ROUTINE MEDICAL EYE EXAMS SHOULD INCLUDE THE FOLLOWING:-
- Newborns should be checked for general eye health by a pediatrician or family physician in the hospital nursery.
- High-risk newborns (including premature infants), those with a family history of eye problems, and those with obvious eye irregularities should be examined by an optometrist.
- In the first year of life, all infants should be routinely screened for eye health.
- Around age 3½, kids should have eye health screenings and visual acuity tests (tests that measure sharpness of vision)
- Around age 5, kids should have their vision and eye alignment checked.
- After age 5, annual comprehensive eye exams should be done.
- Kids who wear prescription glasses or contacts should also have annual checkups.
SPOTTING EYE PROBLEMS
Signs that a child may have vision problems include:
- constant eye rubbing
- extreme light sensitivity
- poor focusing
- poor visual tracking (following an object)
- abnormal alignment or movement of the eyes (after 6 months of age)
- chronic redness of the eyes
- chronic tearing of the eyes
- a white pupil instead of black
In school-age children, other signs to watch for include:
- being unable to see objects at a distance
- having trouble reading the blackboard
- difficulty reading
- sitting too close to the TV
Watch your child for signs of poor vision or crossed eyes. If you notice any eye problems, have your child examined right away so that the problem doesn’t become permanent. If caught early, eye conditions often can be corrected.
COMMON EYE PROBLEMS
Several eye conditions can affect kids. Most are detected by a vision screening using an acuity chart during the preschool years, but a vision screening doesn’t pick up on all the problems there might be. For example, they might read the letter correctly, but this is how they see them:
- Amblyopia (“lazy eye”) is poor vision in an eye that may appear to be normal. Two common causes are crossed eyes and a difference in the refractive error between the two eyes. If untreated, amblyopia can cause irreversible visual loss in the affected eye. (By then, the brain’s “programming” will ignore signals from that eye.) Amblyopia is best treated as early as possible, ideally before a child is 8 years old.
- Strabismus is a misalignment of the eyes; they may turn in, out, up, or down. If the same eye is chronically misaligned, amblyopia may also develop in that eye. With early detection, vision can be restored by patching the properly aligned eye, which forces the misaligned one to work. Surgery or specially designed glasses also may help the eyes to align.
- Refractive errors mean that the shape of the eye doesn’t refract (bend) light properly, so images appear blurred. Refractive errors also can cause amblyopia. Nearsightedness is the most common refractive error in school-age children; others include farsightedness and astigmatism:
- Nearsightedness is poor distance vision (also called myopia), which is usually treated with glasses or contacts.
- Farsightedness (also called hyperopia), which is usually treated with glasses or contacts.
- Astigmatism is imperfect curvature of the front surface of the eye, which is usually treated with glasses if it causes blurred vision or discomfort.
OTHER EYE CONDITIONS
Other eye conditions need immediate attention, such as retinopathy of prematurity (a disease that affects the eyes of premature babies) and those associated with a family history, including:
- Retinoblastoma is a malignant tumor that usually appears in the first 3 years of life. The affected eye or eyes may have visual loss and whiteness in the pupil.
- Infantile cataracts can occur in newborns. A cataract is a clouding of the eye’s lens.
- Congenital glaucoma in infants is a rare condition that may be inherited. It is the result of high pressure in the eye from incorrect or incomplete development of the eye drainage canals before birth and can be treated with medication and surgery.
- Genetic or metabolic diseases of the eye, such as inherited disorders that make a child more likely to develop retinoblastoma or cataracts, may require kids to have eye exams at an early age and regular screenings.
GLASSES AND CONTACTS
Kids of all ages — even babies — can wear glasses and contacts.
Keep these tips in mind for kids who wear glasses:
- Let kids pick their own frames.
- Plastic frames are best for children younger than 2.
- If older kids wear metal frames, make sure they have spring hinges, which are more durable.
- An elastic strap attached to the glasses will help keep them in place for active toddlers.
- Kids with severe eye problems may need special lenses called high-index lenses, which are thinner and lighter than plastic lenses.
- Polycarbonate lenses are best for all kids, especially those who play sports. Polycarbonate is a tough, shatterproof, clear thermoplastic used to make thin, light lenses. However, although they’re very impact-resistant, these lenses scratch more easily than plastic lenses.
Babies born with congenital cataracts may need to have the cataracts surgically removed during the first few weeks of life. Some wear contact lenses after cataract surgery.
Around age 10, kids may want to get contact lenses for cosmetic reasons or if they play sports. To wear contacts, a child will need to know how to insert and remove lenses properly, take them out as required, and clean them as recommended by the doctor. Contact lens problems are almost always due to poor habits and bad hygiene.
