child Health Programs, the National Association of Pediatric Nurse Practitioners. Steele mentions that they are also a founding partner with text4baby which sends out text messages to expectant mothers and mothers with babies up to age 1.
“Educating parents about the need for infant vision care has to occur in tandem with an awareness of the availability of the program,” concludes Steele.
To learn more, visit infantsee.org or call The Eye Center @ SCO at 722-3250.
What can you expect at an InfantSEE assessment?
These five areas are evaluated in every patient regardless of age:
• Ocular motility – The ability to look and follow. This is the foundation on which all other visual function is based. Basic function is established by six months of age and continues developing throughout our lifetime.
• Binocular function – The ability to efficiently use both eyes at the same time. This later evolves into depth perception but we are concerned if basic ability is not present by six months of age.
• Refraction – The typical areas we think of when visiting the optometrist and includes farsightedness, nearsightedness, astigmatism, and particularly, differences between eyes. When there are differences between right and left eyes, the conditions are ripe for development of amblyopia or lazy eye. The earlier this can be addressed with guidance activities or even lenses, the better the potential outcome.
• Visual acuity – The assessment of how well a baby sees. There are a number of non-verbal ways but the primary assessment is made with a forced choice preference. One target is a series of smaller and smaller black stripes on a hand-held paddle and compared to a gray paddle. The child will naturally gravitate toward the paddle with the stripes.
• Ocular health evaluation including dilation of the pupil – While the incidence here tends to be low, early diagnosis of serious conditions here usually leads to better outcome.
There are ranges in each of these areas and within this range no specific treatment may be necessary for a majority of babies. However, when the findings fall near the upper or lower end of the range, it is important to follow them more carefully. We provide the parents with guidance activities for vision development even if the baby shows no need for treatment at the time. — Glen Steele, chair, AOA