Vision really matters. Sight is the sense people fear losing the most, yet many do not know the problems associated to their age group. Here we look at the infancy years of 0-16 and the importance for parents to be aware of potential problems. Early detection is critical when the eye is young and your child is dependant upon you, the parent, grand-parent, family member or family friend to look out for potential health risk.
Below we list the most common eye concerns for the 0-16 years age group:
How are squints detected?
Routine checks at birth and again at the 6-8-week review would usually detect a squint. After this period it would be down to the parents, family, friends or childcare professionals to detect and refer to an optometrist (also known as optician).
What are the treatments for squints?
- Occlusion therapy (patching)
- Botulinum toxin injections
What is the outlook for a child with squints?
- If detected early, the treatments for squints are generally very effective and most will have good vision in each eye in the long term.
- If detected after the ages of 7-8 years old, it can have a permanent effect on the vision in one eye.
Computer Vision Syndrome (CVS), also called digital eye strain, is caused when children spend multiple hours staring at digital devices on a frequent basis. This condition is caused by visual stress, and has a combination of symptoms including fluctuating vision, tired eyes, dry eyes, headache and fatigue.
How is Computer Vision Syndrome (CVS) detected?
Due to the increased use of computers and other digital devices in children, it is largely down to the parents or guardians to spot the first signs of CVS. Should your child complain of a combination of eye strain, headaches or fatigue related posture problems, you should book an appointment with your local eye care specialist (local opticians). You should also cut down the amount of time your child is in front of a digital device, especially around bed-time when room lighting is poor, and the eyes become further strained.
What are the treatments for squints?
- Reduce the time spent using digital devices
- Take frequent eye breaks — every 20 minutes, stop looking at your screen for at least 20 seconds to look at something at least 20 feet
What is the outlook for a child with CVS?
- If detected early, the treatments for CVS are generally very effective and most will have good vision in each eye.
- Significant hours of computer use may put them at greater risk for developing myopia (near-sightedness).
- Long-term, some researchers believe stress on the retina might increase one's risk for age-related macular degeneration.
Far Sighted, also called hypermetropia, is problem with the eye’s focusing that can affect your child’s vision at all distances, but especially close-up. This is a common problem and many young children have mild hypermetropia that simply gets better as they grow older. As a child, the natural lenses in your eyes are very flexible and will often change focus to compensate.
How is hypermetropia detected?
Without an eye examination it is very difficult to detect hypermetropia in children. Most children never complain, and it is usually the school or carer who will first notice something is not quite correct. Symptoms vary but most children will air concerns about poor vision and tired eyes when doing close-up work such as reading. Squinting of the eyelids might be an indication in some instances. Eye squints often accompany this condition and allow for early detection.
What are the treatments for hypermetropia?
- Spectacles. lenses may be thick, heavy and magnify the wearers eyes. This can be limited with the use of high refractive index lenses as well as aspheric design lenses to reduce the weight and thickness of the lenses.
- Contact lenses. Where a strong (high) prescription is prescribed it may be advisable to begin the treatment asap and usually in a step-up basis. A set-up basis involves increasing the prescription over a period of months. Every case should be treated individually.
What is the outlook for a child with hypermetropia?
- It is important to recognise this condition at an early age to avoid amblyopia. This is a condition whereby the eye(s) is not stimulated fully, resulting in underdeveloped vision.
- Treatment before the age of 6-7 years will allow for visual development, although severe hypermetropia will not develop into good vision without glasses.
Short sighted, also called myopia, is problem with the eye’s focusing that can affect your child’s vision at all distances, but especially seeing far-away. Children with myopia often suffer from headaches caused through tired eyes as their distance vision is always blurred until treated. Myopia can appear from early childhood but is most common around puberty.
How is myopia detected?
