InfantSEE Program at Western University of Health Sciences Changes Lives

An astute aunt and a national program that provides free eye exams to infants resulted in a life-changing diagnosis at Western University of Health Sciences.

Pomona, California resident Erica Monique Mendoza wasn’t too worried about her son, Levi Henry Cerda. She thought he was developing normally. But her aunt, Judith Mendoza, suggested Levi get examined at WesternU’s Eye Care Institute (ECI). Judith worked as a front office receptionist in the ECI at the time and is now enrolled as a student in the College of Graduate Nursing’s Master of Science in Nursing – Entry program.

When she tried to make Levi smile, it would take him a minute to grasp what he was seeing, Judith said. When placed in his playpen, he would constantly fall down.

"I told Erica that Levi’s behavior was not normal, and she should take advantage of the free eye exam that was offered at WesternU’s Eye Care Institute,” Judith said. "My instincts were that maybe he could not see or maybe he had a more serious issue neurologically.”

Levi received a free vision examination as part of InfantSEE, a public health program managed by Optometry Cares – The AOA Foundation. American Optometric Association member optometrists provide a no-cost comprehensive eye and vision assessment for infants 6-12 months old regardless of a family’s income or access to insurance. The AOA recommends eye exams at 6-12 months, at age 3, and before starting first grade, then every year following.

WesternU College of Optometry Chief of Pediatric Optometric Service John Tassinari, OD, FAAO, FCOVD, first examined Levi when he was 6 months old.

"When I first greeted him, I observed that he was not that interested in looking at me or others or even just motion in the room. I see that in children who are timid and fearful, and they may have normal vision, so it is not categorically a way to diagnose a vision problem,” Tassinari said. "By simply shining a special light called a retinoscope in his eyes, we saw that the optics of his eyes were way out of range.”

One of the vision tests given to Levi was visually guided reaching, which children start to do at age 3 to 4 months.

"For visually guided reaching, we used targets that are shiny balls on the end of a stick, gold and silver in color. They are visually captivating so that children with normal vision will look at them and reach for them. Levi never did that, which raised the concern level,” Tassinari said. "Again, it could be timidity, but I believe it was because his vision was so blurred, and he didn’t know how to make the visual judgement about where to reach. We ultimately diagnosed him with very high hyperopia – farsightedness – that was way outside the normal range for a baby.”

Glasses were not prescribed after the first visit because Dr. Tassinari gave Levi a chance to self-correct — some babies who have the condition will normalize without corrective lenses. He gave Erica home-based exercises to engage Levi in visually-guided activities — tracking, looking, following and reaching – to prompt self-correction.

"It did not self-correct, despite a very diligent effort on his mom’s part,” Tassinari said. "When he came back (at age 1), he hadn’t changed at all. When a child doesn’t change, that’s a powerful sign they are not going to. Glasses were prescribed after that exam.”

The glasses made an immediate impact on Levi’s outlook on life.

"We went to a park, and he just stood there for 45 minutes to an hour just looking at everything,” Erica said. "Everywhere we go now, with glasses, everything is new to him. It’s really cool to see. He was so into everything. That’s what he was supposed to be doing the entire time.”

Now that she sees how much more active Levi is, Erica realizes he wasn’t developing typically prior to his diagnosis.

"When he was in a walker he would bump into walls,” she said. "We finally understood why when talking about the glasses. He would be running straight but wouldn’t see the wall (in his peripheral vision).”

Erica said she is very thankful that Judith caught something and made the recommendation.

"It’s crazy to know these options are out here. I had no idea about them,” Erica said. "I’ve seen babies with glasses, but I thought that was something doctors would let you know about. I thought they could catch these things and I would be told (he needed them).”

Getting a baby’s vision examined early may prevent a host of problems later in life. Untreated farsightedness might result in a child having crossed eyes, where both eyes do not look at the same place at the same time. Another consequence of being highly farsighted is that overall visual development and motor development can suffer.

"Some of these children who are not diagnosed until preschool or kindergarten may have delays in their motor skills. They have trouble learning how to write letters or hold a pencil properly,” Tassinari said. "It could set them back in terms of academic readiness.”

If not for Judith’s intervention, Levi’s vision could have been much worse later, Erica said. She is spreading the word about the InfantSEE program at WesternU’s Eye Care Institute.

"Now that my friends and coworkers and family see him with glasses, they always ask me about them,” Erica said. "I told them about this program. Now everybody is saying, ‘Let’s bring our grandkids.’ ‘We’re going to start bringing our kids and telling our nieces and nephews.’”