THE DEVELOPMENT OF BABY’S VISION
The second Baby is born, his vision kicks in and his visual development begins. At birth, your baby’s eyes have the visual acuity of 20/400, but his rapidly developing vision will reach the adult level of 20/20 by the time he is 3-5 years old. That rapid growth is why his first months are so important to his visual development.
In the first week, Baby can only see objects about20 – 25 cm in front of her face. This is about the distance from his/her face to yours while feeding. Babies generally hold their gaze for only a few seconds.
Just after birth, your baby sees only in black and white, with shades of gray. As the months go by, your baby will slowly start to develop his color vision. Because of this, Baby loves to look at contrasting colors in bold geometric patterns. Your little one will develop his color vision around 4 months. (See resources below for some great print-outs to stimulate baby’s vision.)
Parents love to decorate nurseries in pretty pastels. In reality, these aren’t naturally stimulating colors for your baby’s vision. Black and white, along with primary colors, such as red, orange, yellow, and blue, are much more stimulating. This rule goes the same for toys.
By two weeks, Baby might start to recognize her caregivers’ faces. She will focus on your face for a few seconds as you smile and play with her. Just remember to stay within her field of vision: it’s still around 20 cm. This is where all of that up-close-and-personal time with your child pays off.
By week four, Baby might start to look at things to either side of her as they move back and forth across her midline. But she’ll do this by turning her entire head. She won’t be able to move only her eyes until she’s about 2-4 months old.
By 1 month, the following will happen:
- Moves eyes and head toward light sources.
- Tracks objects horizontally across midline (especially faces).
- Make eye contact and focuses on a caregiver.
2 to 3 months
- Tracks an object both vertically and circularly.
- Recognizes faces.
- Begins to move eyes independently from head.
- Exhibits increased light sensitivity.
- Studies hands or feet.
- Becomes easily distracted by interesting sights.
- Holds intense eye contact for longer periods of time.
3 to 6 months
- Watches and studies own hands and feet, as well as toys.
- Observes toys falling and rolling away.
- Shifts fixation across midline (moves gaze from left to right).
- Widens visual sphere of attention gradually.
- Focuses attention almost across the room.
- Likes looking at reflection.
- Moves eyes independently from head.
7 to 10 months
- Shows interest in pictures.
- Notices small bread crumbs. (Hopefully, this will be at his high chair and not on the floor!)
- Recognizes partially hidden objects.
- Hand-eye coordination improves as your baby learns to crawl.
11 to 12 months
- Looks through windows and recognizes people.
- Recognizes pictures.
- Plays hide and seek.
- Appears visually oriented at home.
- Shows sustained visual interest
EYE EXAMS FOR PRE-SCHOOL CHILDREN
Eye exams for children are very important to insure your child’s eyes are healthy and have no vision problems that could interfere with school performance and potentially affect your child’s safety.
Early eye exams also are important because children need the following visual skills that are essential for optimal learning:
- Excellent visual acuity at all distances
- Accurate and comfortable eye teaming skills
- Accurate eye movement skills
- Improve your child’s ability to learn
- For young children the tests are similar to regular eye tests using charts with letters, except that special symbols in these tests include an apple, house, square and circle.
- A test that involves shining a light into the to observe the reflection from the back of the eye (retina) helps to determine if you child has any clouding of the lens of the eye (congenital cataract) or significant refractive error.
- Using special patterns of dots and 3-D glasses we can measure how well your child’s eyes work together as a team.
DEVELOPMENT OF TEEN VISION
A teen’s eyesight is still developing. Good nutrition, preventative eye care and a healthy lifestyle are more important than ever. At the same time teens have more obstacles to maintaining a healthy diet and wholesome lifestyle, including greater access to junk foods, alcohol and tobacco, more time on electronic devices and demanding school sports or extra-curricular activities. All of these put great demands on a teenager’s nutritional requirements. Use of recreational chemicals as well as prescription drugs (acne medications, antidepressants, diabetes medications and others) can interfere with absorption of valuable nutrients. For teens nutritional supplements and juicing can be essential to add compact delivery of essential nutrients to a diet which ought to, but may not include large helpings of fruits, vegetables, whole grains, seeds and cold water fish.
- Smartphone use is a primary source of problems with teen vision difficulty: tired eyes, blurry vision, as well as poor sleep. The main issue is the distance we hold smartphones away from the face and eyes. Researchers tested for eye fatigue before and after reading. The scientists measured how far away the students held their phones while reading. The distance varied throughout the reading period but all got increasingly closer as time went on — and — closer than was found in previous research. The subjects reported a significant increase in symptoms of tired eyes, uncomfortable eyes, and blurred vision.
- Computer vision syndrome: poor ergonomics, glare from screens, blinking less often and eye strain from long hours requiring fine focus are resulting in development of nearsightedness (myopia), astigmatism, poor eye-coordination, and ability-to-focus disorders. In addition, sitting in the same position for hours causes neck, back and shoulder stiffness and tension headaches.
