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Q&A: Protecting Young Eyes

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Vision is an essential sense, and as such it’s important to take measures to protect the eyes. With added demand from computers, cell phones and tablets, eyes are under more strain and at earlier ages. When it comes to children’s and adolescents’ eyes, it’s important to ensure good health practices, whether in the classroom or on the playing field. To raise awareness, the American Academy of Ophthalmology celebrates Children’s Eye Health and Safety throughout the month of August.

Children who develop eye problems are at risk of permanently suffering from those affiliations if not treated, as is the case of amblyopia, more commonly known as a lazy eye. According to the National Eye Institute, it affects between two and three percent of children. Like adults, children and adolescents are prone to suffering from dryness of the eye as a result of computer use. Outside of the classroom and the home, children can also suffer from sports related eye injuries, which, according to NEI, is the leading cause of blindness among school-aged children. These injuries account for 100,000 doctor visits each year, and 90 percent of them could be avoided with proper protective eyewear.

Dr. A. Vijay Mudgil, whose practice is located in West Chester, has a familiarity with both young and mature eyes and has been recognized for his research and treatment of young patients by the American Association for Pediatric Ophthalmology and Strabismus. Here, he offers advice for protecting young eyes.

Vijay Mudgil

Dr. A. Vijay Mudgil

MLT: How often should children have their eyes checked?

AVM: The actual recommendations are somewhat loose. I think it’s good to have it done before grade school. Children get their eyes screened from the time they are newborns. Pediatricians screen for cataracts, malformations, visual acuity, and even ocular alignment. Generally, a comprehensive ophthalmological exam is required when there is a failed vision screen by a pediatrician or family doctor. If there are unusual, at-risk medical conditions, such as Down’s Syndrome, prematurity, juvenile rheumatoid arthritis, family history of amblyopia (lazy eye), early onset cataracts, a learning disability, developmental delay, some neuropsychiatric behavioral issues, often times these can be indicators of, or facilitated by, poor vision. Many children can have an unusual refractive error that can contribute to delayed learning.

MLT: What are some symptoms of vision impairments?

AVM: Many conditions can be completely silent. A child is not born with developed vision, just as a child isn’t born walking or speaking. If a child isn’t seeing well out of one eye, a child might not realize that he isn’t seeing well. These ailments are often not an issue that a child will complain about because the child doesn’t know a different experience. That’s why proper screening and vigilance, based on family history, is necessary. Because the visual system matures typically by age 10, if these conditions aren’t discovered and addressed, that’s the way the vision system has matured.

MLT: How can parents keep children’s eyes safe while playing sports?

AVM: The eyes are vulnerable to injury. There are common things like blunt trauma, where you get poked in the eye, penetrating trauma, and radiation type trauma, where you go skiing or to the beach and don’t wear sunglasses to protect the eyes.

To a large extent, in organized sports, eye protection needs to be part of the culture of the team and that has to be lead by parents and coaches. Coaches emphasize proper hydration, stretching, sportsmanship, but they also need to make eye protection part of the culture. Generally, the smaller and softer the particle, the more damage it can do to the eye. A soccer ball, baseball or softball isn’t going to do as much damage as a tennis ball or squash ball.

MLT: How important are sunglasses?

AVM: Sun damage, just like to the skin, doesn’t show up until decades later. The skin carcinoma isn’t due to the last five years of sun exposure, it’s due to exposure for decades. Similarly, there are types of eye diseases that show up from sun damage decades earlier. People who don’t protect their eyes have a higher risk of developing cataracts, pterygia—we see it very commonly in roofers and farmers. In the short term, people who go out doing watersports or skiing without sunglasses develop a short-term “sunburn” called photokeratitis. It can cause painful, burning, red, light sensitive eyes, but long term, it does deeper damage to the eye. When you purchase sunglasses, make sure they are UVA and UVB protected. Just like you wear sunscreen, you need to wear a hat and sunglasses to protect your ocular surface.

MLT: What are the best habits for children to keep from straining while doing homework or even in the classroom?

AVM: Life has changed since I was in high school. We weren’t looking at cell phones, computer screens, tablets. It’s been shown that extended computer use tends to result in dryness of the eyes. When you’re reading a book, you tend to blink a few times and then turn the page. On the computer, you might switch between websites, so there’s no stimulus or break, so eyes tend to get dryer. It tends to result in more fatigue as a result of dryness. It’s a good idea to look around, look outdoors, blink a few times every 15 or 20 minutes, to prevent the ocular surface from getting dry. Children who wear contact lenses and are constantly on the computer tend to be a bit more vulnerable to ocular fatigue and dryness.

It’s been shown that nearsightedness is so much more common today than in the 1970s. Nobody fully understands why, but there are theories suggesting children aren’t getting enough outdoor time. Parents need to be aware of the demands on vision and traditionally accepted levels of visual acuity may not be tolerable to the demands that kids have in the classroom today.

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