Vision 101: Learn more about your child's eye health
The American Optometric Association says that children with uncorrected vision conditions or eye health problems face many barriers in life academically, socially and athletically. The bright side is that with comprehensive eye exams, early detection and treatment, your child will be able to preserve their sight. Dr. Allison Babiuch, ophthalmologist at the Cleveland Clinic, took the time to answer some common questions about kids’ vision.
Q. How can you tell if your child is not seeing well?
A. It is good for parents to look for abnormalities with their infant's vision. The first thing is infants are expected to have a good red reflex which means when you take a picture or shine a light on the eyes that they have a nice, bright red coloring in the eyes. If you see it in one but not both, there could be an abnormality in one eye.
By 2 months old, children should be looking at objects and faces and tracking them. So, if they are not doing that, there may be a delay in visual maturation or something could be wrong. If you notice the eyes do not look like they are straight, are wandering in or turning out, it could be a sign of an eye misalignment. For older kids, turning their head to the side or squinting one or both eyes could be signs they are not seeing well.
Q. What is the best age for your first eye check?
A. If there is no family history of any eye conditions and the child seems to be seeing okay, then a formal eye exam by an eye doctor is not required
Instead the child should go through routine screening with the pediatrician and school system. If there is a family history or suspicion of an eye problem, they should be seen as soon as it is identified.
Q. You hear a lot about nearsightedness, farsightedness and astigmatism. What do those conditions mean?
A. Most children are farsighted (trouble seeing objects up close) when they are little because their eyes are small and as they grow, just like they get taller, their eyes get longer and they grow out of it and can end up becoming nearsighted (difficulty seeing distant objects). Most kids do not need glasses for farsightedness, but if their eyes are crossing inward, it could be a sign that they need glasses for farsightedness or if the child has a difference in prescription between the two eyes it could be an indication of needing glasses. For nearsightedness you typically need glasses. Astigmatism is blurred or distorted vision that can also be corrected with glasses.
Q. Are there other conditions that you see in kids?
A. In little babies, nasal lacrimal duct obstruction is common which is when they are born with blocked tear ducts. Symptoms are watering, mucusy discharge and crusting of one or both eyes that will resolve by 1 year old. Misalignment of the eyes, called strabismus, is common. Less common are droopy eyelids, called ptosis, and cataracts which are rare.
Q. Are there things you can do to promote good eye health?
A. We encourage playing outside, being in the sunlight and limiting screen time. You want to have good lighting because it can put a strain on a child’s eyes if they are reading in dim lighting. Because kids do a lot of screen time and reading, it is common to get dry eye and eye strain, so they should take breaks every 20 minutes or so and allow the eyes to relax. Carrots are good for the eyes because they contain carotene.
Q. Do kids tolerate glasses well?
A. Sometimes it can be a battle for kids to keep glasses on and they can be a source of frustration. If your child is prescribed glasses and does not like them, give him a couple weeks but if he is really rejecting them it is good to go back to the eye doctor and have the prescription checked to make sure it is right.
Q. What is the appropriate age for contact lenses?
A. Usually we recommend starting contact lenses if the child is motivated around 12 years old, but there are always exceptions to that. Girls are more responsible and have proven to their parents that they are ready for them. There are all sorts of lenses ranging from soft to hard and it depends on the refractive error, so if there is a high amount of astigmatism or a special shape to the eye they might require hard contact lenses. Most children wear soft lenses and then there is the daily disposable versus the weekly or long-term which is decided upon by the parents, child and doctor.
Q. When does someone get Lasik?
A. Usually we recommend until someone is 21 or older before getting Lasik since the eye is still developing. There are some exceptions to that rule and some trials are starting up in the United States doing it for kids with special conditions and circumstances. Typically the refractive surgeon who performs it has you come in and they take measurements and pictures of the eyes to determine if you are a good candidate. Not everybody is. Lasik has a good success rate but there are other refractive surgeries as well with the same goal of reducing someone’s need for glasses. Refractive surgery is expensive and typically not covered by insurance and it is not recommended to try to get a bargain rate.
Q. Are there new developments in ophthalmology?
A. It is amazing the changes that have occurred and it is hard to keep up in the field. Gene therapy for certain eye conditions is exciting. There are new surgeries coming out that are advancing like different lasers and procedures. Mainly the technology with imaging has changed things quite a bit.
Q. Is there a take home message for parents?
A. Kids who have glasses should come in on a yearly basis. If we see that the prescription is changing rapidly they may have to be seen more frequently. Just like any other thing, it is important that if you notice a problem with your child’s eyes or have a family condition, it is important to bring him in to make sure. It is almost always easier to treat if a condition is diagnosed early.