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Children Under 6

This group of patients is arguably the most important optometrists deal with because all of a child’s critical visual development takes place during these very early formative years. If for some reason these developmental stages are interrupted, (ie due to a significant undiagnosed optical error for instance), this can have life-long consequences for that patient.

The main thing being diagnosed at this age is a strabismus (commonly called a “lazy eye” or “squint”), or a tendency or risk of developing a strabismus or deviating eye.

From the moment they are born an infant is starting to develop and order the visual information of their surroundings. It is vitally important to be able to “fuse” or make single, the images coming from each eye, otherwise the child will suffer from persistent double vision.

The child who cannot develop the ability to “fuse” the images of both eyes, must nevertheless learn to secure a single visual impression, since double vision is intolerable, and secondly because he must find consistency between what he sees and what he can touch.

This is the point where erroneous development can occur. The desired single vision is secured by the development of either:

• normal single vision via “fusion” of the two images and the development of normal binocular vision, or
  
• adaptive single vision via “suppression” of the image from the non dominant eye, which results in the development of monocular  vision. The eye with poorer vision or weaker fixation, has its image suppressed or completely turned off, so that only the image of the dominant eye is transmitted and interpreted by the brain. This is the most common adaptation, or
  
• a more complex form of adaptation termed “anomalous correspondence”, which for simplicity we will describe as a bit of both.

Pupil reflexes to light are present at birth so your child should respond to a light shone in their eyes, with pupil contraction.

Fixation develops from monocular irregularity to binocularity within 5-6 weeks, and binocular vision seems to predominate at 6 months. Determining whether a child has a vision problem or not can usually be made at this point.

The sooner the diagnosis of a strabismus is made the better, as steps can then be taken to treat it.

There is probably a window of opportunity of about a year to correct the problem, otherwise the patient is battling powerful suppression mechanisms that are starting to become ingrained.

Take our short test. 

Please complete the short self test below to see if your child has a vision problem

• Short Test Ages 0 - 8 years

If you know your family has a history of strabismus (“lazy eye”), or one or both parents has a high degree of long-sightedness (hypermetropia), or if you are simple unsure and concerned, then make an appointment to have your infant’s eyes checked by one of our fully qualified Eyecatchers optometrists.