- Many doctors recommend a break every 20 minutes, especially one in which exercise, fresh air and distance focus are included.
- Computer eyeglasses are for those who wear corrective eyeglasses. They have a larger field of focus in the mid-focus range, where the computer screen is located.
- Good ergonomics include lighting, body position, and screen set-up.
- Eye exercises and acupressure relieve strain, are soothing and help eye sight to develop in a more balanced way.
- Attention to nutrients is important preventative care.
- School Eye checkups are insufficient. Vision is more than seeing 20/20. Good vision includes skills in accommodation, eye movement, hand eye coordination, eye teaming, depth perception, visual memory and form perception. Also, we at De Jongh Optometry have quipment to look at the inside of the eye and can catch more serious eye diseases in their early stages when treatment and prevention is still possible.
- Many teens with poor grades, difficulty doing schoolwork, poor social adaptation, have seeing problems that are not diagnosed by school eye checkups. These teens often don’t know they can’t see as others do. They may experience print that turns into squiggly lines, double images, print that runs off the pages, headaches, dizziness, eyestrain or they may refuse to do their schoolwork or take a very long time to do simple work. Their inability to keep up with their peers ruins self-esteem and leads to poor social adaptations. Eye therapies can help behavior and learning problems.
Myopia or nearsightedness often shows up in teen or young adult years. Studies are showing that outdoor activity reduces the incidence and the severity of myopia. Experts think the incidence of myopia has increased in recent years because of the excess of time spent on TV and computer combined with too little exercise, distance eye focus, or sunlight.
Hereditary optic neuropathy has its onset in young men in late teens or early twenties. Typically one eye painlessly loses vision and then a few weeks later the other eye loses vision. There are many causes, some hereditary or environmental, but deficiencies of vitamin B12, proteins and folic acid, and toxins from alcohol-tobacco use are causes of concern to teen parents. B12 deficiency damages the nerves and alcoholism prevents the absorption of B12.
Usher syndrome is a group of genetically related disorders that produce hearing and sight loss due to retinitis pigmentosa. Type two Usher affects teens who were born deaf and type three affects teens born with normal hearing but whose hearing and vision deterioration becomes evident by the teen years. There is no conventional treatment but catching it early can help the child develop alternate communication skills. Some nutrients including lutein, zeaxanthin, vinpocetine, l-lysine, and some vitamins such as vitamin A, enzymes, and fish oil may help slow down loss of vision.
Ocular migraines are thought to be caused by a constriction of blood vessels in the retina or changes in the retina’s nerve cells and could be triggered by stress, some foods such as alcohol, additives and chocolate, and eyestrain. A visual disturbance in the side vision lasts for 15 to 20 minutes followed by a headache or fatigue. These migraines are considered to be harmless with no lasting results. Magnesium supplementation may be helpful for migraines. Anti-oxidants such as lutein, zeaxanthin, vinpocetine, l-lysine, a number of vitamins such as vitamin A, enzymes, and fish oil have also been shown to be helpful.
Stargardt’s disease is a type of macular degeneration whose first symptoms show up in pre-teen years when the child exhibits difficulty in reading and seeing in situations with low lighting. Vision continues to deteriorate until the teen becomes legally blind. It is a hereditary disease carried by recessive genes, which means the parents may not be affected. Scientists have isolated the gene responsible but there is no treatment as of yet. The children with Stargardt’s should wear UV protective sunglasses and avoid foods and supplements with vitamin A as they experience increased retinal damage as a result of their inability to process the waste products that result from metabolized vitamin A. They should avoid leafy greens like kale, lettuce and spinach and other foods that vitamin A content such as carrots, peppers, sweet potatoes. See detailed info.
Styes are red swollen pimple-like areas on the eyelid. They are caused by infections of the sebaceous gland and are more common among children and teens because of irregular function of the sebaceous glands and/or poor hygiene. Styes are related to acne in that they can arise or are made worse by poor digestion and improper diet (for instance fried food.) They can be treated by laying a warm wet cloth over the area and will usually clear up in two or three days. They should never be squeezed. Teens should eat plenty of fresh vegetables and stay away from soft drinks, coffee and fried food.
GOOD EYE HEALTH FOR TEENS
- Exercise ensures good blood circulation and oxygen intake, both essential to eye health. Exercise also helps keep weight in the normal range, reducing the risk of diabetes.
- Use sunglasses with UV protection
- Protective eyewear: most injuries to the eye happen to men between the ages of 13 and 40; use protective eyewear in sports and when using tools.
- Nutrition. Pay attention to nutrition; increase antioxidants.
- Checkups. Consult with our optometrist Carina Janzen as a preventative measure.
For some interesting videos, links and print-outs, click here to visit our resource page. RESOURCES