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The Importance of Pediatric Eye Examinations for Children

Comprehensive pediatric eye examinations are critical for monitoring vision and overall eye health in children.

A pediatric eye exam is more than a simple screening, it is an assessment of your child's visual function and development and eye health including:

  • Eye diseases and disorders
  • Infections
  • Evidence of visual-motor, cognitive, and neurological deficits. 

An accurate description of visual strength not only takes acuity into account but our ability to gather and process visual information. A child may have "perfect" vision but struggle with optometric deficits that affect learning. Studies show that most vision problems that affect learning are not caused by poor eyesight. In many instances, there is nothing wrong with the visual system. Often, issues related to visual-motor or cognitive-developmental delay can be detected during such examinations.

Vision Development

While fundamental stages of visual advancement take place in infancy and toddlerhood, it is possible to develop these skills in young adulthood and beyond. They are important for monitoring conditions that might affect learning in school which can lead to stress and anxiety. Vision is crucial for learning and development for the following reasons:

  • More than 85% of our brain is linked to vision
  • It is the brain’s fastest and most effective way of processing information. 
  • The early development of visual skills and neuroplasticity allows children to meet age-related visual demands as they get older.  As new nerve pathways are developed, they have a greater chance of being visually on par with their peers. 
  • It allows children to develop critical skills needed to process what they read, learn, and how to interact with the world around them.

Signs of Visual Problems

  • Reduced hand-eye coordination: An example can be seen when a child is unable to catch a ball that is thrown towards them. The inability to do so points to their difficulty in interpreting speed in relation to where they are. 
  • Compensation: When a child points to each word they read. Doing so is often a way for them to compensate for their inability to track words. 
  • Avoidance: If a child finds it too difficult to read or track the words on a page, she may avoid the material altogether. This kind of avoidance is often displayed through excessive movements, such as squirming in their seat, speaking out of turn, or "spacing out" because they cannot focus on the material.

Physical Symptoms

Eye problems that involve an inability to focus or poor vision often present as physical symptoms. These include:

  • Headaches
  • Red eyes
  • Eye rubbing
  • Eyestrain
  • Complaints of poor vision ("I can't see!")

Knowing What to Look For Problems with Visual Perception

A child who struggles with visual perception will often struggle with mastery of any number of tasks. That is why it is important to recognize the signs that suggest the presence of a deficit, particularly if they have:

  • Poor handwriting
  • Difficulty in copying from a whiteboard
  • A tendency to omit or re-read words
  • Poor reading comprehension
  • Difficulties with letter and number reversals, such as confusing “b” with “d”.

Emotional Symptoms of Visual Perceptual Problems

The emotional effects of having a visual perception problem can be devastating. The inability to perform well in school often leads to low self-esteem and can lead a child to think they are stupid, causing them to lose the motivation needed to succeed. Being able to identify signs of emotional distress is critical, particularly if a child exhibits:

  • Signs and symptoms of depression or stress
  • Extreme irritability or temper tantrums
  • A short attention span
  • Difficulty focusing on tasks

Common Eye Problems Found In Children

Many optometrists recommend at least one comprehensive pediatric eye exam before your child begins school. Some common eye conditions in children include:

  • Myopia (nearsightedness)
  • Hyperopia (farsightedness)
  • Genetic diseases
  • Astigmatism
  • Amblyopia (lazy eye). This condition occurs in  the absence of normal visual development. Treatments include vision therapy, patching, and eye drops.
  • Strabismus (double vision)

Vision Screening from a Pediatrician vs. Eye Exams From A Pediatric Optometrist

It's important not to get confused between a rudimentary screening performed by a pediatrician (or a school nurse) and a comprehensive eye examination from a pediatric optometrist. The former is done by a pediatrician as part of a standard physical exam. The latter is an exam by a trained eye doctor, which can extensively test all aspects of visual health.

Anatomy of a Pediatric Eye Exam: What to Expect

The examination will begin with a case history of the child, including family and personal medical history, observations from the school, and complaints from the child. Following this, the optometrist will examine the following:

  • "Good vision" or visual acuity: Tests involve the eyes working together and the individual eye. For children and babies unable to communicate there are special technologies for babies using pictures to assess their vision.
  • Usage: Tests include the cover test, testing for color, 3d, track
  • Phoropter for older children to check if they need prescription lenses.
  • Slit-lamp gives a good look at the eye
  • dilating drops allow for analysis of the back of the eye.
  • Review of findings, recommendations, treatments, scheduling future testing

Early Stages of Testing

  • Newborns: Newborns require a proper assessment to check the startle reflex and any noticeable signs of eye disease, in particular if there is a family history of such complications. Such tests can be done by the pediatrician.
  • Babies 6-12 months: Within the first year, the pediatrician will assess eye movement, alignment, and overall eye health.  
  • 12 to 36 months: Overall eye health is assessed often with the aid of photo screening to monitor for signs of eye problems.  If any problems are noted, follow-up will usually involve an eye doctor. 
  • 3-5 years: The child will be checked for issues of alignment and vision. If there are signs that further intervention is required, they will usually involve an optometrist.
  • 5 years and older: Further assessment of eye alignment and to gauge visual acuity. Signs of eye issues will be addressed by an optometrist.
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Pediatric Eye Exams Are Important

There are no substitutes for routine pediatric examinations to monitor and maintain overall ocular health to detect eye disorders and visual motor neurological deficits. Contact us to find out more.

