Does My Child Need Glasses?

Half the children who need glasses don't have them or don't wear them

Even though your child’s doctor checked his vision at his last checkup, you’re still wondering whether he might need glasses. It’s important to find out, says Glen T. Steele, O.D., spokesperson for the American Optometric Association (AOA) and a professor of pediatric optometry at the Southern College of Optometry in Memphis, Tennessee.

“Some kids are tagged as having learning difficulties, or even developmental delays, when all they need are a good pair of glasses,” Here’s what you need to know:

Get your child tested. Regular vision exams are the best way to know if your child needs glasses -- before problems surface. The American Academy of Pediatrics recommends that all children get vision screenings before 6 months, between 3 and 4 years, and after age 5. If she suspects a problem, she may refer you to an eye doctor for further testing. Once your child is school-aged, he may also receive a vision screening at school.

The AOA, however, recommends that these exams be done by an optometrist. “Pediatricians do vision screenings, not comprehensive exams,” says Dr. Steele, a spokesperson for the American Optometry Association on children’s vision issues. “Our position is that many eye conditions are missed in the screenings, which would be picked up by a comprehensive exam.” Talk to your doctor to find out what’s best for your child.

Know the signs. Parents can play an invaluable role in helping to spot a child’s need for glasses, says Dr. Steele.If your child squints, frequently loses his place while reading, turns his head to see, rubs his eyes, covers one eye to read, holds reading material very close, sits right up in front of the television or is struggling in school or with homework, there's a chance that he may need glasses. According to the AAP, your next step should be to talk to your child's doctor and see whether your child should see an eye doctor.

Understand the likely problems. Nearsightedness – having difficulty seeing things far away – is the most common need for glasses, says Dr. Steele. A common tip-off: squinting. Ask your child if he can see what’s on the chalkboard at school, see friends or relatives clearly across a room, or read billboards on the highway. Squinting may also signal astigmatism—an imperfect shape of the cornea that causes blurred vision, and often occurs with nearsightedness.

And the less common ones. Farsightedness – which affects the ability to see things up close – is less common and easy to miss since kids may pass an eye test because they can read the chart. Watch for a child having trouble writing or reading up close. Another need for glasses is a big difference in visual acuity – for example a child with 20/20 vision in the right eye and 20/200 in the left. While an eye test can diagnose the problem, it can also be easy to miss if a child is able to see well enough out of one eye.

Follow up. If your child needs glasses, make sure to follow up and be sure that your child is actually wearing them.Fewer than half the kids who need glasses are wearing them, says Dr. Steele. If you’re worried about cost, check with your insurance company or doctor’s office. Comprehensive vision exams are essential preventive health care benefits under the Affordable Care Act, which means your insurance has to cover it, according to the National Commission on Vision and Health.


Bob Barnett is a health journalist and editor in New York City. Follow him on Twitter and Google +.

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