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Essential newborn care (ENC) is a comprehensive strategy designed to improve the health of newborns through interventions before conception, during pregnancy, at and soon after birth, and in the postnatal period. -- The components of essential newborn care.

1st eye examination

1. Family history of eye disease including lazy eye, eye turns and glaucoma; check at 2 years
2. Premature infants evaluated immediately in hospital
3. Signs of problem including unequal eyes, eye turns, mucous in one eye, red eye lid (one only) or premature birth – have evaluation post-natally up to 6 months of age
4. Clogged tear ducts are common – they usually fix themselves, but if actively clogged for more than 1 week, consult your obstetrician – may have you gently massage the skin over the tear duct and may.
   Supplement with erythromycin ophthalmic ointment – consult with physician only before massaging or instilling anything into your childs eyes.
5. One pupil may be larger than the other – this is common, don’t panic. Make sure both pupils react to light and have a pediatric ophthalmologist evaluate any pupil differences – most likely ok but check anyway.
6. Remember, learning is 85% visual, so any problem with eye coordination or vision may lead to slower visual and learning development.
7. Many eye vision related problems can be helped up to around age 7, so don’t delay having your childís vision checked – many problems can be avoided.
8. Between 3rd and 4th grade, print in school gets noticeably smaller, and many advanced children read chapter books earlier, so a bright child who suddenly has problems in school may just be having trouble with smaller print or eyestrain. This is especially true if the.
9. Child passes the school screening – farsighted children will often go undetected, because they can over-focus through any test a School nurse can administer, but since they are farsighted, they see well far but are strained or blurry at near. Be sure an eye doctor screens for farsightedness – the pediatrician usually only screens for nearsightedness and other problems that are easily detected.

Even if you have 20/20 vision, it’s important to have your eye health evaluated periodically.

Certain eye diseases may be present without symptoms, such as glaucoma, peripheral retinal holes, and early-stage macular degeneration.

The Canadian Association of Optometrists recommends the following specific guidelines:

• Children should visit the optometrist:
  • For the first time between six and nine months of age
  • again between two and five years of age
  • annually after starting school
• Adults between 19-65 with no ongoing health concerns should visit the optometrist every two years.
• Adults over the age of 65 should visit the optometrist every year.
• Patients with diabetes require an annual eye examination to check for diabetic retinopathy, serum glucose-related refractive changes, and neuropathies
• Patients wearing contact lenses should visit the optometrist every year.
• Make an appointment to see your optometrist if you:
  • have been diagnosed with a systemic disease that can have ocular complications such as hypertension, thyroid disease, rosacea, arthritis, or multiple sclerosis.

    

  • are taking medication with known ocular side effects, such as steroids, Plaquenil, Accutane, or amiodarone
  • are experiencing transient vision loss, sudden visual acuity change or visual disturbances, such as flashes of light, floaters, or distortions.
  • are experiencing red eye(s). Your eyes need to be assessed using a biomicroscope to accurately diagnose the cause and determine appropriate treatment. Conditions could include conjunctivitis, uveitis, keratitis, corneal ulcer, allergy, episcleritis, scleritis, or dry eye syndrome.

The red reflex test is a non-invasive test that can show early warning signs of serious eye conditions in children. Your GP or optician will usually perform a red reflex test during your child's routine appointments using an ophthalmoscope (a magnifying instrument with a light at one end).

There are also some things you can look out for at home. When using a camera flash, a red reflex is usually produced in the eye as it lights up the blood-rich retina. If the eyes are looking directly at the camera lens and the colour of the reflex in both eyes is red, in most cases that's a good indication that the retinas of both eyes are healthy.

An "abnormal red reflex" is a white, yellow or black reflection in one or both eyes. This can be a warning sign for the presence of a serious eye condition.

Other important signs to look out for are:

• a squint
• a change in the colour of the iris – in one eye or sometimes only in one area of the eye
• a red or inflamed eye – though your child won't usually complain of any pain
• poor vision – your child may not focus on faces or objects, or they may not be able to control their eye movements

How can I test my baby's eyesight?

The pupil reflex test involves shining a light into each of your baby's eyes to check how their pupils (black dots at the centre of the eyes) react to light. Your baby's pupils should automatically shrink in response to the light. If they don't, it could be a sign of a problem.

Reference:

• nhs.uk/conditions/eye-tests-in-children
• youreyesite.com -- Vision Changes After Giving Birth
• mb-opto.ca - Manitoba Association of Optometrists
• moorfields.nhs.uk/news/checking-red-reflex Moorfields Eye Hospital NHS Foundation Trust

See also:

• Your Baby's Vision
• Your baby's first hours of life
• How Pregnancy Impacts your Vision