Myopia is one of the easier conditions in children to detect, largely because children will openly complain about difficulties seeing objects at a distance, such as a whiteboard. This is why it is important to listen to carers and school teachers as children may complain more openly during a competitive environment, compared to a home environment. Depending on the severity, children might move closer to distant objects in order to see them clearer, the television is usually a giveaway and myopic children will tend to sit very close to the TV. Difficulty in judging distances, catching balls and noticing distant objects are early indicators for myopia.
What are the treatments for myopia?
- Glasses. EyeWearThese would highly recommend that children's glasses be fitted with an anti-reflective coating, this reduces the risk of computer vision syndrome. Children's lenses are also available in high refractive indexes which allow for a better cosmetic appearance and lighter to wear.
- Contact Lenses. Particularly useful for active children that participate in sporting activities.
- Prescription sporting eyewear such as swimming goggles.
What is the outlook for a child with myopia?
- If detected early, the treatments for myopia are generally very effective and most children will have good vision in each eye in the long term.
- Children with severe myopia will not develop good vision without the use of glasses.
- Early detection is also important to allow full development of the visual system, including eye-hand coordination, educational gains and self-esteem.
Solar Macular Burn, also called solar retinopathy, is caused by looking directly at the sun for prolonged periods. No treatments exist for solar retinopathy, so it is important to educate your child not to look directly at the sun. In most cases the swelling at the back of the eye will go down but this depends on the extent of the damage.
How is macular burn detected?
Macular burn, staring at the sun, can cause blindness or retinal burns. Excessive exposure to ultraviolet light floods the retina and destroys cells in the back of the eye that transmit what you see to the brain. The visual effects are not noticed for several hours, post exposure, but typical symptoms include watering or sore eyes and discomfort looking at bright lights. In extreme cases it is so painful any light seepage to the eye(s) causes pain. It is strongly advised to educate your child NOT to look directly at the sun, the risks to your child’s vision could be permanent and irreparable. Children with short-term damage often recover quickly from their symptoms, but have lasting vision problems that would show up during an eye test, such as a small blind spot in their vision.
What are the treatments for macular burn?
- Prevention is better than cure as there is no cure for severe macular burn.
- If your child insists on looking at the sun, during an eclipse for example, it is recommended that you employ non-direct visual aids. Black card, when held at the correct angle, would show the eclipse in a safe manner.
- Sunglasses with 3-4N filter rating and 100% UV protection, preferably polarized, are recommended for children as these will aid against short term exposure. It is also highly recommended to fit conforming sunglasses (with a strap) to infants and toddlers as it is impossible to educate these age groups in the dangers of looking directly at the sun.
What is the outlook for a child with macular burn?
- This depends on the severity of the burn. Severe exposure is irreparable and permanent damage will mean the child will lose central vision.
- Most macular burns, those caused by short-term exposure, will dissipate within 36 hours. If your child is still complaining of serious pain after the 36-hour period, seek more urgent medical assistance.
Keratoconus is a progressive, non-inflammatory, eye disease that see’s the normally round-in-shape cornea, bulge into a cone-like shape. The bulging impairs the eyes ability to focus properly causing distorted vision. Keratoconus is common in non-caucasians and is usually diagnosed in young people at puberty.
How is keratoconus detected?
Detection in children is usually diagnosed at puberty, and only detectable by your local optometrist. Children may complain of poor vision across all fields of view and squinting may also be a be a sign of early detection. Keratoconus impairs the vision slowly, so children become accustomed to poor vision. This makes early detection harder to for children to verbalise and parents to pick-up on.
What are the treatments for keratoconus?
- Glasses or soft contact lenses are used in the early stages.
- As the eyes cornea becomes more distorted, soft or rigid gas permeable (RGP) contact lenses are often required to correct vision more adequately.
What is the outlook for a child with keratoconus?
- Most individuals lead a normal life restricted only by having to wear glasses or contact lenses.
- More severe cases require a corneal transplant due to the progression of the condition, this type of intervention is rare, especially in children.
