Pediatric Eyecare

Pediatric eye care, paediatric eye care specialistsAt 360 Eyecare – Metro, our optometrists have been trained as pediatric specialists to better serve the unique demands of your children’s eyes.

Our specialists perform ocular assessments to better understand your child’s vision health history and the demands that they place on their eyes daily. After these assessments, we work with your family to determine the best eye care solutions that will help your children to see with clarity.

Your whole family will enjoy their visits to 360 Eyecare – Metro. Our warm and welcoming staff will ensure that even your littlest ones love their optometry appointments. While parents will be happy to know that children and young adults under the age of 19 are covered for yearly eye exams with the presentation of their OHIP card. Yearly eye exams are essential to protect your children’s visual health. The majority of parents wrongfully assume that they will notice if a child has a visual impairment. However, many degenerative conditions do not have any external symptoms. Additionally, because young children do not have anything to compare their eyesight to, they will not inform you even if something is wrong. Therefore, the sooner that you and your children visit one of our pediatric optometrists, the more proactive we may be in protecting your children’s vision.

When you visit for an eye exam, our optometrists will discuss your child’s performance in school, specifically in math and reading. Connections are made to discover potential eye disorders explained in more detail below. Looking at the vision history, school performance, and your child’s comprehensive eye exam, the doctor will decide if your child needs further examination in binocular and accommodative function. This additional testing will uncover any eye tracking, eye teaming or focusing disorders that could potentially interfere with the child’s school performance.

Once a condition is diagnosed, the doctors at 360 Eyecare – Metro initiate a treatment plan. Treatment plans can be as simple as specific lens therapy, contact lenses, occlusion therapy (patching or atropine penalization), or vision therapy. Parents need to be aware that, in most cases, a child’s vision problems need to be managed differently than an adult’s. That is why it’s important to work with optometrists who have dedicated themselves to fully understanding the unique complexities of pediatric eyecare.

At 360 Eyecare – Metro, specialty binocular and accommodative assessment has a battery of tests that go above and beyond the routine eye exam. These advanced diagnostic tests require special equipment and training to perform. Our optometrists are specifically trained to perform these tests so that they more accurately assess your child’s vision needs. These tests are carefully planned and implemented for each unique patient and his/her condition.

Binocular and Accommodative disorders that commonly affect children

Convergence insufficiency

  • A prevalent and distinct binocular vision disorder
  • Typical symptoms include double vision, eyestrain, headaches, and blurred vision while reading
  • Affects a significant number of children in North America, and may have serious negative affects on a child’s performance in school, at work, as well as their quality of life
  • The CITT (Convergence Insufficiency Treatment Trial) study found that vision therapy is an effective treatment that will help your child lead a fuller, happier life.
If you are concerned that your child might have convergence insufficiency, consider taking the CI symptom Survey found at the bottom of this page. If you have further questions about the symptoms or solutions associated with this disorder, please contact our pediatric eyecare specialists.

Accommodative insufficiency

  • Sometimes this condition is referred to as premature presbyopia
  • A condition that causes the amplitude of accommodation in a child’s vision to be chronically lower than the expected amplitude for that child’s age
  • This accommodative deficiency results in a reduced ability to focus on near objects or letters.
  • One study reported as many as 16.8% of their study population had symptoms that were directly linked to this condition
  • Young patients with accommodative insufficiency usually suffer from blurry vision, headaches, and asthenopia associated with near work.
  • Burning, irritated vision, photophobia, and nausea are also occasionally reported.
  • These symptoms make concentrating on schoolwork nearly impossible, causing children to fall behind their peers.

How to Treat Accommodative Insufficiency

  • Therapeutic lenses in a multifocal form will help to alleviate the symptoms of accommodative insufficiency
  • Vision therapy will also help to increase the amplitude of accommodation

Amblyopia (lazy eye)

  • A loss of vision that cannot be improved by corrective lenses
  • The word ‘amblyopia’ literally translates as ‘blunt sight’, which is an acquired unilateral or bilateral decrease of visual acuity
  • There is no obvious structural or pathologic causes that can be detected by physical examination of the eye
  • Amblyopia produces few symptoms because the patient usually has normal vision in the other eye
  • Amblyopia develops in infants and very young children, beginning only during the first 6 years or so of life.
  • Once established, however, it can persist for life
  • If treated early, its effects are completely or nearly completely reversible
  • One of the causes for Amblyopia is strabismus: when the strabismic eye is not treated, the brain ignores that eye and causes it to become progressively weaker

How Amblyopia in Children is Treated

  • Amblyopia is usually treated by occluding (patching) the good eye and initiating vision therapy
  • This therapy forces the amblyopic eye to work harder, ultimately improving visibility
  • Atropine Penalization is another treatment of Amblyopia
  • Penalization is a useful alternative to occlusion therapy in amblyopia of mild and moderate degrees
  • This treatment may also help to preserve the therapeutic gains made by previous occlusion treatment
  • Penalization at near, total, and alternating penalization are more valuable than penalization at distance.


  • A condition where the two eyes are not aligned in the same direction
  • This misalignment between the two eyes is sometimes referred to as ‘crossed eyes’ (Esotropia, which is the turning in of an eye or Exotropia, which is the turning out of an eye)
  • One of the common symptoms of strabismus is double vision.  However, children can develop amblyopia quite quickly and never have double vision.

How to Treat Strabismus in Children

  • Vision therapy is a common and effective treatment for children suffering with strabismus.
  • Depending on the type of strabismus and the magnitude, sometimes a surgical intervention is required to attempt to align the two eyes
  • A comprehensive eye exam will determine the steps that our optometrists need to take to alleviate your child’s strabismus

Convergence Insufficiency Survey

1. Do your eyes feel tired when reading or doing close work?
2. Do your eyes feel uncomfortable when reading or doing close work?
3. Do you have headaches when reading or doing close work?
4. Do you feel sleepy when reading or doing close work?
5. Do you lose concentration when reading or doing close work?
6. Do you have trouble remembering what you have read?
7. Do you have double vision when reading or doing close work?
8. Do you see the words move, jump, swim or appear to float on the page when reading or doing close work?
9. Do you feel like you read slowly?
10. Do your eyes ever hurt when reading or doing close work?
11. Do your eyes ever feel sore when reading or doing close work?
12. Do you feel “pulling” feeling around your eyes when reading or doing close work?

Toddler receiving an eye examDon’t gamble with your children’s vision. Even if they are not experiencing the symptoms of an eye condition, an eye exam may reveal that their vision could benefit from enhancement. Get the eye care that your children need to succeed from the pediatric specialists at 360 Eyecare – Metro. Contact our pediatric eyecare specialists and help your children thrive with clearer vision.