Eye eye!

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We’ve all heard that eating carrots will improve our eyesight, and have all been admonished by mums threatening, “If you cross your eyes, they’ll stay that way!” There are plenty of old wives’ tales when it comes to the eyes, but apparently we could use a bit more factual information. According to the Department of Health, Hong Kong has one of the highest rates of vision problems in children under five years old in the world.

Scary. But the good news is that for those children who have vision problems, most problems can be corrected. However, those corrections are dependent upon parents or caregivers getting professional assistance for children as early as possible.

So, here’s the low-down on what to look out for, and when to get tested.

The first seven years

Throughout the first seven years of your child’s life, the vision centre in their brain is constantly developing. It is during this critical stage that most diagnosed problems can be corrected. But leave a suspected eye problem unattended to or untreated, and you’ll risk your child developing permanent damage, which, in some instances, can lead to varying degrees of blindness.

Detecting problems

Unless your child’s eyes are “turning” (looking in different directions), it is almost impossible to tell if there is a problem without an eye test conducted by a professional optometrist. If there is a history of poor eyesight in your family, particularly if either parent needed glasses from a young age, then take your child for an eye test after they turn two and a half years old. Eye problems can be detectable earlier than this, however, and if you have any concerns, see an optometrist sooner.

Babies and toddlers will often try to compensate for poor vision rather than complain about it. Here are some key signs that your child’s eyesight might need checking:

  • consistently sitting too close to the TV or holding a book too close
  • losing their place while reading
  • using a finger to follow along while reading
  • squinting
  • tilting the head to see better
  • frequently rubbing their eyes
  • showing sensitivity to light
  • tearing excessively (watering eyes)
  • closing one eye to read, watch TV or see better
  • avoiding activities that require near vision, such as reading or homework, or distance vision, such as participating in sports or other recreational activitie
  • complaining of headaches or tired eyes
  • avoiding using a computer because it hurts their eyes
  • receiving lower grades than usual
Early testing

If you suspect your child might be having troubles, they should get tested as early as possible, for two reasons:

First, many children need patching to correct their eyes, and school-aged children are typically more reluctant than pre-school children to wear patches.

Secondly, patching can sometimes be disruptive to a child’s learning programme at school. And so can poor eyesight. By introducing patching or correction techniques at age four or before, your child’s vision could be corrected by the time they start school.

If you suspect an eyesight problem in a school-aged child, it’s also a good idea to mention it to your child’s teachers, as they are in a prime position to look out for signs of troubles in the classroom. Often, kids experiencing eye problems fidget or fuss when they are reading, or resist reading for long periods of time. (Since these can also be signs of learning problems, you’ll want to evaluate the situation carefully.) Teachers might also notice if a child covers one eye when they’re reading, holds things very close, squints, or blinks a lot.

Common eyesight problems

Amblyopia – often referred to as “lazy eye” – is the most common cause of poor vision in children. Any problem that causes the vision to be blurry through childhood can cause amblyopia. These include:

  • myopia (nearsightedness) In myopia, the eyeball is too long for the normal focusing power of the eye. As a result, images of distant objects appear blurred.
  • hyperopia (longsightedness) In this condition, the eyeball is too short for the normal focusing power of the eye. In children, the lens in the eye attempts to accommodate for this error with considerable effort that often causes fatigue and sometimes crossed eyes (strabismus).
  • astigmatism (irregularity of the focus). Astigmatism results primarily from an irregular shape of the front surface of the cornea, the transparent “window” at the front of the eye. People with astigmatism typically see vertical lines more clearly than horizontal ones, or sometimes the reverse.

These eyesight problems are all related to focus when the length and shape of the eye is not ideal. Incoming light is either focused too early or too late and is therefore unable to create a perfect image on the retina.

Squint, another eyesight problem, occurs when the two eyes are not looking in the same direction. One eye may turn in or out, or one eye may sit higher than the other. Babies can often have the appearance of a squint due to their relatively wide nose bridges. This appearance typically disappears as the face develops. A child with a true squint, however, will not grow out of it and must be seen by an eye specialist.

Another eyesight problem is colour deficiency (colour blindness). Children with colour blindness are not really blind to colour; instead, they have trouble identifying some colours.

Treatment for eye conditions

Beyond the age of five years it becomes increasingly difficult to reverse amblyopia successfully. Beyond seven years, it is usually impossible. It is therefore imperative to have your child checked earlier rather than later to ascertain any problems.

Patching, or covering the good eye, is the most common method of treating amblyopia. There are also eye drops available that blur the good eye sufficiently to cause the brain to revert to using the poor eye again. Your eye specialist can guide you on what method will be most effective for your child.

Treatment for squints can often include patching as well, especially if a child squints with one eye only, as this leads to a lazy eye. Glasses will also be prescribed for squints if there is a focusing error, particularly in longsightedness.

Remember: though the thought of vision problems in your child might seem scary to you, most conditions can be treated if they’re detected and treated early enough.

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