Eyes are extremely delicate organs, especially for children. Parents should closely observe and participate in disease screening at appropriate intervals because vision affects children’s learning and development. The Eye Clinic at Phyathai 2 Hospital, with ophthalmologists and standard eye assessments for children, is ready to help. If your child shows any abnormal eye symptoms listed in the Check List below, you should promptly consult an ophthalmologist.
1. Age 0 – 2 years: Infants and Toddlers
- Premature infants born before 30 weeks of gestation or with a birth weight less than 1,500 grams
- Full-term infants who do not follow objects with their eyes by 3 months of age
- Infants with excessive tearing in one or both eyes that do not respond to lacrimal duct massage, at risk of pediatric glaucoma
- Drooping eyelid(s) on one or both sides, at risk of complications such as amblyopia or one eye being blurrier than the other
- Infants with delayed development
- Infants with Down’s syndrome should be evaluated and monitored for vision because they are more likely to have strabismus, cataracts, and allergic conjunctivitis than typical infants
- Infants with abnormal pituitary hormone levels, often associated with smaller optic nerves
- Infants with nystagmus (involuntary eye movement)
- Infants with abnormally large corneas, at risk of pediatric glaucoma and congenital large corneas
- Infants with any form of strabismus should be examined and monitored until the age when strabismus is no longer possible, approximately 6 – 7 years
- Infants with abnormal eye reflections, such as opacity or unusually bright reflections
2. Age 2 – 5 years: Preschool Age. Ophthalmologists recommend that all children aged 3 years and older should have at least one eye examination before starting school to screen for visual abnormalities and amblyopia.
- Children with any form of strabismus should be examined and monitored until the age when strabismus is no longer possible, approximately 6 – 7 years
- Children who tilt their head or face when focusing on objects
- Children who blink abnormally often, which may be due to allergic conjunctivitis, refractive errors, or TIC Disorder, a behavioral disorder
- Children with a family history of visual abnormalities
- Children with learning difficulties, which may be related to vision problems
- Children with allergic conjunctivitis often have itchy eyes, rub their eyes, and blink frequently, commonly associated with other systemic allergies
3. Age 5 years and older: School Age
- Children experiencing headaches, especially headaches triggered by visual tasks
- Children who squint when watching TV or looking at the board, or who always need to move closer to see clearly
- Children with any form of strabismus should be examined and monitored until the age when strabismus is no longer possible, approximately 6 – 7 years
If you observe any risks or abnormalities from the Check List, even just one item, you can consult an ophthalmologist immediately. The Eye Clinic at Phyathai 2 Hospital is ready for pediatric eye assessments and examinations. The evaluation depends on the child’s age, cooperation, and suspected diseases or symptoms. Pediatric eye assessments include…
- Vision or visual behavior
- Assessment of visual acuity to evaluate amblyopia using various techniques depending on the child’s cognitive function and cooperation
- Assessment of binocular vision and 3D vision
- Color vision testing for those at risk, such as children with a family history of color blindness, especially boys, to prepare for ongoing educational planning
- Evaluation of eye movement to detect strabismus or squint
- Examination of the anterior segment of the eye, including the cornea, anterior chamber, and lens, using a slit lamp biomicroscope
- Assessment of refractive error and retinal examination, requiring pupil dilation for accurate evaluation, especially in children under 10 or 12 years old
- Measurement of intraocular pressure in cooperative children and those at risk of pediatric glaucoma, such as children with myopia before school age, family history of glaucoma, or asymmetrical corneal sizes, especially the larger one
- Visual field testing for those at risk of glaucoma and for screening and monitoring children with increased intracranial pressure
- Retinal imaging in cooperative children, at least to establish a baseline for comparison
Important Information for Pediatric Eye Assessment and Pupil Dilation
- The entire assessment and pupil dilation process takes approximately 40 – 50 minutes
- Pupil dilation drops last about 6 – 12 hours depending on the medication. For refractive error measurement, the effect lasts about 12 hours but can last up to 72 hours, during which the child will have blurred near vision and will need reading glasses
- The pupil dilation drops used specifically for measuring refractive error are 1% Cyclogyl (1% Cyclopentolate). The child may feel a stinging sensation when applied. The drops are applied 3 times, every 5 minutes, and results are available immediately
- Ophthalmologists recommend bringing sunglasses, hats, or umbrellas to protect against light sensitivity after dilation
- For children who need glasses, a prescription will be provided to take to any optical shop. For those diagnosed with other conditions, the doctor will evaluate and inform the parents accordingly
Dr. Warakorn Thiamthat
Ophthalmologist, Eye Center
Phyathai 2 Hospital
