Vision and hearing Q&A
Hearing and vision examinations are an important part of a child’s overall health. ParentingNH reached out to a trio of experts to talk about when, how and why such testing is vital.
- Gerald Astorino, OD, Amoskeag Health Optometry. amoskeaghealth.org/
- Adam Grimm, Optometrist, Evision Eyecare. evisioneyecare.com
- Jennifer Dionne, Audiologist with Specialty Certification in Pediatric Audiology, Core Physicians. corephysicians.org
Why are vision screenings so important?
Astorino: “A vision screening detects if a patient needs glasses and it can reveal any underlying conditions that may need further testing or treatment such as diabetes, glaucoma, or macular degeneration. All pediatric, adolescent, and adult patients should have their vision checked once per year to ensure eye health, to track vision changes, and to make sure that any abnormalities are caught early.”
Grimm: “Nearly 80% of what a child learns is obtained visually. Undiagnosed vision problems can cause your child to suffer. Periodic school screenings aren’t as thorough and can miss up to 60% of eye problems in children. Vision is the dominant sense and forms the basis of a child’s perceptual, cognitive, and social development. Many common and developmentally impactful childhood eye problems come with little to no signs or symptoms. Left untreated, many of these problems can lead to permanently reduced vision throughout a person’s entire life. Luckily, through a series of regular vision screenings during the early childhood years, these – and many other problems – can be detected, treated, and remedied, setting a child up for a long healthy life unhindered by preventable vision problems.”
How common is hearing loss in children?
Dionne: “Thankfully it is not terribly common, because perfect hearing is a gift. If you have it, treasure it. Sadly though, one to three in 1,000 babies are born in the U.S. with permanent hearing loss. Thanks to the tireless work of the late, great audiologist Marion Downs (fun fact, she smoked in the soundproof booth in the ‘60s and ‘70s, oh my!) all babies born in New Hampshire and throughout the U.S. are screened for hearing loss at birth. However, the prevalence of hearing loss increases as we age. By school age, the number of children with permanent hearing loss rises to 9-10 per 1,000. Broadly, the factors that can influence this increase are injury, disease, and genetic factors. As early as fourth grade we can start to see the effects of unsafe loud noise exposure! The vast majority of pediatric hearing loss is due to acute otitis media, commonly known as an ear infection. 70% of children in the U.S. will experience an ear infection by age 2. Those episodes generally do not cause permanent hearing loss with appropriate medical care.”
How common are vision impairments in children, and what milestones should I watch for?
Astorino: “Some common signs and symptoms of vision problems in children are unusual sensitivity to light, complaints of double vision or ‘seeing double,’ squinting, turning/tilting of the head while watching TV, avoiding reading altogether or reading very close to the face, or lack of interest in objects or people at a distance. These vision problems are in addition to those signs and symptoms of a medical eye problem, like red/pink eye, swollen eyelids, constant tearing, or any other symptom that isn’t normal for the child. All should be evaluated by your child’s medical provider or by an optometrist as soon as possible.”
When should I have my child’s vision checked?
Astorino: “Your child’s medical provider will examine their eyes during their pediatric well-check visit from birth to 5 years old. After age 5, children should transition to an optometrist for yearly eye exams.”
How often should my child’s hearing be screened?
Dionne: “All infants should have their overall development screened at ages 9, 18, 24 and 30 months of age or any time there is a family member or professional concern. If an infant doesn’t pass the speech-language or hearing screening, that child should be referred for a speech and language evaluation and a comprehensive hearing test. Children should be further screened in preschool through fourth grade, and in seventh and ninth grade. By screening all children according to this schedule, we are able to catch over 90% of hearing losses. Any child with an identified permanent hearing loss should be tested every year or more often if recommended by his or her audiologist.”
Are there any vision-related milestones I should watch for in my child, and what should I do if he/she misses one of those milestones?
Grimm: “There are two major developmental milestones that can be easily observed at home. By 12 weeks of age your child should be able to maintain eye contact with a caregiver and to be able to fixate on and follow a close moving target. By 6 months of age your child should demonstrate normal ocular alignment. If the eyes appear to cross, drift apart, are misaligned in any way, the child will not have met this milestone. If you are concerned that your child has not met these milestones, they should be seen for a comprehensive eye exam by a licensed eye care provider. Children should have a comprehensive eye exam by the time they are 3 years of age, and just before they enter kindergarten around age 5.”
Why is screening hearing so important?
Dionne: “Routine hearing screenings provide crucial heath information about a concern that might otherwise go undetected. In the vast majority of cases, a child who failed a hearing screening will be found to have an ear infection or non-infected fluid in his or her ear. These conditions can cause hearing loss which generally resolves when the fluid clears. So often I hear from parents who say their child “wasn’t complaining” when we discover that child had fluid in his or her ears or an ear infection they weren’t aware of. These conditions can be chronic in some children or more occasional in others. In many but not all cases they can resolve without medical intervention. I recall bringing my preschooler to work on a school snow day and for “fun” we tested his hearing. He had a hearing loss in his left ear from fluid in his middle ear which I didn’t even know about because he wasn’t a complainer even though he understood what I did for work! The lesson here — never assume!”
What vision services are available at Amoskeag Health?
Astorino: “Amoskeag Health Optometry provides comprehensive eye exams, diabetic eye exams, and can see anyone for an acute same day medical eye problem, like conjunctivitis (pink eye) or an object in the eye. If the patient’s vision screening or eye exam suggests that the person requires eyeglasses, we can fit and order glasses in-house or we can provide a prescription for the person to buy glasses wherever they choose. If eyeglasses are needed, children may qualify for a free pair. Amoskeag Health uniquely offers interpretation services to all patients who prefer a language other than English.”
What new technologies are being used in eye exams at Evision Eyecare?
Grimm: “Evision Eyecare is proud to use state-of-the-art vision technology, ensuring the most accurate ophthalmic prescriptions and personalized eye health services for you and your loved ones. We also feature the highest quality vision solutions for your family’s optical needs. Our eye care professionals hold themselves to the highest level of excellence. Our team continuously strives to keep current on the latest techniques and standards so we can provide our patients with the most optimal care & the clearest vision solutions available.
“Some of the eye exam technology we use includes, but is not limited to: Optical Coherence Tomography (OCT); Visual Field Testing; and Optomap (Fundus Photography / Retinal Camera). We Also Offer personalized eye exams for the whole family; contact lens exams; medical eye problem visits; contact lens purchases; name-brand eyewear; blue-light blocking lenses and more!”
What services are available at Core Physicians?
Dionne: “Core Otolaryngology & Audiology has nine practitioners who take a team approach to diagnosing and treating hearing loss of any type and degree. We perform hearing tests on patients beginning at age 7 months and work with all populations of any developmental ability. We provide hearing tests, hearing aids, and implantable devices, however young cochlear implant candidates are referred elsewhere. We perform Central Auditory Processing Disorder testing which helps to determine how the brain interprets the signal the ears are sending. We also provide hearing assistance technology and collaborate with area educational audiologists and Teachers of the Deaf to ensure a child with hearing loss issues is getting the support services they require.”