Among various child health issues that parents are most concerned with, eyes and vision rank near the top. Good vision is essential for proper physical development and educational progress in children.
Vision problems affect one in twenty pre-schoolers and one in four school children in America. Since many vision problems can be cured or prevented if diagnosed early, it is important for children to receive proper eye care at the right time.
Understanding Normal Vision
The visual system in young children is not fully mature. The brain centres and visual pathways need clear images from both eyes to develop normally. If the image from one eye or both eyes is blurred because of any reason (glass number, cataract, squint or retinal problems, etc.), it can result in permanent damage to vision. Normal pathways for vision evolve till 7-8 years of age.
Common Childhood Problems
Common problems seen in children are amblyopia or "lazy eyes" "squinting" or "wandering" eyes, vision problems, eye infections and injuries. These can be prevented by early vision screening as suggested by The American Academy of Pediatric Ophthalmology and Strabismus and The American Academy of Family Physicians and The American Academy of Pediatrics.
Warning Signs for Early Ophthalmic Examination
The pediatrician, nurse or family physician should screen for any white reflex in the pupil, discharge or watering, droopy eyes or crossed eyes. An ophthalmologist should be asked to examine high risk infants, i.e., those at risk of developing retinopathy of prematurity (ROP), those with family history of glaucoma, or childhood cataracts, retinal dystrophies, systemic disease associated with eye problems and children with neurological problems.
For Infants and Toddlers:
Children will not be able to communicate about their vision problems to parents at this age, therefore parents need to notice their behavior and be alert for any kind of problems. Look for tell-tale signs of poor vision in your child.
- Misalignment, crossed eyes
- Poor fixation of eyes, not following objects
- Jerking eye movements, wandering, purposeless eye movements
- White pupil
- Excessive tearing, swelling of eyes, discharge
- Intolerance to normal light
- Excessively large eyes, large corneas
- Head tilt to one side
- Drooping of eyelids
In School Children:
At times children or their school teachers might complaint about vision problems, but as parents you need to take these complaints and observe your child to find some clues about their vision.
- Not seeing the board clearly
- Squinting the eyes to see the TV or distant objects
- Holding books too close or moving very
- Close to the TV
- Running into objects or falling down at night in places that are not well lit
- Frequent blinking or rubbing of eyes
- No interest in reading or surroundings
Child's Visuals Milestones
- At Birth: Babies see in black and white and shades of gray. They can focus only at the distance of 8 to 12 inches and most of their vision is blurred.
- 1-2 months: Infants start to follow objects by moving the head and prefer objects with sharp contrast like checkered patterns.
- 2-4 months: Eyes which were wandering start to see in tandem and start appreciating colored objects.
- 4-6 months: They learn to fuse images from both eyes resulting in better depth perception, learn hand-eye coordination, able to locate and hold objects. Vision is near 20/20 now.
- 6-12 months: They learn finer coordination, spatial arrangement, tracking of fine moving objects.
- Toddlers and preschoolers: The higher centres in brain keep maturing and evolving.
Prepare Your Child For Examination
Children are apprehensive about new surroundings and interaction with strangers. They may not cooperate for eye examination easily. You can try to allay their fears and reduce their anxiety about an unfamiliar environment by talking and explaining about the subject.
- You can tell your child in advance about what is going to happen in the consult room.
- The doctor will shine some light in your eyes to check you.
- It is not going to hurt and there will be no injection/ shots involved.
- You may be required to put some drops.
- You will be shown some letters or pictures and you just need to identify them
At home, follow some simple rules to avoid/ minimize eye injuries:
- Avoid toys with sharp or rigid points, spikes, rods, and dangerous edges
- Keep toys intended for older children away from younger children
- Do not give projectile or flying toys to children
- You may be required to put some drops.
- You will be shown some letters or pictures and you just need to identify them.
‘Child Eye Care’ is a joint responsibility of the pediatrician, family physician, ophthalmologist and parents together. Any child having serious vision problems should be attended to immediately by the ophthalmologist. Parents should pay attention to the child's eyes and behavior. They should also take it seriously if the child is complaining of visual problems consistently. Every child should have at least one eye examination by an ophthalmologist before the age of 5 years, especially if the parents are wearing glasses. School going children should also be examined at least once between the ages of 7 and 18 years. Early detection provides the best opportunity for an effective treatment.
Some Eyecare Tips
- Eating healthy -Grandmother was always right when she told you to eat your greens and fruits
- Don't read in moving vehicles
- Use good quality UVs protection sunglasses
- Commercial workers should use eye protection glasses while working
For Computer Users
- Maintain right posture to avoid back pain or shoulder stiffness
- Avoid too much glare, use anti-glare screen
- Computer screen should be 4 -5 inches below your eye level in a book holding position
- Blink often consciously
- Follow 20-20-20 rule, every 20 minutes, for 20 seconds look 20 feet away, blink 20 times or close your eyes
- Use lubricating eye drops
- Wear proper glass correction if you have number with anti-reflection coating