Did you know that babies should have their first eye exam before their first birthday? According to the American Optometric Association, children should have their first eye exam between 6 and 12 months. Children should have another eye exam by the age of 3 and again just before starting school.  My family had no idea how important an exam would be and how it would change our lives.

Image from Dr. Slotnick’s Blog


My twins were born healthy at 36 weeks, and after 4 days in the hospital we all came home together. By the time they were 3 months old we noticed that my son couldn’t rotate his head from one shoulder to the next, a common sign of children born with Torticollis. In a nutshell, Torticollis is the shortening of muscles on one side of the neck, and it is relatively common in twins. This diagnosis resulted in 14 months of physical therapy, as his therapist worked to help him catch up and meet developmental milestones.

Soon enough, we were told that he was on par with his peers and he graduated from physical therapy. This did not last. He started preschool just before turning 3 years old. Immediately his preschool teacher began to share minor concerns about my son’s inability to perform tasks that children his age could typically do with ease. At 3, he struggled to feed himself with a fork or spoon, wouldn’t color, couldn’t catch a ball, and had not yet developed a dominate hand. This led to many evaluations and tests, as we attempted to identify the problem.  This process resulted in 10 hours of therapy a week for this little guy (physical therapy 3 days a week, occupational therapy 2 days a week, and Special Education Itinerant Teacher spent an hour a day with him in the class room).

Eye Exam

While all of this was going on, my daughter struggled a little to learn the alphabet. My pediatrician immediately recommended that she get an eye exam.  Ordinarily this is the kind of thing that I would have scheduled for the both of them. If you’re going, you might as well take them both. However, we recently had a disastrous double visit to the dentist’s office. Thus, I only took my daughter to the eye doctor and intended to take him the following week. However, she hated getting her eyes dilated and I made the decision to cancel his appointment. He had been through so many tests, so many evaluations, so much therapy and I concluded this was a test we could skip for now. I would live to regret this decision.

After 8 months of therapy we walked into our parent-teacher conference expecting to hear great news; instead, we walked into the news that my son had made no developmental progress in the past year. We were also told that he was unable to cross the mid-line, which means he wouldn’t cross his hand from one side of his body to the other in order to perform a task. For example, when writing the letter “T”, he would first draw a 7 with his left hand and then put the pencil in the right hand to draw the other half of the top line. People were convinced that his inability to cross the mid-line was evidence of a significant cognitive problem. Off to the developmental psychologist we went.

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Around the same time, we headed to see our pediatrician for their annual check-up. She performed a basic eye exam. My son covered one eye and read the top line with ease and enthusiasm, and THEN he refused to let anyone cover the second eye. We coaxed him into covering the other eye and waited for him to list letters. Nothing happened…”but I can’t see”, he protested. I handed him a kaleidoscope and asked what he could see. When he looked with his right eye, he listed colors and as said, “wow, look mommy.” When asked what colors do you see, when looking with your other eye he said, “nothing, it’s black.” My heart sunk. We couldn’t get an appointment with eye doctor quickly enough.

Amblyopia Diagnosis

It turned out that my son is Amblyopic. This is an eye condition where the brain and the eye do not work together. In my son’s case, his brain ignored the image from his left eye because the vision in that eye was so poor. It also turns out that he is left handed. However, his left hand failed to emerge as his dominant hand because much of the time he couldn’t see his left hand. You see, toddlers live in an out of sight, out of mind world. So when I put a spoon on the right side of his plate, he attempted to use his right hand to feed himself. In a nutshell, his inability to see out of his left eye was the root cause of most of the developmental delays. If left untreated, children with Amblyopia can only see out of one eye. This impacts hand-eye coordination and peripheral vision. Thus, my son could not catch a ball.

The optometrist gave my son glasses and put him on an aggressive treatment plan. He started patching, or covering the working eye, 10 hours a day. This required the brain to use the weak eye, which forced a connection between the brain and the eye. His vision began to improve and this made all the difference. His left hand dominance finally emerged, leading the way for other developmental strides. While I regret canceling that initial eye exam, I will be forever grateful for the day we could see what he couldn’t. I am so thankful that we discovered this early enough for treatment to be effective and that we were able to make a difference in the way he sees the world.

There are several lessons here:

  1. “It is important to remember that you can’t depend on your child to tell you he is having an eye problem. Most children believe that everyone sees the same way they do, even if they don’t see clearly in one or both eyes” ( http://www.visionforkids.org/lazyeyeqanda.htm).
  2. Developmental delays can be a symptom of vision problems. So, get an eye exam at the first sight of a concern.
  3. Don’t delay!!! Several eye conditions can lead to permanent blindness if undetected or left untreated. The doctor told us that my son would not have benefited from treatment if we had waited another year. 


Warning Signs of Vision Problems in Children


About the author

Shari Crandall is TLC’s Westchester Associate and the mother of fraternal girl/boy twins. Shari coordinated trainings, speaking engagements, and reading groups to support parents as they transitioned into the world of multiples through her local multiples club. She is passionate about helping expecting parents anticipate all the ways their lives will change once their babies arrive and how to negotiate all the decisions that parents of multiples make before, or shortly after, the babies arrive (what gear, how much gear, to breastfeed or not, if and when to go back to work, etc.). She was as stay-at-home parent until her twins were 3, when she returned to work full-time. You can contact her at shari@twinloveconcierge.com for more information on our Westchester services.