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Monday, July 17, 2017

Pediatric eye care

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Add eye exam to back-to-school list

School supplies, backpacks, lunch boxes, clothes and shoes are items that can be found on a parent’s back-to-school list. Good vision is also essential for a successful school year, so it’s a good idea to add an eye examination to the list.

According to the American Optometric Association (AOA), regular eye exams and vision care are important because vision may change many times as a child grows.

Optometrist Dr. Rachel Borel of Silverblatt Eye Clinic in Shreveport says checkups should begin during infancy. “The first exam should be at six months, followed by an exam between 2 to 5 years old, then again before the start of first grade, and then every two years after that,” she said. “If there are any abnormal findings, we would modify the exam schedule.”

An eye exam includes dilation of the eye to examine the retina, an intraocular pressure/glaucoma test, and an assessment of visual acuity and whether glasses are needed. Some other things that are checked during an exam are whether the eyes are straight, move normally and work together. Additional tests may be performed if needed.

The AOA lists frequent eye rubbing or blinking, a short attention span, frequent headaches, blurred or double vision, avoiding reading or holding reading materials close to the face, losing place when reading, difficulty remembering what was read, covering one eye, tilting the head to one side, and an eye turning in or out, as signs of possible eye or vision issues.

“If your child is squinting or frequently bumping into things, they need an assessment, but some children show no signs at all that they have a significant refractive error,” said Borel.

“So it is important that every child maintains routine eye exams.”

According to the AOA Web site, “A child who can see 20/20 can still have a vision problem. In reality, the vision skills needed for successful reading and learning are much more complex.”

It seems like it could be difficult to perform an eye exam on a child who doesn’t know their letters, but optometrist Dr. Amy Coburn of Eye Docs for Kids in Shreveport says they can use pictures instead of the standard eye chart. For children who cannot communicate verbally, she said, “We dilate the eyes – we do that on everyone. We use an instrument called a retina scope, and we look at the light reflex inside the eye to determine what they need without them having to talk to us.”

Coburn said parents should observe their children for signs they may need glasses. She said farsightedness (hyperopia) could show up at a very early age and usually in children whose eyes cross, while nearsightedness (myopia) doesn’t show up until age 7 or 8.

In a learning environment, Coburn said nearsightedness usually presents with a child unable to read the board or squinting when the child looks at something far away. A telltale complaint for farsightedness is fatigue or headaches when reading or doing homework.

“Kids can grow out of farsightedness.

They’ll need the glasses when they’re younger, but as they get older they grow out of it. Not such great news for nearsightedness; it tends to get worse,” said Coburn.

There are other visual problems that would require glasses such as astigmatism and strabismus. Both near and far objects appear distorted when astigmatism – where the eye is more oval-shaped instead of round – is present. It is possible to be near- or farsighted and also have astigmatism. Corrective lenses are one of the options available to treat strabismus/ lazy eye.

Regular eye exams can also help rule out a possible learning disability. That’s because learning disabilities can be mistaken for vision problems. A child with difficulty learning should have a comprehensive eye exam by a pediatric eye professional. According to the AOA, eye focusing, eye tracking or eye coordination problems may affect a student’s academic and athletic performance.

“Not every kid that has a learning problem needs glasses, but it’s a great place to start in trying to figure out what can be done to help your child,” said Coburn. “If they’re getting fatigued when they’re reading or their eyes aren’t working together when they read, you can get a lot of symptoms of poor reading skills and poor comprehension, because the brain is trying to get the eyes to work together, rather than comprehend what it’s reading.”

Borel said another childhood eye condition is conjunctivitis, commonly called pink eye. Conjunctivitis can either be a viral or bacterial infection (both very contagious) or an allergic reaction. Contagious pink eye will typically go away in three to seven days.

As school starts back up, so too will extracurricular activities like sports. The American Academy of Ophthalmology says eye injuries occur often in children and young athletes. Children should wear eye protection for all eye-risk sports and activities.

– Melissa Airhart

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