Glasses transform preschooler’s eyesight and energy levels

Noah* is a sweet, friendly 5-year-old. He loves making friends, building Legos, reading, drawing and playing with his little sister. But in May 2023, a few months after his fourth birthday, Noah’s nursery schoolteachers told his parents, Drew and Alexis, they thought Noah was having trouble with his vision.

When drawing, painting or reading, the little boy would get just a couple of inches away from the page. He occasionally appeared clumsy, walking into objects that were at his eye level.

His teachers suggested his parents take Noah for a comprehensive eye exam with a doctor of optometry. One teacher recommended Andrea Thau, O.D., who practices in Manhattan in New York City, where the family lives.

In retrospect, Alexis says, they should have noticed he was having trouble seeing. The signs were there, she says. Plus, Noah was often exhausted by the time he got home from school. His energy from focusing on seeing all day left him zapped. But Noah is the couple’s first child; there weren’t older siblings to compare his development to. And neither Alexis nor Drew wears glasses.

Dr. Thau says most of the time it’s impossible for a parent or teacher to tell when a child has a vision problem. “Children assume however they see is normal, so they often do not complain because they have no basis of comparison,” she says.

While children may have their eyes “tested” at school or in the pediatrician’s office, those are only vision screenings. Children or adults who pass a vision screening could still have an eye health or vision problem. “The only way to ensure that a child is developing good vision and on the path of developing well overall is to have an in-person comprehensive eye examination with a doctor of optometry,” Dr. Thau says.

Dr. Thau, who treats patients of all ages, tells children she’s an “eye doctor detective,” looking for clues. She uses the same types of tests to examine a child’s eyes as adult patients are accustomed to, but she uses finger puppets, toys and picture book-type drawings to keep children invested.

During Noah’s exam, he could not track her moving target with his eyes without moving his head. He had reduced depth perception, which is the ability to see objects in three dimensions and determine how far they are from you. Noah was far-sighted, meaning his eyes could see better far than near. Dr. Thau explains that his eyes were “underpowered” and that he had to focus to see far and had to work twice as hard as everyone else to see up close. He also had an astigmatism in both eyes, which is an unequal curvature of the eye that distorts whatever the eye is looking at, adding additional strain and challenges.

“This young man was having trouble seeing things clearly, both at far and at near,” Dr. Thau says. “He was also having trouble keeping his place and tracking his eyes. It was no wonder that he was exhibiting some of the behaviors that his teachers observed.”

The good news? Noah’s eyes were healthy. Eyeglasses would allow him to see properly.

Dr. Thau recommended Noah wear eyeglasses full time. She wanted him to work his way up to his full prescription, so that his eyes could adjust to the change. A 4-year-old might not want to wear his glasses, but that was never a problem, Alexis says. As soon as his new glasses were on, Noah grinned widely and said, “I can see everything, but bigger!”

Six weeks later, in June 2023, he returned to Dr. Thau for a progress evaluation. His vision, depth perception and eye tracking had improved. He was ready for an increase in his eyeglass prescription. By his September 2023 visit, his vision, depth perception and eye tracking were even better.

Dr. Thau can’t say whether Noah will need glasses for the rest of his life. As he grows, his eyes will grow too, which may lead to a lower prescription, but he might still need glasses or contact lenses as he gets older.

Dr. Thau points out that 1 in 4 children have vision problems. After babies are born, their eyesight is still developing. The American Optometric Association recommends comprehensive eye examinations starting between 6 and 12 months of age. “There’s a lot of change that happens to the visual system in the first 12 months,” Dr. Thau says. “That’s why we like to see them between 6 and12 months, because if there’s something wrong, we want to start to intervene before they go off track.”

If a child does not have a vision problem at that first visit, they should return for another comprehensive eye exam with a doctor of optometry at age 3, age 5, then every year after that.

“Poor vision impacts academic performance, social, emotional and motor development,” Dr. Thau says. “It has a profound impact on a child’s overall development. Making sure your child is seeing well is one of the most important and impactful things you can do to get them on the right path for a great academic year.”

As for Noah, he has two pairs of eyeglasses that he wears with a strap. He chooses which pair he wants to wear each day. He hasn’t scratched, broken or lost them. They haven’t flown off while he’s playing. He now has energy at the end of the day and has become an even more voracious reader.

Out in public, Noah continues to make friends. But he’s now particularly drawn to adults and kids wearing glasses. He has created the “Glasses Club,” consistently inducting friends and strangers into it.

“Last summer, Noah’s camp counselor was having a difficult day, so he welcomed her into the club to cheer her up—and was proud to report that it worked,” Alexis says. “We’ve seen him go up to bespectacled TSA agents, grocery store shoppers, people walking their dogs and other little kids to give them invites to his special club. It always generates a smile.”

Dr. Andrea Thau

Andrea P. Thau, O.D., is an Associate Clinical Professor Emerita of the SUNY State College of Optometry, a Diplomate of the American Board of Optometry, a Fellow of the Optometric Vision Development and Rehabilitation Association, and a Distinguished Practitioner of the National Academies of Practice. She is the owner of Dr. Thau and Associates, located in New York City.

 Dr. Thau served as President of the American Optometric Association from 2016 - 2017. Prior to her election to the AOA Board, she served as the first woman president of the New York State Optometric Association, the New York Academy of Optometry, and the Optometric Society of the City of New York. Dr. Thau was a founder of the AOA's InfantSEE® public health program, a national program that provides no cost vision assessments to every baby in this country. She was a founding member and vice president of the New York Children's Vision Coalition, a multi-disciplinary coalition dedicated to ensuring that every child in New York receives an eye examination prior to school entry. A champion of children's vision, she has been called upon to advocate on their behalf at the state and national level including as a speaker at a Congressional staff briefing.