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Today's Family Magazine

Keeping an eye on your child’s vision health

Aug 20, 2019 03:04PM
By Deanna Adams

The American Optometric Association recommends a child’s first eye examination at 6 months old, even if there are no obvious vision problems. School-aged children should have their eyes examined every one–two years.  Children with uncorrected vision conditions or eye health problems face many barriers in life academically, socially and athletically.

Here, Today’s Family delves further into this topic, with the help of Dr. Lauren Tedesco, an optometrist at Family EyeCare Clinic, which has offices in Mentor, Painesville, Highland Heights and Chagrin Falls.

Q. Why is it important that a child’s eyes be examined at such a young age?
A. It’s important to have your infant’s eyes examined to detect any eye health or eye movement problems, and to check for high amounts of nearsightedness, farsightedness, and astigmatism.  I’m an InfantSEE provider and offer free eye examinations to children 6–12 months of age.  This is a public health program through the American Optometric Association, designed to educate the public about the need for eye examinations in infancy and the need for early intervention of eye problems that may be present.

Q. How can you tell if your child is not seeing well?
A. Signs include squinting, moving closer to objects or holding books too close, poor focusing or having a short attention span for their age, tilting their head, eye rubbing or frequent blinking, avoiding near work or reading, poor hand-eye coordination, light sensitivity, or turning of an eye in or out.  If there is something you are questioning or unsure about, it is best to see an optometrist.

Q. You hear a lot about nearsightedness, farsightedness and astigmatism.  What do those conditions mean?  Any of these more serious than the others, or can worsen as they move onto adolescence?
A. Nearsightedness means that the person can see better up close than they can at distance.  Farsightedness means that the person can see better far away than they can up close.  Astigmatism means that the cornea (the front part of the eye) or the lens (within the eye) is more oval or football shaped than round. This causes the light that enters the eye to focus in two different places on the retina instead of one, causing a distortion in the vision.  All three of these conditions can be serious if they’re to an excessive amount. Nearsightedness and astigmatism can worsen in adolescence, but not with every patient.  Farsightedness doesn’t usually worsen during adolescence, and in some cases, can slightly improve.

Most babies are born slightly farsighted.  As they grow, their eyeballs lengthen, which should lead to normal vision.  Some children have farsightedness that remains or are born with a severe amount of farsightedness.  It’s important to catch moderate to severe farsightedness at a very young age because these children are at a high risk of amblyopia or “lazy eye.”

Q. Are there other conditions that you see in children that can cause concern?
A. There are a lot of other eye conditions that I see in children which can be concerning and drastically interfere with the ability to learn, and can lead to permanent vision loss if not corrected.

Amblyopia or “lazy eye” is a communication problem between the eyes and the brain.  When one eye does not see well (either from an eye turning in or out, having one eye that is severely farsighted or nearsighted, or having a congenital cataract in one eye), our brain relies on the better seeing eye, causing a decrease in vision in the eye that does not see well.  If early intervention is not taken to improve the vision, the vision loss can become permanent. This can negatively impact the child’s learning, day-to-day activities, and even sports and depth perception. 

Also, I commonly see binocular vision issues, such as convergence insufficiency (when the eyes do not turn in enough when looking at things up close) which can cause headaches, eye strain, or even double vision when reading.  It is important to have your child’s convergence and eye muscles checked throughout their school years as this can cause difficulty with school performance and reading.

Q. Are there things parents should be aware of to promote good eye health?  And what about the longtime rumors that eating carrots and other veggies is especially good, etc.?
A. I stress the importance of children, and everyone, wearing sunglasses outdoors on bright sunny days, and even bright snowy days.  Most of the UV damage in our eyes happens before we turn 18 years old.  Check that the sunglasses block 100% of UVA/UVB rays.  It’s important to speak to children about protecting their eyes while playing sports and even while playing with toys.

I’m also a big believer in limiting screen time with children.  Excessive amounts of screen time can lead to dry eyes, eye strain and fatigue, and exposure to a lot of blue light from our devices, especially before bed, may interfere with our sleep-wake cycle by suppressing melatonin.

And yes, eating your carrots is good for your eyes.  Carrots contain beta-carotene which our body converts to vitamin A.  Vitamin A is essential to maintaining a healthy retina, cornea, and to help protect against macular degeneration.  Eating green leafy vegetables, such as spinach and kale, is also important. Green leafy vegetables contain carotenoids called lutein and zeaxanthin, which promote healthy retina function, enhance contrast and improve glare discomfort, and protect against cataracts and macular degeneration.

Q. How can a parent help a child get used to wearing, tolerating glasses?
A. I recommend parents ease their child into wearing glasses, especially if it is a strong prescription.  Have the child wear the glasses a few hours the first day, then increase it a few hours every day.  After one week of wearing the glasses, parents often report that the child will then ask for the glasses as soon as they wake up in the morning.  Once they put them on, they realize how much better they can see!  I think it helps when the parents turn the need to wear glasses into a positive during the eye exam, such as telling them, “Let’s go try on some cool glasses!” or “You’re going to get glasses, like Mommy and Daddy!”

Q. What about contacts? Is there an appropriate age, or does it depend on the condition?
A. I fit children in contact lenses from as early as age 10 and up.  I think it’s important for them to be motivated to wear contact lenses.  If they’re not motivated, then waiting until they are older, or until they ask about wearing them is best.  Contact lenses are a medical device and wearing them requires responsibility and good hygiene habits.

Q. Would you recommend Lasik for children under 16/18?
A. I would not recommend Lasik for children under age 18 since their eyes are still changing.  Waiting until they are in their mid-late 20s is best because the eyes tend to start to stabilize.  Lasik surgeons usually require that the patient has a stable glasses prescription for 2-3 years before they will perform the surgery.  I do think Lasik is safe and has changed a lot of patients’ lives, but it’s best to wait until the patient is ready to make the decision, and until their prescription is stable.

Q. Are there new developments in ophthalmology?
A. There are new developments in ophthalmology that have truly made a difference in patients’ lives such as new cataract surgery lens implants and equipment that allows the cataract surgeons to have even more precision during the surgery. There is always research being done to improve patient outcomes.

Q. Any other issues good for parents to know?
A. Yes.  Even if a child doesn’t know their letters, or if a child is shy and/or unable to communicate with us, we can still perform a comprehensive eye examination.  We try to make it a fun experience for the children. 

Children who require glasses don’t know what “normal vision” is until they experience 20/20 vision with their glasses. They may not tell parents that they’re unable to see well because they don’t know any different.  Therefore, it is important to have your child see an eye care provider for a comprehensive eye examination every 1–2 years.

Some eye diseases may be present in children and adults, but they may not cause any symptoms.  So even if you have perfect vision, you should still make visits to your eye doctor to ensure that your eyes are healthy and that they remain that way for life!

Dr. Lauren Tedesco earned her Doctor of Optometry degree at Indiana University School of Optometry and has been practicing for over three years as an optometrist. Dr. Tedesco has a special interest in pediatrics and vision therapy, and provides primary and emergency eye care, fits contact lenses and glasses, diagnoses and treats ocular diseases, and provides vision therapy to patients with binocular vision problems.

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