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Children with uncorrected vision conditions or eye health problems cause many obstacles in life such as academically, socially
and physically. High-quality eye care can reduce these difficulties and help allow the child to reach their highest potential. Vision
doesn't immediately occur. A child's brain learns how to use eyes to see, just like it learns how to use legs to walk or a mouth
to form words. The longer a vision problem goes undiagnosed and untreated, the more a child's brain learns to adjust the vision
problem.

That’s why a comprehensive eye examination is so important for children. Early detection and treatment provide the very best
opportunity to correct vision problems, so your child can learn to see clearly. During regular well baby exams, from birth to 2
years of age, pediatricians should use history and a vision evaluation to see if vision problems exist. Beginning at well child
exams at age 3 and continuing through 10 years of age, vision screenings should be performed assessing visual perception and
optical alignment. In most cases, these problems can be identified, and treated, even during the first few days of life. But
without early intervention, usually before the age of five, a child with an untreated eye problem may suffer from serious vision
loss, or even blindness.

Your young child might not be able to tell you if he or she has an eye problem, but parents are usually the first to recognize the
signs of eye disease in their children. You may also take your child to an eye screening to determine whether your child’s eyes
need further attention. By working with a pediatrician, family physician and an eye specialist, parents and other early childhood
caregivers can help recognize disorders and ensure that treatment is received that can save a child’s sight or even life. If you
suspect that your child has a vision or eye problem, then your child should have his or her eyes examined by an eye specialist,
pediatrician or family physician. Every child should have at least one eye examination appropriate for their age and ability to
cooperate, before the age of five.

Signs and Symptoms of Vision Problems

Characteristics that may help you identify eye problems in children:

Appearance

•        Eyes shake or wander randomly
•        Eyes are not able to follow parent’s face
•        Pupils of the eyes are excessively large or small
•        Pupils of the eyes are not black; they appear to have a cloudy layer on them
•        Eyes do not appear to be evenly lined up; they cross or turn outward

Behavior

•        Rubs eyes frequently
•        Does not appear to focus with central vision
•        Turns or tilts head when looking at detail
•        Covers or closes an eye when looking at detail
•        Avoids close effort or becomes tired after close exertion
•        Can see better during the day than at night
•        Complains of tired eyes
•        Squints eyes
•        Sits very close to the television
•        Has difficulty walking and running; appears clumsy

Types of Vision Impairments

Eighty percent of all learning is achieved through vision. Make sure your child has the best possible tools to learn successfully.
Your child’s vision is a learned and developed skill that requires inspiration and understanding. The visual system involves much
more than the eyes. The visual system interacts with the muscles of the body to develop reaching, crawling, grabbing and
walking. In fact, two thirds of the functions of the brain are connected with vision.

Because vision requires motivation, problems that occur in the eye or in the visual areas of the brain can affect your child’s
vision. Examples of these problems include: eye diseases, such as congenital cataracts, retinopathy of prematurity, ocular
albinism, optic nerve and retinal disease; and neurological abnormalities to the visual pathways and visual centers of the brain.
Children with visual impairments should be assessed early to benefit from early intervention programs, when applicable. A
young child with visual impairments has little reason to explore interesting objects in the environment and, thus, may miss
opportunities to have experiences and to learn. This lack of exploration may continue until learning becomes motivating or until
intervention begins.

Visual impairment including blindness means injury in vision that, even with correction, negatively influences a child's
educational performance. The term includes both partial sight and blindness. The terms partially sighted, low vision, legally
blind, and totally blind are used in an educational circumstance to describe students with visual impairments. They are defined
as follows:

•        Partially sighted signifies some type of visual problem which has resulted in a need for special education.
•        Low vision generally refers to a severe visual impairment, not necessarily limited to distance vision. Low vision applies to
all individuals with sight who are unable to read the newspaper at a normal viewing distance, even with the aid of eyeglasses or
contact lenses. They use a combination of vision and other senses to learn, although they may require adaptations in lighting or
the size of print, and, sometimes, Braille.
•        Legally blind indicates that a person has less than 20/200 vision in the better eye or a very limited field of vision (20
degrees at its widest point).
•        Totally blind students learn via Braille or other non-visual media. Visual impairment is the consequence of a functional
loss of vision, rather than the eye disorder itself. Eye disorders which can lead to visual impairments can include retinal
deterioration, albinism, cataracts, and glaucoma, muscular problems that result in visual disorders, corneal disorders, diabetic
retinopathy, congenital disorders, and infection.

Children Visual Impairments

•        Retinopathy of prematurity (ROP) is a potentially blinding eye disorder that primarily affects premature infants weighing
about 2¾ pounds (1250 grams) or less that are born before 31 weeks of gestation (A full-term pregnancy has a gestation of 38–
42 weeks). The smaller a baby is at birth, the more likely that baby is to develop ROP. This disorder—which usually develops
in both eyes—is one of the most common causes of visual loss in childhood and can lead to lifelong vision impairment and
blindness.

•        Cortical Visual Impairment (CVI) is the most common cause of permanent visual impairment in children (1-3). The
diagnosis of CVI is indicated for children showing abnormal visual responses that cannot be attributed to the eyes themselves.
Brain dysfunction must explain the abnormal visual responses, as abnormal ocular structures, abnormal eye movements, and
refractive error do not. Fixation and following, even to intense stimulation, may be poor and the child does not respond
normally to people's faces. Visual regard and reaching (in the child with motor capabilities) toward objects is absent.

•        Coloboma is a hole in one of the structures of the eye, such as the lens, eyelid, iris, retina choroid or optic disc. The hole
is present from birth and can be because when a gap called the choroid fissure between two structures in the eye, which is
present early in development in the uterus, fails to close up completely before a child is born.

These conditions occur during infancy and early childhood, when it is difficult to assess their effects on vision and quality of
life. In addition, many of these conditions occur with increased incidence in children with nuero-developmental delay, further
complicating the assessment of level of vision and the evaluation of quality of life. The rate at which visual impairments occur
in individuals under the age of 18 is 12.2 per 1,000. Severe visual impairments (legally or totally blind) occur at a rate of .06 per
1,000.

More boys than girls are visually impaired. Additionally, increasing numbers of infants are born very prematurely and survive.
These children are at high risk for multiple disabilities, including visual deficits, and will substantially increase the number of
Americans with visual impairment. The effect of visual problems on a child's development depends on the severity, type of loss,
age at which the condition appears, and overall functioning level of the child. Many children who have multiple disabilities may
also have visual impairments resulting in motor, cognitive, and/or social developmental delays.

Education for Children with Vision Problems

A young child with visual impairments has little reason to explore interesting objects in the environment and, as a result they
may miss opportunities to have experiences and to learn. This lack of exploration may continue until learning becomes
motivating or until intervention begins. Because the child cannot see parents or peers, he or she may be unable to imitate social
behavior or understand nonverbal cues. Visual handicaps can create obstacles to a growing child's independence.

Children with visual impairments should be assessed early to benefit from early intervention programs, when appropriate.
Technology in the form of computers and low-vision optical and video aids enable many partially sighted, low vision and blind
children to participate in regular class activities. Large print materials, books on tape, and Braille books are available.

Students with visual impairments may need additional help with special equipment and modifications in the regular curriculum to
emphasize listening skills, communication, orientation and mobility, vocation/career options, and daily living skills. Students with
low vision or those who are legally blind may need help in using their remaining vision more efficiently and in working with
special aids and materials. Students who have visual impairments combined with other types of disabilities have a greater need
for an interdisciplinary approach and may require greater emphasis on self care and daily living skills.