Lazy eye is one of the most serious yet correctable eye disorders in
babies: Catch it early, from age 6 months through preschool, and it's
easily corrected -- but wait too long and one eye can go virtually blind.
But how do you test a baby's eyes?
The answer lies with that annoying red eye in flash photographs and a new
computer software to test children. Scientists hope eventually babies and
toddlers will get easy screenings not just from eye professionals, but
from pediatricians and day-care centers.
"If all pediatricians could do this, you wouldn't need pediatric eye
doctors," says Dr. Gerhard Cibis, ophthalmology chief at Children's Mercy
Hospital in Kansas City, Mo.
"A skill problem and a manpower problem" means less than half of children
today are diagnosed before kindergarten, when a cure is easiest.
That's not just a problem with lazy eye. One in four school-age children
has some vision problem, yet experts say the vast majority don't have a
true eye exam before starting school -- even though vision and learning
are inextricably linked. Indeed, some studies suggest 80 percent of
children who have trouble reading have eyes that don't properly coordinate
Typical eye charts, even with symbols instead of letters for the very
young, aren't enough. They may catch serious nearsightedness, but don't
test if eyes focus and shift properly between distances, if the eyes work
together or are hooked up to the brain correctly to give realistic images.
Amblyopia, or lazy eye, afflicts up to 5 percent of children who have one
eye so much stronger than the other that it eventually takes over and
renders the weaker eye useless. Catch it young -- ideally before
kindergarten but definitely before age 9, when brain-eye connections are
set -- and it's fixable by patching over the strong eye for a few hours a
day, thus exercising the weak eye's brain links.
To properly check children's vision, eye professionals shine a special
instrument called an ophthalmoscope into the pupil to cause a red reflex
-- the same red eye your camera flash causes. Compare this reflection of
light from the back of the eye to pupil size, distance from the light and
the light's angle, and doctors can diagnose nearsightedness,
farsightedness, astigmatism and other disorders.
If both eyes have the same problem, the child may just need glasses. But
if one eye is nearsighted and the other farsighted, or if they don't focus
together, the disparity can cause amblyopia.
Few people are skilled in such diagnosis. To compensate, Lions Clubs
screenings shoot special black-and-white Polaroid photos of toddlers for
experts to analyze. But if a child isn't looking directly at the flash,
that doesn't work, Cibis says.
So with Lions Club funding, Cibis and University of Missouri-Columbia
computer engineer Jim Kelley are creating software that scans videotape of
babies' faces, pinpointing pupils and measuring the red reflex. For an
extremely nearsighted eye, for instance, the computer shows greater
brightness on the pupil's left edge; a farsighted eye lights up on the
The goal is to use the computerized test for routine screening, such as in
That could be several years away. Until then, make sure your children get
a comprehensive eye exam from an optometrist or ophthalmologist before
And the American Optometric Association recommends an eye exam every two
years starting at age 6 months -- more frequently if vision problems are