Q&A For Children’s Eye Care
Q: We hear a lot about “seeing your eye doctor regularly.” In school aged children, ages 5 through 17, what does regularly mean?
We like to see children every year during this critical period of development. There are a couple reasons for this: 1) The eyes can change quickly during this time and children often have difficulty communicating their visual experience2) Children are prone to visual disorders that can greatly compromise their ability to excel in school as well as their social interactions/ confidence in sports & other activities
Examples of visual conditions that are commonly found in children:• Nearsightedness/ farsightedness/ astigmatism - corrected with glasses.• Binocular vision disorders - inability to use the eyes effectively or comfortably. Makes reading and learning very difficult (often misdiagnosed as ADHD). Treated with glasses or vision therapy.• Amblyopia – inability for the eye to develop normally, causing reduced vision (even with glasses). Often only affects one eye and thus goes undetected because the child appears to function normally. Must be treated before a critical age of 5-9 years old or permanent vision loss will occur.
Q: What about pre-schoolers? Are there signs parents should look for that would indicate a trip the optometrist is necessary?
All preschoolers should see the optometrist for a comprehensive eye exam because most of the time the most important eye problems go undetected because a) the child is unable to express their visual experience and b) they may have one normal eye.
Important signs for parents to watch for: • Headaches/ obvious visual discomfort with near tasks• Avoidance of near work• Covering one eye, turning or tilting the head• An eye that turns in or out
Q: Because many children may be too young to read, how is an eye exam conducted if they cannot read a Snellen Chart?
To measure the child’s vision, we often use numbers or pictures. Even if the child is too shy to play along, we can still gather valuable information with our retinoscope (requires no subjective input). This instrument allows us to see what the child’s prescription is and if glasses are necessary.
Q: One of the greatest tasks of a school-aged child is learning to read and in older children, the amount of reading required. What should parents be on the lookout for concerning their child’s reading and potential vision problems?
Transitioning from learning to read to reading to learn is a critical part of any child’s education. If a child is having difficult with the process or mechanics of reading, comprehension will of course suffer and the child will fall behind in school. If a child is having difficulty with reading, or even avoids reading (says they don’t like it), it’s crucial to have the child’s eyes examined to ensure there isn’t an underlying need for glasses, or an inability of the eyes to function effectively together (due to a binocular vision disorder).
Q: We often discuss vision problems as they relate to sitting in a classroom, but what about the playground, or the effect of visual acuity on socialization and play?
We cannot underestimate the effect that vision has on self-confidence and socialization. If for example, a child is unable to see far away, they may be less likely to play outside because they cannot find their friends or anticipate a ball thrown their way. Furthermore, accurate depth perception requires two fully functional eyes that work together. Therefore, an undetected vision disorder, even if in one eye can cause clumsiness & poor performance in sports/play which may affect a child’s confidence.
Q: Today it seems that many children are very quickly diagnosed as learning disabled or dyslexic. How does vision play into the problems and what are the differences?
Reading and learning are extremely complex processes. When a child has difficulty with learning, sometimes it is due to an underlying vision disorder that affects the ability of the eyes to work together and rather than ADHD medications (which can blur vision), the child may simply require glasses or vision therapy (exercises to train the eyes to become more coordinated and efficient). Interestingly, there is a higher prevalence of vision-related learning disorders among children who have other non-visual causes or learning difficulties (ADHD, developmental delays, dyslexia, etc). In these cases, it’s still crucial to treat the visual component, which then reduces the overall burden that the child must overcome to succeed and advance in their learning.
Q: We have many choices today to correct our vision. What do you recommend as the earliest age for contact lenses?
There’s no set age for when a child is ready for contact lenses. Rather it largely depends on the child’s maturity and ability to care for the lenses and understand the need for safe handling. There are certain circumstances where we may encourage contact lens wear for more medical (rather than aesthetic) reasons. In these cases, we often rely on the parents for encouragement and assistance in handling.
Q: Kids can be hard on glasses. Are there effective glasses for children today that last?
Children’s frames are specifically designed to be flexible and withstand mechanical distress. Some frames have removable arms that can be switched out; others have an adjustable strap that helps them stay put, especially during sports. This being said, children still find a way to break or lose frames, and we often recommend having a back up pair.
Q: Vision Therapy appears to be making a comeback and is being utilized by some students to address their vision problems. Can you talk about vision therapy and when it is right for your child?
“Vision Therapy” refers to a customized rehabilitation program that consists of eye exercises/ activities that are used to improve visual efficiency, accuracy, and sustainability. Analogous to physiotherapy, vision therapy is a personalized program that is designed based on the patient’s particular visual disorder, as well as their age, ability level, and visual demands.
There are a whole host of vision disorders that are amenable to treatment by vision therapy including accommodative dysfunction (inability to focus up close), convergence insufficiency (inability to bring the eyes together as required during near work), strabismus (tendency for one eye to turn out or in), as well as many others. Most of the time, these vision disorders cannot be recognized except by a vision exam by your optometrist. The patients often complain of headaches, blur, eye strain, tired eyes, loss of place while reading, etc and the goal of therapy is to alleviate these symptoms and allow the patient to read and use their eyes in a comfortable and sustainable manner.