Q: My niece just got glasses, but she's only two! Isn't that kind of young? When should children have their vision checked, and how would I know if my own 16 month-old daughter was having vision problems?

A: Although seeing young children with glasses is not as common as school age children or adults, the early detection of visual disorders is critical for kids’ future development. The American Optometric Association recommends that children be evaluated by the age of 6 months, then again at the age of three years, and once more before starting school.

When evaluating infants and toddlers the doctors use objective measurements to determine whether the eyes are straight (checking for strabismus), the refractive error, and the general health of the eye. The prevalence of visual disorders in children under age 6 is higher than you might think: 33% suffer farsightedness, 22% astigmatism, 9% nearsightedness, 21% eye turns (strabismus), and 8% lazy eye (amblyopia). A good pediatric optometrist can determine whether or not a prescription would be indicated at a young age, and how to prescribe in order to enhance normal visual developmentof the eyes.

Usually, only higher prescriptions are given to very young children. Of serious concern is the early detection of amblyopia. Amblyopia is caused by a large difference in prescription between the two eyes, and\or an eye turn that causes too much disparity of the visual images in the brain. If the eyes present double vision or very blurry images to the brain, the brain will start to ignore feedback from one eye, and visual development in one eye ceases. This can lead to permanent disability and poor vision in one eye. But if this condition is caught early enough, a doctor can intervene and eliminate the problem.

Often it is very difficult for parents to determine a visual problem in a young child because they rarely report a problem, and if one eye is good, the child will also be unaware of the problem. If covering one of your child's eyes causes an increased amount of resistance or agitation, this can be a symptom of amblyopia in that eye. Also, watch for an eye turning in or out, clumsiness or bumping into things, and difficulty with small objects or toys. Another concern would be a white reflex of the pupil seen in a photo of your child which could indicate congenital cataracts or a tumor. The best precaution is to bring your child to an eye doctor for a full assessment. The American Optometric Society offers a free eye exam for infants 6 to 12 months of age through their InfantSEE Program. Various optometrists across the country donate their time to serve the community in this way. Search for a local doctor by logging on to www.infantsee.org.

Dr. Corinne Odineal has been practicing optometry since 1985 and is a proud mother of two. She specializes in family vision care and developmental optometry. Find her online at www.auburnfamilyoptometry.com.