Infants and Pediatrics

Ensuring proper visual development unlocks the path to optimal overall development in children.

The visual system continues to develop after birth and influences developmental milestones. Therefore, vision evaluations between the ages of 6 months and 5 years are important to a child’s overall growth and success. Here are observable signs of proper visual development by age:

Birth-6 weeks

  • Momentarily holds gaze on bright lights/objects

  • Eyes and head move together

  • One eye may turn inward at times

8-24 weeks

  • Eyes move more widely with less head movement and track objects/people

  • Begins to watch their own hands and people’s faces

  • Begins to start looking at distant objects

30-48 weeks

  • Eyes begin to converge on near objects

  • Eyes track with little head movement

  • Moves towards toys or people they enjoy

12-18 months

  • Using both hands and visually steering hand activity

  • Holds objects close to inspect them

  • Looks for and identifies pictures in books

24-36 months

  • Likes to watch movement of wheels or fans

  • Watches own hand while scribbling

  • Watches and imitates other children

40-48 months

  • Brings head and eyes close to page of book while inspecting

  • Draws and names circle and cross on paper

  • Can close eyes on request or even wink one eye

4-5 years

  • Moves and rolls eyes in an expressive way

  • Colors within the lines and can copy simple forms/letters

  • Able to tell stories about places, objects, and people seen elsewhere

6-12 years

  • Is on grade level for reading and other academic subjects

  • Is able to write full sentences and paragraphs

  • Learning to ride a bike and participating in sports

Skills Necessary for Effective Visual Function

Eyesight and Refractive Error

A refractive error, known as nearsightedness, farsightedness or astigmatism, can occur in children in one or both eyes which ultimately influences the clarity of vision. Oftentimes, when a child has one eye with little to no refractive error, but the other eye has high refractive error, the child may not be able to articulate the problem. If left untreated, eyesight will continue to deteriorate, and amblyopia (link to page) may develop.

Eye Teaming

If the eyes are unable to work together efficiently as a team, they run the risk of causing poor eye alignment, or even an eye turn. Compromised binocularity (two eye coordination/teaming) may cause symptoms of double vision. To compensate, this may cause the brain to suppress the information coming from one of the eyes in order to avoid double vision and confusion. If left untreated, it may cause convergence insufficiency and strabismus.

Eye Tracking

Properly developed eye movement and eye tracking skills are essential for a good visual foundation. Young babies will often track with their heads, but soon develop accurate eye movements independent of head movements which are essential for efficient reading and good school performance. Poor eye contact or behaviors such as tantrums may suggest eye tracking skills may not be developing appropriately.

Depth Perception

Being able to judge depth accurately is important for many life skills including school and sports performance. When the impaired visual system struggles to orient the body in space, it can cause symptoms such as poor coordination, avoidance of playgrounds, and uncertainty in new environments. If these symptoms are present, this is an indication that the child’s vision development needs to be assessed.

Available Treatment Options:

Performance Lenses are specialty lenses that support the function and development of the visual system. They may be prescribed in combination with a near or distance prescription or can also be prescribed to benefit patients who need functional visual support despite having 20/20 acuity.

Prism Lenses

These special types of lenses support the performance of the visual system by moving light to a position most comfortable for the eyes which relieves visual stress allowing the visual system to perform optimally. They may be worn part time or full time depending on the diagnosis and may often elicit desired results in a short amount of time.

SHAW Lenses

These unique iseikonic (image balancing) lenses relieve visual stress induced by prescriptions that are significantly different between the two eyes thus allowing for more equal input from both eyes to the brain. SHAW lenses prescribed at a young age may positively impact the development of visual system and prevent the development of amblyopia or strabismus.

Binasal Occlusion

This form of partial occlusion often replaces the need for patching in cases where there is reduced binocular function, eye misalignment or when strabismus is present. It allows for enhanced peripheral awareness and prevents cross fixation in esotropic (crossed eye) patients. This is an important step in the remediation process because it supports visual development and prevents long-term effects of strabismus.

Vision Therapy

A customized treatment program to support the development of the visual skills necessary for efficient visual and overall function. This treatment, often prescribed in conjunction with performance lenses can correct underlying binocular vision dysfunctions and supports the development of foundational visual skills.

Treatment Outcomes & Patient Successes

“My son has a vision condition called Nystagmus. He was diagnosed with this condition at 6 months old and it causes reduced vision, depth perception and peripheral vision. I have seen many specialists /ophthalmologists in the Midwest that suggested surgery with no guarantees on improving his vision. The vision therapy my son has been doing at Clarendon Vision has greatly improved his vision. He is very excited about the results and understands how the therapy has helped him. I am so grateful for Dr. Spokas and her awesome team!”

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