Physician Perspective
Lee S. Friedman, M.D. specializes in pediatric ophthalmology and strabismus with the Florida Eye Microsurgical Institute, Inc. in Boynton Beach, Fla., and is a member of the PediaVision® MAB.
Dr. Friedman earned his undergraduate degree from Florida State University and his medical degree from the Chicago Medical School. He completed both his internship and residency at Tampa General Hospital, an affiliate of the University of South Florida, and his Fellowship in Pediatric Ophthalmology and Strabismus at Manhattan Eye, Ear and Throat Hospital.
Dr. Friedman is certified by the American Board of Ophthalmology and the American Association for Pediatric Ophthalmology and Strabismus. He is a member of various organizations, including the American Medical Association, the American Academy of Ophthalmology and the Florida Medical Association, and has published several articles on night blindness and myopia.
Here are a few excerpts from a recent interview with Dr. Friedman regarding infant vision:
Q: How does a baby’s vision develop over the first few months?
R: “Babies are born without any vision experience, so their brain is like a blank slate. As the baby develops and begins seeing the world, images become imprinted on the visual cortex and the neural inputs develop. The focusing reflex that allows babies to clarify what they are seeing is also developing. All of this begins by 6 weeks to 2 months of age.”
Q: How can parents expect their infant’s eye color to change?
R: “Most children are born with slate grey or light brown eyes which tend to darken over the first year as pigment develops. Babies born with very light blue or green eyes frequently retain the color throughout.”
Q: What problems should parents look for?
R: “Parents should see that their children are attaining their developmental milestones on track. Children with poor vision may crawl and walk late and may be clumsy when they do walk. Parents should look for squinting of the eyes which could signal high refractive errors, refractive asymmetry or strabismus (crossed eyes). Infants’ eyes may deviate during the first 6 months of life as their focusing reflex develops, but deviations after this age should be investigated. A family history of eye problems is an indication for early evaluation as it is not uncommon for multiple family members to suffer from the same condition. The pediatrician should screen for children’s visual development at 6 months and at all well baby visits. We recommend a full comprehensive dilated eye exam by a pediatric ophthalmologist by 3 to 4 years of age. However, diagnosis of visual abnormalities can be made at any age if there is a particular concern.”
Research Supports the Efficacy of PediaVision®
and Photoscreening in Pediatric Vision Screening
There are many quotes from some highly regarded physicians regarding the use of the PediaVision® Assessment Solution (PAS):
“The [PediaVision®] Plusoptix vision screener is a useful tool to detect amblyopia risk factors in pediatric populations. Our study shows that the referral criteria can be modified to improve specificity and positive predictive values of the device without reducing sensitivity in this study group. The [Pediavision®] Plusoptix vision screener is an accurate, fast, user-friendly and portable way to detect amblyopia risk factors”
“Performance of the [Pediavision®] Plusoptix vision screener for Detection of Amblyopia Risk Factors in Children.”
Noelle S. Matta CO, CRC, COT; Eric L. Singman MD, PhD; David Silbert MD, FAAP – Family Eye Group, Lancaster PA – April 2008
“Photoscreening can outperform deliberate conventional acuity testing in pediatrician’s office preschool screening. While ABCD [Alaska Blind Child Discovery program] was happy with the ADBC (amblyopia detection by camera) as an intermediate portable digital step to follow Polaroid photoscreening, the rapid computer interpretation with age-based, user definable referral criteria makes the [PediaVision®] PlusOptix S04 a most potent weapon against amblyopia for any program that can obtain them.”
“Pediatric Eye/Vision Screening: Referral Criteria for the PediaVision® PlusOptix S04 Photoscreener Compared to Visual Acuity & Digital Photoscreening”
Binocular Vision & Strabismus Quarterly, Second Quarter, 2007
“Photoscreening, particularly with commercial digital flash cameras and specific interpretation, is a cost effective screening tool particularly for younger children.”
“Validated portable pediatric vision screening in the Alaska Bush”
Alaska Medicine, Jan-March 2007 - View Abstract
“The Vision Screener [PediaVision®] Plusoptix S04 is easy to handle and even young children show good compliance. Measurements are repeatable and accurate for myopia, astigmatism and anisometropia, however hyperopia measurements are biased by accommodation. In summary, the Vision Screener [PediaVision®] Plusoptix S04 can improve early detection of amblyogenic refractive errors in pre-verbal children.”
“Screening for Refractive Errors in Preschool Children with the Vision Screener plusoptix S04”
Presented at Beilschowsky Tagung, November 19, 2005, - View Summary
“Photoscreening is more time efficient than traditional screening and has a significantly higher PPV in 3- and 4-year-old children.”
“Predictive Value of Photoscreening and Traditional Screening of Preschool Children”
Journal of AAPOS, April 2005 - View Abstract
“As a technique to screen for amblyogenic risk factors, photoscreening appears to offer certain conveniences and advantages over traditional methods of vision screening, especially in its availability to screen children who are most difficult to screen but in whom the prevalence of amblyopia is higher than in the general pediatric population, such as premature infants or children with developmental delays or a family history of eye problems.”
“Use of Photoscreening for Children’s Vision Screening”
Pediatrics, March 2002 - View Article
”This automated digital imaging screening system eliminates human bias and provides accurate and immediate results.”
“A new objective digital computerized vision screening system”
Journal of Pediatric Ophthalmology and Strabismus, Sept.-Oct. 1999 - View Abstract
