Employee & Community Health

Get an early start on eye health

10/5/2017 by Dr. Kara Fine

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One of the first tests a newborn undergoes is a check for eye health. Healthy eyes, from the time a child is born and throughout their life, support good vision, along with success in school, sports, social activities and work. 

From screening recommendations to general eye questions, your health care provider has the information you need to make sure your children's eyes remain healthy, no matter their age. 

  • Routine childhood vision screening 
    • Newborn: Starting after birth, your health care provider will routinely check the "red reflex" of the eye. With this check, they're looking to see if something; such as a cataract or mass, is blocking light reflection off the retinas. 
    • Infant: Your provider will continue to check the red reflex at well-child visits and also may ask about eye alignment. It's important to let your provider know if you notice your child has crossed eyes or a "lazy" eye because catching these problems early makes correction more effective. 
    • Preschool: At a well-child visit around age three, your child will have their first vision screening using an eye chart. This screening will help identify any problems with their ability to see things clearly. 
    • School age: Many schools will perform periodic vision screening for students, and your provider will continue to offer vision screening at well-child visits. If any of these screenings are abnormal, then your child should be evaluated by an optometrist or ophthalmologist. Nearsightedness (myopia), or difficult seeing objects in the distance, is the most common vision problem for school-aged children and can be corrected with eyeglasses. 
  •  Eye protection 
    • Injuries: Eye injuries are the leading cause of blindness in kids, and sports are the major source of eye injuries in school-aged children. Baseball, basketball, soccer, football and hockey are the sports most commonly associated with eye injury. So it's worth having your children wear eye protection during these activities. 
    • Sun: It's never to early to protect eyes from the sun. The best sunglasses will block at least 99% of UVA and UVB rays. Look for glasses with large lenses that fit well and close to the eye surface for the best protection. 
  • Red or pink eyes 
    • Infection: "Pink eye," or redness of the white part of the eye, is a relatively common infection in childhood. 
      • Viral: Viruses cause most cases of pink eye, which is also called conjunctivitis. One way to think of viral conjunctivitis is an "eye cold." Viral conjunctivitis can be very contagious, so good hand washing is key to help prevent it from spreading. Symptoms of pink eye include: 
        • Isolated redness of the eye
        • Fever, sore throat or respiratory symptoms
        • Burning, gritty or sandy feeling in the ey
        • Crusty discharge when waking up or watery, mucousy discharge throughout the day
        • What to do: 
          • Use warm compresses to help clear the discharge
          • Antibiotic eye drops will not work for this type of infection, and in fact could cause additional irritation
        • The infection may worsen over the first three to five days, but typically improves gradually and is gone within two to three weeks. 
    • Bacterial: It can sometimes be difficult to distinguish between viral and bacterial conjunctivitis. Most importantly, a bacterial infection will cause thick, pus-like discharge that continues throughout the day. Within minutes of wiping the eye lids, more discharge appears. Viral conjunctivitis usually cases watery discharge. Antibiotic eye drops or ointment are prescribed. 
    • Allergy: Allergies also commonly cause red eyes. Children often complain of itchy eyes, or they may have a watery discharge. Their eyes may be crusted shut in the morning. They also may have symptoms associated with a variety of allergic disease. For example, they may sneeze or have a runny nose, or have a history of asthma or eczema. Treatment consists of antihistamine eye drops and or oral allergy medications. 
  • Newborn issues 
    • Eye color: Many parents wonder when their baby's permanent eye color will become apparent. Eye color is determined by the production of melanin, a pigmented protein. The calls that make up melanin (melanocytes) respond to light, so many babies will have gray or blue eyes right after birth. Over the first year of life, the eye color may change with light exposure. most of the time these changes become apparent in the first six months, but the final color may not be clear until a baby is a year old. 
    • Blocked tear ducts: Parents may notice clear discharge from one or both of their baby's eyes. This often is caused by blocked tear ducts. A blocked duct is not dangerous, and usually will go away over time. Parents may want to gently massage the corner of the eye to help open the duct; ask your baby's provider to show you how. If the watery discharge is still present by the time your baby is one, then your provider may refer you to an ophthalmologist to possibly open the duct. The majority of blocked tear ducts go away by age one without any interventions Contact your provider if your baby's eyes appear red, or the discharge is yellow or green, since these can be signs of infection. 

Between prevention and knowledge of some common eye issues, you and your family are well on the way to maintaining healthy vision!

Dr. Kara Fine is a senior associate consultant in Employee and Community Health’s (ECH) Division of Community and Adolescent Medicine (CPAM). In addition to general pediatrics, she is the medical director for the newborn nursery and has an interest in the care of children with special health care needs.