Blue Light causes retinal damage. Continued exposure to blue light is highly likely to cause very serious vision problems such as age-related macular degeneration, an untreatable disease that causes rapid blindness. Digital screens, TV’s, computers, laptops, smart phones and tablets emit very strong blue light waves. Parents must be aware of the risk to their children from Blue Light.
How is blue light detected?
Natural blue light and small amounts of artificial blue light can enhance mood and is essential for good health. Blue light is very important in regulating circadian rhythm, the body's natural wakefulness and sleep cycle. However, excessive exposure to artificial blue light, especially in children, has serious consequences. Firstly, higher exposure, particularly at night, can lower production of melatonin. Melatonin is a hormone that regulates sleep and lower levels can cause disruption in sleeping patterns. Blue light is also linked to eyestrain, tired and dry eyes which effect the mood of children greatly. Long term exposure, years of exposing your eyes to artificial blue light (classically digital devices such as computer monitors, mobile phones, iPads, tv’s and fluorescent lights) has been linked to macular degeneration, a condition classified as blindness.
What are the treatments for blue light exposure?
- Prevention is the best treatment. Fewer hours spent on mobile devices, particularly before sleep time, will help.
- Many digital devices now have a ‘night’ setting that turns off blue-light. It is good practice for parents to have their child’s device switched to ‘night shift on’ permanently.
- Blue light absorbing coatings on glasses lower the amount of blue light entering the eye.
What is the outlook for a child with blue light exposure?
- Short term exposure in children can cause eyestrain, tired eyes and dry eyes.
- Long term exposure, from childhood into adulthood, can cause macular degeneration and depression.
Childhood Glaucoma is a disease of the optical nerve which, if left untreated, results in childhood blindness. Many different types of Childhood glaucoma exist yet it is of paramount importance that early diagnosis and treatment be made for all variants. If left untreated, this eye disorder can result in permanent and significant vision impairment.
How is juvenile glaucoma detected?
Childhood and juvenile glaucoma are rare conditions. Typically, glaucoma is hereditary, so if it is in your family inform your optician so they can test for this condition regularly. An indication that your child may have glaucoma is where your child’s eye may appear larger than normal due to excessive pressure on the eye while it is developing. Your child may also complain about poor or deteriorating vision. Eye examinations are crucial for early detection.
What are the treatments for juvenile glaucoma?
- Glaucoma in children cannot be cured. Most children with glaucoma will need an eye operation to bring the pressure down.
- Where an operation is not required, glaucoma is treated with topical drops. This medication lowers the pressure and limits nerve damage.
What is the outlook for a child with juvenile glaucoma?
- Post operation, many children with glaucoma will see better when wearing glasses.
- If the operation fails to lower the pressure, your child will have to use eye drops at intervals recommended by your optician.
Oval Eye, also called astigmatism, is extremely common. Children can be born with astigmatism or it can develop later in life, however, it cannot be prevented, just treated. The condition changes the shape of your eye from a round football to that of an oval rugby ball making a child’s vision blurred. Many children have a little astigmatism and remain unaffected whereas more severe cases must be treated.
How is astigmatism a detected?
Astigmatism can range from mild to severe and is common in children. Because the levels of severity are wide ranging, children usually do not complain about poor sight as they cope with day to day tasks. As a parent or career, if the child has difficulty seeing the whiteboard, check to see if there is a family history of astigmatism as genes inherited from the parents can play a part. An optometrist would be able to detect astigmatism during a routine eye examination so be sure to mention any family history. Astigmatism cannot be prevented, just treated.
What are the treatments for astigmatism?
- For children in this age category glasses and contact lenses are the preferred method of treatment.
- Normal soft contact lenses do not always work well as the mould to the uneven shape of the cornea, whereas hard contact lenses can help create a smooth, even surface. If your child is having difficulties with a hard contact lenses, ‘toric’ soft lenses can help.
What is the outlook for a child with astigmatism?
- Children will have good vison if treated with glasses or contact lenses.
- Refractive eye surgery is available where the cornea is reshaped, however this is not recommended until your child reaches adulthood (typically post 25 years).