Common Q&A for the Eye Care of Babies and Kids

Questions:

1. How often should babies and kids have eye examination?

2. Can vision screening or a pediatrician exam substitute for a comprehensive eye examination?

3. What is amblyopia and how it is treated?

4. Why does my kid become myopia (nearsighted)?

5. Should my nearsighted kid wear glasses?

6. How to control the progression of nearsightedness?

7. Is Ortho-K /CRT a choice for correction of myopia (nearsightedness)?

8. Children’s TV watching is linked to nearsightedness, attention deficiency and autism?

9. Toys, Games and Your Child’s Vision

Answers:

1. How often should babies and kids have eye examination?

Pediatric eye care is an extremely important part of your child's health care. For instance, the prevalence of amblyopia in US is 2% (2.4-4.8 million). Most of amblyopia could be easily avoided if the child's eyes are checked and corrected before the critical age of seven. It is recommended by The American Optometric Guideline, for developmentally normal kids, that the first eye exam should be done at 6 months of age, the 2nd exam should be 3 years of age. Routine exams starting from 3 years old should then be conducted every one or two years.

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2. Can vision screening or a pediatrician exam substitute for a comprehensive eye examination?

Many parents think that passing the school vision screening means their child has perfect vision. This is not always correct. The American Optometry Association believes that an eye/vision screening in the public or private schools does not substitute for a professional eye examination. Vision screening is only intended to find severe visual disturbances and does not substitute for a thorough professional exam which corrects and prevents problems with your child's eyes.

Parents also rely on pediatricians, assuming the pediatrician does a thorough vision analysis. But actually pediatricians just check visual acuity (how well the child sees at a distance). It takes a complete eye exam by an eye care professional to get an accurate picture of the child's eye health and vision status.

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3. What is amblyopia and how it is treated?

Amblyopia (lazy eye) is the loss or lack of the full development of vision in one eye that is not fully correctable with lenses and is not the result of any identifiable eye health problem.

For children, the key to prevent or treat amblyopia is early detection by routine eye examination. About 2% of the American population, namely, around 40 million people, have amblyopia. In fact, if they had been treated before 8 years old, they would have been mostly properly corrected. The causes of amblyopia are usually strbismus, uncorrected high myopia (nearsightedness), high hyperopia (farsightedness), or uncorrected large difference of refractive error between two eyes. If found in time (before 8 years old), these problems can be corrected by wearing corrective lenses or by other treatment.  At about 8 years old, the vision system has been fully developed. It is still possible, though much harder, to correct amblyopia after 8 years old.

For young children, patching the good eye may help the amblyopic eye to improve. In addition, vision therapy techniques may be used to help improve vision functions. Eyeglasses or contact lenses may be also prescribed to correct any refractive errors.

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4. Why does my kid become myopia (nearsighted)?

There are two possible reasons:

1). Genetic reason: myopia is genetic. If one of the parents is myopia, then the probability of the child having myopia is extremely high. If both parents are myopia, then it's almost guaranteed that the child will have myopia.

2). Use and abuse theory: most of the changes in myopia is due to axial length elongation. For instance, the use of computer and reading cause greater near stimulus, which leads to greater "accommodation". When "accommodation" lags behind the forvea, then there is a stimulus for axial length to elongation, which causes myopia. This phenomenon occurs in children at a faster rate that for adults.

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5. Should nearsighted kids wear glasses?

Nearsighted children need to wear glasses. Proper correction with eye glasses or contact lens can prevent amblyopia, eye strain and headache. It is OK for low myopia children to take off glasses to read and do computer work.

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6. How to control the progression of myopia (nearsightedness)?

There are two ways to slow down myopia progression:

1). Bifocal glasses: Use lower power of minus lens at the bottom of your glasses can relax accommodation and control the stimulus of accommodation, so you can control axial length elongation, which will slow down the myopia progression.

2): Contact lens: Full time wearing of RGP (hard contact lens) can greatly slow down the myopia progression. In the myopia control study by Shapiro et al., about 73.4% of contact lens wearers did not change in myopia, and 10% of spectacle wearers (glasses) did not change in myopia. If you intervene with myopia progression earlier, you might be able to decrease it or slow it down by more than 2.00D or 3.00D. The contact lens to some degree has the effect of slowing down axial length elongation.