Parent’s Assesment of Kids Visual Problems

Investing in our Patients With Advanced Technology

As part of our commitment to provide the best eye care to our patients, we are constantly enhancing our innovation edge by investing in cutting edge technology and offering only the best for our patients. At Amplify EyeCare Chattanooga we have an advanced retinal camera to produce a high definition image of the inside of the eye. With retinal imaging we can better prevent and diagnose disease in a simple, quick and patient-friendly method. It is critical to evaluate the health of the retina, optic nerve and other retinal structures. The digital camera snaps a high-resolution digital picture of your retina. This picture clearly shows the health of your eyes and is used as a baseline to track any changes in your eyes in future eye examinations. Our office also has advanced technology for dry eye, visual fields and functional vision. 

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Heather McBryar, OD, FCOVD

Dr. Heather McBryar is a certified optometrist and a Tennessee native. She has more than 16 years of experience in the field of optometry. Her fascination with the field began at a young age with a visit to the eye doctor for a minor vision issue of her own, and later upon learning about a vision condition that ran in her family. With her son both having a vision issue and being on the autism spectrum, Dr. McBryar hit on the novel concept of combining both low vision treatment and vision therapy to achieve the best possible results for patients in need of more specialized help.

Dr. McBryar graduated with honors from Nova Southeastern University College of Optometry. She is a Fellow of the College of Optometrists in Vision Development (COVD), a candidate for Fellowship in the Neuro-Optometric Rehabilitation Association (NORA), and a Diplomate of the American Board of Optometry (ABO).

Dr. McBryar has hospital privileges at Siskin Hospital for Physical Rehabilitation and is a co-founder of the Chattanooga Area Low Vision Network. She has lectured extensively on the topics of neuro-optometric rehabilitation and low vision
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The Amplify Eyecare Chattanooga accepts:

  • Cigna
  • Cigna health Spring
  • UHC
  • AmeriGroup
  • Medicare
  • Medicaid
  • Blue Cross Blue Shield
  • Aetna
  • TriCare East
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 Elizabeth’s school work has shown a big improvement as well as the ease in which she completes it herself.

Her comprehension and fluency in reading has improved also. Vision therapy has definitely made a positive impact on Elizabeth school work.

Linda U.

Wes vision therapy has given him the skills he needed to promote confidence in his reading, writing, etc. For quite some time he was very defeated by school and didn’t even want to try. I saw quick improvements in tracking and fine motor which really got him to try on things that he didn’t even bother to try before. Because of his therapy and diagnosis and strongly believe he is on the road to success. He loved coming therapy and always felt comfortable coming to work with Dr.McBryar and his staff. Thank you for helping Wes, and giving him his confidence back! 

Amy B.

I am so appreciative to Dr.McBryar and the staff  at the Institute for Vision Development! My daughter, Caitlin, is thrilled to be able to read without fighting the battle of blurry vision and double vision. She suffered with headaches and complete exhaustion throughout fourth grade. She would reread material up to five times because she was aware she was skipping words and lines. She was also self conscious that she was not reading as quickly as her peers and also worried that her vision problem could not be resolved.

Dr.McBryar encouraged Caitlin to persevere in therapy even when it was difficult and no immediate change was noticed. She also explained the purpose of exercises in therapy and explained the need for homework assignments. 

When results were achieved, Caitlin was THRILLED! I Remember her excitement when she could read with no vision problems. She felt confident and proud of accomplishments! I feel that she could not have achieved this great success without the guidance and instruction from Dr.McBryar I am so grateful!!!

Lisa H.

Meredith came to visit the Vision Center for a regular eye-cheek When we were told one had oculomotor, binocular vision and accommodative disorder. She had trouble in school with numbers and letters (certain ones), adding extra zeros skipping words + lines and missing directions for her work. With just the glasses, which helped her with up close vision and therapy with her accommodative disorder, she immediately made some improvement with her blurred vision. The extra zeros, we discovered, were due to her double vision.

After 24 weeks of eye therapy, Meredith has finally graduated. She has great improvements in Math and reading comprehensions. She will also sit and read books for hours on end, whereas before she would start and stop a lot (due to eye fatigue). Manyof her ADD symptoms have been minimized. She is focusing, able to complete assignments much more frequently and has been making straight As recently!. I am a Firm believer that the vision therapy did wonders for her eyes, her abilities, and her self-esteem. I'm so glad i've found you.

Caroline J.


My son used to excuse himself from class because of the anxiety of not being able to do the work. He would throw tantrums when it came time to do homework. He would never attempt to read, always wanted me to read to him, however if you asked him to read a single word he could. He could not read a sentence, only single words.

I think my child's words Best sum up what V.T. has done for him:” Mom, can we get this?” (the easy button on Staples) “That way i can hit it each time I finish a page of homework!” Or : “Mom, the worst thing about V.T. is that it is almost over!” He loved coming to Dr.McBryars office.

In 6 months my son went from not being able to read Hop on Pop by Dr. Seuss to finishing 2 diary of a Wimpy Kid books. The Results SPEAK FOR THEMSELVES! We what Vision therapy has done for our son and his confidence!

Julene S.

Dr. McBryar, Kristen and John are all marvelous and we would physically recommend them to anyone… Our one wish is that we would have found them sooner.

Staci J.



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