Healthy Habits: Children's Eye Health and Safety

 As schools prepare to welcome back students, it’s time for parents to start stocking up on school supplies and scheduling all necessary doctor's appointments. August is Children’s Eye Health and Safety Month– a perfect reminder to check on your child’s eye health to ensure they enter the year seeing and feeling their best.  

I had a chance to interview Dr. Andrew Swan, M.D. from ReFocus Eye Health, the leading group of world-class ophthalmologists, optometrists, and retinal specialists located in Connecticut, New Jersey and Philadelphia to discuss the importance of children’s eye health and safety.

 

1. When should children start getting eye exams?

 

Human beings don't see 20/20 as newborns; it takes years for our eyes and our brains to develop sharp vision. It is crucial that infants and children are monitored for healthy development of their visual system, as any disruption in how a child sees in either one or both eyes can have lasting effects on their vision for the rest of their life. The American Academy of Ophthalmology recommends regular, periodic screening of children's eye health from birth through school age. Particularly with infants and toddlers, an eye screening is best performed by a pediatrician or other trained health professional. A full eye exam with an ophthalmologist or optometrist with dilating drops to check the retina is not considered routinely necessary unless a specific problem is suspected, or the child is at high risk of developing an eye issue due to underlying health problems. We recommend that a parent or guardian seek out a comprehensive eye exam by a trained eye doctor if their child fails a vision screening or one cannot be done, is referred by a pediatrician or school nurse, or if the parent suspects a visual concern or abnormal visual behavior. 

 

At birth, a newborn should be examined for a "red reflex", and for an intact pupil response to light.  The red reflex is what you see when light bounces off the back of the eye (the retina) and casts a reflection, such as from a camera flash.  Any absent or unequal red reflex may signal to the practitioner that there could be a misalignment of the eyes or something in the eye blocking the vision. It is normal for newborns and infants to have "wandering" or "crossed eyes" at times, where the eyes don't seem to be looking in the same direction. However, any fixed or constant misalignment should prompt a more in-depth examination.

 

A child will undergo continued, periodic checks by their healthcare provider at their well-child visits.  This includes repeating the tests of alignment and red reflex for infants and toddlers. Photoscreening is a type of picture that helps detect blurred vision or amblyopia (lazy eye) that may be done by the pediatrician for toddlers and very young children. Vision checks will begin as soon as they are old enough to start reading the eye chart. Children will also undergo yearly vision screenings at school starting in kindergarten and usually continuing through elementary school.

 

2. If a child isn't complaining about vision problems, why are those eye exams still important?

 

Developing normal vision depends on healthy eyes and good focus. A child’s maturing brain is so amazingly adaptive that often visual problems occurring in one eye will be suppressed in favor of the healthier eye so that the child doesn’t “see” any problem. Also, less-severe problems occurring in both eyes may simply be considered normal to them. We cannot just rely on children to know and to tell us that something may be wrong with their vision. Anything that blocks visual development in the formative years--even up to the early teens--can lead to permanent problems that may not be correctable even once the child is fully grown. For that reason, it is very important that a trained health care provider check each eye carefully for age-appropriate development. Screenings can detect when a child may benefit from glasses or uncover an issue that needs timely intervention by an ophthalmologist or optometrist.

3. What are some eye safety and health tips that are often overlooked for children?

 

Just like adults, children should have appropriate eye protection when performing any activities that could lead to ocular injury. This includes sports, recreation, and projects around the home. Per the American Academy of Ophthalmology, over 90% of all eye injuries can be prevented with proper protective eyewear. 

 

Sports protectors should be shatter-proof lenses made out of polycarbonate. This would also apply to a child who wears glasses normally; “rec specs” or contact lenses are much safer to wear on the field than regular eyeglasses that may break, snap, or shatter during impact. Furthermore, if a youngster is helping around the house with any dangerous home improvement or yard work, they should have ANSI-approved protective eyewear, just like the adults who are carefully supervising them. 

 

Children are particularly vulnerable to eye injuries from projectile toys. Avoid darts, bows and arrows, or missile-firing guns. Playing with or being in the presence of people using air rifles, BB guns, or pellet guns is also to be avoided, as they are extremely dangerous and have led to serious eye injuries in children and adults alike. The same holds true for home fireworks.

 

Common sense and thoughtful protection can help prevent many injuries, but accidents still happen. If a child’s eye is injured, seek immediate assistance from an ophthalmologist, optometrist, primary care doctor, or school nurse. If a chemical injury is suspected, flushing the eye with water is a good start. Do not try to remove any objects stuck in the eye, or apply pressure by rubbing or pressing on the injured eye. Gently cover it until prompt medical attention can be obtained. 

 

Remember: when in doubt, ask your eye doctor! Nearly all ophthalmologist and optometrist offices are available to answer questions 24 hours a day, 7 days a week. A phone call can help determine if and when a child should be seen for an eye exam. The health and safety of your children's eyes is an eye doctor’s greatest concern.