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How do the optometrist test babies eyesight?

Ann Z
There are quite a few different tests that can be done to assess a baby's eyesight. My daughter was tested first at 9 months (because she crossed her eyes), and she's been wearing glasses since 14 months.

For what it's worth, her ophthalmologist told us that for babies, it's often as much art as science, and the prescriptions are never quite as exact as they are for adults, though it's not such a big deal since babies aren't trying to read small print or anything.

Here's the tests that are done at my daughter's eye appointments:
1. They dilate her pupils and measure the curvature of the back of her eye. Which gives an indication of the prescription.

2. They have these cards that are long rectangles (probably 2 feet long, by half a foot wide). On one end is a little square with black and white lines. The rest of the card is the shade of grey that's exactly between the black and the white. They have a whole series of lots of these cards with progressively thinner lines.

Ok, so you know how when you look at black and white lines that are really thin and close together, they kind of look like they're moving? Well the same happens with kids, but it happens with wider lines. So if the child can distinguish the lines, then they'll notice the square. The eye doctor watches to see if the child focuses on that square. They show the child the cards with smaller and smaller lines until the child doesn't notice the square because the lines have all blurred together and match the grey. The smaller the lines, the better their vision.

3. Since my daughter crosses her eyes because she's farsighted and is trying to focus so hard that her eyes cross. The doctor gives her a toy to play with, and then holds lenses of varying prescription up to her eyes to see which one straightens her eyes the best.

they put an object across the room and move it, they see if the baby follows the movement

baby kayden
the optometrist will hold up a light that he/she use to check the ears and mouth. What he does is put the light in front of the babies eyes and see if the baby can follow it

I believe is a light reaction test......

Although infants cannot speak, optometrists have the clinical education, training and experience, as well as the instruments and resources, to provide non-invasive eye and vision assessments for any non-verbal patients such as infants.

During the assessment, parents might hold the baby on their laps or on a lap pillow and might also assist by holding targets or toys to hold the baby's attention. Optometrists will gauge the babies' comfort levels with specific techniques and adjust them as necessary, but will typically evaluate visual acuity, refraction, motility, alignment, binocularity and overall eye health. These tests will determine signs of strabismus, amblyopia or diseases of the eye.

Visual Acuity/Refractive Status Assessments for visual acuity and refraction are largely intended to measure for nearsightedness or farsightedness common risk factors for amblyopia, which develops when an otherwise healthy eye has not received adequate use during early childhood. Nearsightedness or farsightedness in an infant developing eye can cause the brain to favor seeing through one eye, suppressing vision in the other eye, which can lead to permanent vision impairment. Because the traditional eye chart with letters or symbols cannot be used with infants, assessment of visual acuity may include tests to ensure that the infant can fix his eyes on an object and follow it. Tools such as gray cards with various sized stripes or pictures may be used to determine at which objects the baby prefers to look, and at what distances.

The doctor may also use lenses and light from a small hand-held instrument to assess how the eye responds to particular targets. Some doctors use photographic testing to analyze the pupil reflex in the photo. In many cases, the infant may have some degree of refractive condition not requiring intervention.

Ocular Motility/Alignment/Binocular Potential – Assessments for motility, alignment and binocularity can determine the presence of strabismus, which occurs when one eye does not aim at the same object as the other eye. Strabismus can lead to amblyopia, if undetected, or may indicate a number of ocular diseases. These assessments also measure eye coordination, which is the ability of both eyes to work together as a team to create one three-dimensional image in the brain. Good eye coordination, a skill that is not innate and must be developed, keeps the eyes in alignment.

Using very simple instruments, such as penlights, finger puppets or toys, the optometrist tests the eye's ability to move by getting the baby's attention and observing how the baby follows the movements of the object. By shining a penlight toward the baby's eyes, the doctor can gauge eye alignment, which is straight if the light is reflected in the center of both eyes.

The optometrist can also assess a baby's depth perception by using red/green glasses (commonly known as 3-D glasses), and displaying 3-D pictures. To a baby with good eye coordination, the pictures will appear in 3-D, and the infant will then reach to touch the picture.

Overall Eye Health The optometrist will assess the eye's external structure as well as eyelids, tear ducts and other parts of the eye. Often, the optometrist can detect existing allergies from an external assessment. Pupil function is then checked, followed by an examination of the inner eye through dilated pupils, which can also detect ocular diseases such as retinoblastoma, the seventh most common pediatric cancer.
Following the assessment, in addition to sharing findings with the parents, the optometrist may send summary information to the infant's pediatrician, family physician or other appropriate practitioners reporting and explaining any significant condition diagnosed in the course of the assessment.

check these sites for more infos:

I have no idea sorry.

they measure the pressure of the eye, and the refractive surface of the lens. There are many ways that Im not sure of though.. I would call the doctors office and ask them directly. THey are always more than happy to answer all questions.

c if they react to light

First, I think optometrists are great for refracting older children and adults, but for infants, my bias is that it be performed by a pediatric ophthalmologist. However, the American Optometric Association has a good set of guidelines for testing the vision in infants.

First you ascertain that the infant follows movement, and that the eyes work together, without one turning in or out, including after being covered up. There are other gross (as opposed to fine) tests such as visual fixation. But the most accurate method is cycloplegic refraction. In this procedure the doctor puts drops in the infant's eyes that temporarily prevent the baby from focusing (accommodating). He/she then looks into the eye with a refractometer to ascertain the infant's vision. Most infants and toddlers are somewhat nearsighted, which is fine as long as the vision in both eyes is about the same. If there is a disparity in vision, glasses may be prescribed, otherwise the infant will learn to ignore the vision in the weaker eye, and complicated pathways in the brain will not develop well, nor will good binocular vision necessary for depth perception.

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