Jay M. Bernstein, MD
Dr. Bernstein graduated from Alfred University in 1975 and Northwestern University School of Medicine in 1980. His ophthalmology residency was performed at the University of Medicine & Dentistry of New Jersey. He completed fellowship training in Pediatric Ophthalmology and Strabismus at Moorefields Eye Hospital in London. He has been in practice for nearly three decades, specializing in all aspects of pediatric eye care, pediatric and adult strabismus surgery, and BOTOX® injection treatment for strabismus.
Dr. Bernstein is board certified by the American Board of Ophthalmology and is a member of the American Association for Pediatric Ophthalmology and Strabismus.
Many of us have had the experience of joy that comes from a new eyeglass prescription that improves our vision. We initiate a visit to the ophthalmologist because we become aware that we may possibly be able to get better vision. Most children, however, are unaware of their visual status and do not know if their vision is good.
Parents often wonder "Does my child have normal vision?" In children, routine eye exams are even more important so that various eye and vision disorders can be detected early and treated. In this way, the intellectual and social development can proceed unimpeded.
Your baby's eyes: A good start for good vision
Your baby's eyes are his or her windows to the world, and to you. It is important that you protect your baby's vision as he or she grows.
What can my baby see?
Newborns can see the shape of their parent's faces. By three months old, a baby can focus on objects and follow them with his or her eyes. By 6 months old, babies will use their eyes to find and focus on objects.
Do I need to have my baby's eyes checked?
Yes, your newborn's eyes should be checked by a pediatrician (children's doctor) or family physician in the nursery to make sure they are all right. Your baby's eyes are not like yours. They still need to grow. If both eyes are not working the right way, your baby's vision might never develop properly.
It is important to have your baby's eyes examined when he or she is:
- A newborn
- 6 months old
- 3 ½ years old
Many serious eye diseases that affect babies can be found at a very early age. The earlier they are found, the easier it is to fix the problem.
Some newborns have a greater chance of having eye problems than others:
- Was your baby born early?
- Did your baby weigh less than 5 lbs. at birth?
- Does anyone in your family have an eye disease?
- Did you use drugs while you were pregnant?
If you answered yes to any of these questions, then you should take your baby to a special doctor an ophthalmologist. An ophthalmologist is a medical doctor specially trained to treat eye problems. At 6 months and 3 ½ years old, your baby's eye health should be checked again by the doctor.
How can I tell if something is wrong with my baby's eyes?
Here are some signs that your baby might have an eye problem:
- Crossed eyes or eyes that don't line up after your baby is 2 months old
- Milky white or yellowish pupils (the dark circle in the center of the eye)
- The front of the eye looks swollen
- Tearing or discharge from the eye that won't go away
- The white part of the eye looks red
- A drooping eyelid
- Eyes that move so quickly they seem to shake or dance
If you see any of these warning signs, take your baby right away to an ophthalmologist, a medical eye doctor. But remember, even if you don't see any of these signs, it's important that your baby's eyes are checked at 6 months and 3 ½ years old.
Refractive Errors, Strabismus, and Amblyopia
The most common difficulty children face is refractive errors, usually myopia (nearsightedness). With this condition, distant objects are blurred because the eye has too much focusing power, and light rays come to a focus before they reach the retina.
Astigmatism (an optical distortion of the eye) and farsightedness (the relaxed eye does not have enough focusing power for clear distance vision) are other refractive errors children may have. Children may have difficulty seeing the blackboard at school, or the soccer ball downfield, and suffer poor performance. Fortunately, many of these children come to medical attention as they often fail school eye exams, whereupon the refractive error can be discovered and remedied with glasses.
Also common amongst children is strabismus (misalignment of the eyes). The eyes may be crossed inwards (esotropia), or outwards (exotropia). When this occurs, either on an intermittent basis or on a sustained basis, each eye will see a different object causing the eye to shut down (amblyopia). The child will go to great extremes to remedy it, sometimes by changing head posture.
Up to the ages of 7-9, the visual system is sufficiently flexible so as to correct the amblyopia. If one waits too long, the brain and visual system will not develop the neurological pathways needed to see with the deviated eye.
In addition to strabismus, refractive errors producing worse vision in one eye can cause the child to preferentially use the other eye, causing the visual system to ignore the relatively more blurred eye producing amblyopia. While refractive errors are usually treated with glasses, strabismus is usually treated with patching of the good eye, such that the visual system is forced to use the amblyopic eye and develop good neurological pathways.
Since children are exposed to numerous viruses during the cold season, schools and play groups are known to experience outbreaks of 'pink eye'.
This condition represents a viral infection of the mucus membranes of the eye (the conjunctiva) caused by the cold/flu virus (usually the Adenovirus). Some patients may primarily have chest involvement, throat involvement (sore throat), or eye involvement ('pink eye'). The ocular involvement can range from mild to severe, consisting of redness, discharge, lid swelling, discomfort or pain. Thus the ocular infection actually represents a viral conjunctivitis.
This condition is extremely contagious, and sunglasses/towels, etc. should not be shared during the infectious period (7 days before and 7 days after onset). It is appropriate to keep children home during this time to avoid spreading the infection to others. However, since children are contagious for 7 days before they even develop symptoms, it is almost impossible to prevent all spread of the virus.
The viral nature of the infection means that antibiotic drops, which kill only bacteria, are ineffective in treating the condition. Cool compresses and supportive comfort eye drops form the backbone of viral conjunctivitis treatment.