Although Hearing Is Fully Developed at Birth, Visual Development Continues to Progress

Chapter 18

■■■ Key Concepts

•  Although hearing is fully developed at birth, visual development continues to progress until about age 7 years.

•  The relatively short and horizontally positioned eustachian tubes of infants and young children make them more susceptible than adults to otitis media.

•  Binocular vision develops by age 4 months; visual acuity progresses to 20/50 by age 3 years and usually reaches 20/20 by age 7 years.

•  To maximize speech and language development, hearing loss should be identified early and intervention begun immediately.

•  The corneal light reflex test and cover test are useful tools for identifying strabismus and amblyopia.

•  Tympanometry is used to determine the presence of fluid behind the eardrum (such as with OME).

•  Topical ophthalmic medications are used to treat certain infectious eye disorders.

•  Systemic antibiotics are used for the treatment of periorbital cellulitis and AOM.

•  Very premature infants are at high risk for developing visual deficits related to ROP and are also at increased risk for hearing impairment compared with other infants.

•  Children with genetic syndromes or family history are at increased risk for visual and hearing impairments.

•  Strabismus, glaucoma, and cataracts may all lead to visual impairment if left untreated.

•  Recurrent or constant nasal congestion contributes to OME.

•  Asymmetry of the corneal light reflex occurs with true strabismus.

•  A cloudy cornea indicates the presence of cataract.

•  Eye strain, eye rubbing, and headaches may indicate a visual deficit.

•  Delay in language acquisition may occur when hearing loss is present.

•  Appropriate handwashing is the single most important factor in reducing the spread of acute viral or bacterial conjunctivitis.

•  Otitis externa can be prevented by keeping the ear canal dry and altering canal pH.

•  Children with visual disorders should be encouraged to use prescribed corrective lenses.

•  The child with hearing loss should receive early intervention with hearing aids or other augmentative devices.

•  Hearing and/or vision impairment can significantly hinder developmental progress.

•  The fluctuating hearing loss associated with recurrent AOM and the hearing loss associated with chronic OME can both significantly hinder language development in the infant and toddler.

•  Amblyopia must be identified early and treated with patching, corrective lenses, or surgery to prevent visual deterioration and promote appropriate vision development.