Children and vision


When to visit: When take your child for a visit: The first visit must be made about a year old. Such an investigation is strictly objective and is important to highlight the presence of major visual defects that may affect proper development of visual-motor skills. It is not required a great cooperation of the child and the visit lasts a few minutes. Are not always necessary topical eye drops (the Optom will tell you in advance if may be necessary).   
The second visit, if the first was negative,  should be done about three years of age. During this phase, tests may be performed better adding others to look into the issue regarding the development of visuo-motor skills for the child is already able to collaborate. Even at this stage usually are not used drugs of any kind and every examination is not invasive.    The third visit takes place approximately when the child starts to attend the primary school. The visit now takes the form of a complete examination and can analyze all the structures connecting objective and subjective tests for  the child is now able to cooperate fully with the optometrist. It is possible now to refine a previous prescription and start, if necessary, an intervention to prevent any further deterioration of an existing visual problem.    
Visual defects:
With hyperopia (longsightness) the focus of rays coming from infinity would be to focus behind the retina and therefore on the retina a blurred image is formed. In this situation, especially for low hyperopia, the eye increases its dioptric accommodation carrying forward the image that will focus on the retina. This "effort" makes troubles with the onset of possible symptoms such as headaches, burning eyes, tearing, redness, sensation of foreign body. It is also possible that from time to time the image becomes blurred (especially when working at close distance) and then returns back in focus.
With myopia (shortsightness) Rays fall in front of the retina and a blurred image is formed on the retina. In this case the eye cannot adjust the focus and the subject sees just blurred, usually without symptoms. Myopia can be generated by functional causes related to the study (working at too close distance) and therefore may worsen from year to year if not effectively countered with appropriate therapies and improved posture during the study. Optometrist usually takes care of young patients that tend to deteriorate their vision with orthokeratology and/or visual education, depending on the type of myopia and the age of the young patient. Orthokeratology is a good option for those children who experience a developmental myopia that could bring the child to have a medium to high myopia when they grow up. These children will be treated from the age of about 10-12 years and also assessing their ability to handle contact lenses (even if only for night time).
With astigmatism, the focus is no longer one (generated by a sigle curvature, ball-like), but it is generated by two elliptic curves: one curve is flatter more than the another, just like a rugby ball . The rays passing through the flatter curve focus further away, while passing through the steeper curve they focus closer. Can exist five types of astigmatism, simple myopic  (one focus onto the retina and the other in front of the retina), simple hyperopic (one focus onto the retina and the other behind the retina), compound myopic (both focuses are in front of the retina), compound hyperopic (both focusses lay behind the retina) and mixed one (one focus in front of the retina and the other behind it).
Ambliopya: represent a state of "poor" vision in one or both eyes (Lazy eye). It is usually monocular. It is a very subtle problem for often the child exhibits a behavior that might suggest no problem for he/she uses the good eye. It is therefore essential every child has regular eye test as stated above. The causes are several and the optometrist will rule them out. It 's important to know that if nothing is done within 8-9 years of age, hardly the amblyopic eye can be recovered in the future, remain compromised forever.
Aphakia: represent the lack of the lens in one or both eyes, which causes a strong hyperopia (10 to 19 diopters) with a consequent very bad vision. It is detectable even with a quick visit and sorted out with surgery or with the use of corneal contact lenses even for very young children.    Congenital cataracts: represent the clouding of one or both lenses from birth. Under these conditions the child is blind in the affected eye and the pupil is whitish, making impossible to see the back of the eye. The solution is surgery, after that the baby will begin to see the world around him/her straight away.
Anisometropia: represents the fact that both eyes have to be corrected with different prescription. If the difference is higher at 3.00 diopters (especially if the anisometropia is detected at an advanced age), the individual may find it difficult to merge two images that come from the two eyes with different sizes. Under these conditions, the fusion may not be possible, and double vision would occur unless the person does suppress one eye, uing only the better eye. At this point, the eye will become amblyopic and start worsening: if not corrected in time will be difficult to recover (anyway it is very hard over 9 years of age).   
Ocular deviations (Squint): occur when the two eyes fail to focus on the same object (this may happen in each direction of gaze). In this situation, the deviation is manifested also known as strabismus. May be horizontal, vertical or a combination of bothr. There are also rotatory deviations, but less frequent and it is difficult to detect to the naked eye. Particular attention should be made to micro-strabismus, small and very small deviations hardly visible to the naked eye, but clearly measurable instrumentally. These small deviations greatly affect binocular vision and should be compensated and/or re-educated as soon as possible.   
Behavioral Optometry: Optometry is the vision science that deals with the functional recovery of the visual system using refractive aids such as glasses and/or corneal contact lenses, magnifying aids for the visually impaired people, visual education exercises and whatever else is necessary to resolve visual problem. The importance of behavior with regard to study or work at close distance is great, for is the starting point of many visual probelms. The methods of visual education, then, are to improve behavioral skills training them with visual-intellectual exercises and at the same time with the instruction to correct visual-postural behavior at close distance, but above all are methods designed to preventing visual appearance never considered before by any branch of optics and ophthalmology.