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7. Is Ortho-K /CRT a choice for correction of myopia (nearsightedness)?

Ortho-K or CRT is a corneal reshaping therapy which shapes and molds the front of the cornea, and improves your vision while you sleep at night. This procedure is safe and effective and any age group will benefit. This is especially true for people who enjoy sports. There is no healing and no recovery because there is no invasive surgery. This procedure has the added advantage that it is reversible. If you wants to discontinue the process, you only have to quit wearing the lenses. The cornea will then return to its shape in only a few days.

Dr. Gan is a certified CRT (FDA approved) specialist. Please call or e-mail to schedule an appointment for free consultation exam to see if you or your child is a good candidate for this procedure.

Click here for more information on CRT and Ortho-K.

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8. Children’s TV watching is linked to nearsightedness, attention deficiency and autism?

Dr. Aric Sigman, an associate fellow of the British Psychological Society and author of Remotely Controlled: How Television Is Damaging Our Lives, recently studied the link between long hours of television viewing and nearsightedness, attention deficiency, autism, and other brain damages among children.  The following points, from his and other similar research results, are summarized here to your attention.

Nearsightness in Children: Nearsightness was once associated with genetics now is being strongly linked to excessive TV viewing, according to recent study.

Dr Sigman reported that overexposure to television and computer screens were to blame for the increase in childhood myopia because both activities require long periods of visual fixation.

ATTENTION SPAN: LONG periods of TV viewing may affect what are called the "neuronal mechanisms" behind attention and impulse control. This means damaging brain-cell development and the person's ability to concentrate on non-TV subjects. For children this could mean learning difficulties and attention disorders.

AUTISM: EARLY childhood television viewing may be an important factor in autism, which currently affects one in every 166 children. Dr Sigman quotes Cornell University, which last year published research suggesting television may be a trigger in young children with a tendency to the condition.

The study also showed that the average child by age 6 will have spent 1 year in front of a television. Computer use and television viewing are common activities for older children, too. In light of the study, consider discussing these findings with parents andsuggesting they limit television and computer use to 1 hour a day for children over 3 and to 1 ˝ hours a day for teenagers.

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9. Toys, Games and Your Child’s Vision

From the moment of birth, your child is learning to see. He or she progresses from the newborn’s blurry world of light and dark to school-age child’s sophisticated ability t handle complex vision development.

Here is a list of toys and activities that can help your child develop or improve various vision skills.

Birth through 5 months

  • Toys: Sturdy crib mobiles and gyms, bright large rattles and rubber squeak toys.

  • Activities: Peek-a-boo, patty cake

6 months through 8 months

  • Toys: Stuffed animals, floating bath toys

  • Activities: Hide and seek with toys

9 months through 12 months

  • Toys: Sturdy cardboard books, take-apart toys, snap-lock beads, blocks, stacking/nesting toys

  • Activities: Throwing a ball 

One-year olds

  • Toys: Bright balls, blocks, rocking horse, riding toys pushed with the feet

  • Activities: Throwing a ball

Two-year olds

  • Toys: Pencils, markers, crayons, bean bag/ring toss games, peg hammering toys, sorting games, puzzles, blocks

  • Activities: Read to child, outdoor play, catch

3 to 6 years

  • Toys: Building toys with large snap-together pieces, stringing beads, puzzles, pegboard crayons, finger paints, chalk, large balls, modeling clay, simple sewing cards, tricycle, follow-the-dot games, sticker books

  • Activities: Climbing, running, using a balance beam

7 years and older

  • Toys: Bicycle; jump ropes, pogo sticks; roller skates; different size and shape balls; target games; remote controlled toys; complex puzzles.
  • Activities: Active sports; cycling.

When buying toys, remember to select those that are well-made and age appropriate. Provide proper eye safety equipment for older children and be certain that they wear protective eyewear when participating in eye hazardous sports and, when using chemistry sets, shop tools, BB guns or other such items. Inexpensive homemade toys can be just as effective in helping children develop and improve their vision skills as expensive store bought one.

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