Many parents, at one time or another, will ask the question of their pediatrician or their eye care doctor, whether it is an optometrist or an ophthalmologist. Myths abound and opinions are strong. For years the answer was an emphatic “No”. Research has begun to suggest that changing the fate of your child’s use or need for glasses is possible. To reach this goal, a combination of good vision habits (also called vision hygiene); patient compliance and corrective lenses are needed.
Between the ages of birth to five, a process called “emmetropization”, a natural biological event, will correct minor refractive errors. In essence the body will coordinate the growth of all of the eyes’ inner components to neutralize minor refractive errors all by itself without the need for lenses. Animal studies have confirmed that prolonged near activity interferes with emmetropization.
To promote this phenomenon, a child should observe good vision and nutritional habits to reduce the visual stress that may be a result of looking up close for too long. Some examples are:
- Taking periodic breaks when reading or playing on a computer or game device
- Outdoor activities of at least an hour a day. Children who spend more time outdoors were found to have less myopia than those who stayed indoors all of the time.
- Keeping reading material at the ideal distance from the third knuckle to the elbow when reading or working at a desk
- Whenever possible, using a slant board or working on a surface of 45 degrees angle towards you.
- Eating healthy foods, rich in leafy vegetables and maintaining a diet low in sugar.
Most nearsighted parents often don’t want to just sit back and wait for the day their child will need glasses to see the blackboard at school. Developmental optometrists take a more preventative and active approach, fitting some children with specially prescribed glasses during their early years of visual development. These lenses will help guide the visual system and counter the consequence of hours of reading, playing on a computer or handheld device. Optometric vision therapy is also a part of the active approach and can also help the child maintain flexibility in their visual system from too much close work.
If a child has significant myopia at any age, spectacle lenses are needed and prescribed for clarity. Recent studies show that a blurred image will stimulates faster progression of myopia. Spectacle lenses can be prescribed as single vision or in multifocal. Multifocal (either bifocal or progressive addition) lenses have helped some children slow their myopia progression with their final prescription at age 18 being less than predicted.
A newer form of therapeutic lens prescription is the use of rigid contact lenses to gently modify the shape and contour of the eye. This is called Corneal Refractive Therapy (CRT) and can be used at any age, even in a child as young as age five.. CRT lenses are worn during sleep and are removed in the morning, eliminating the hassles of daytime glasses or contacts. In addition CRT have been found to change the balance between central and peripheral focus which appears to be a key factor in slowing, if not eliminating, the rate of myopic progression. CRT lenses are appropriate for both adults and children who have myopia up to six diopters and is perfect for those that have dry eyes or allergies and who are active in sports or perform in dance or theater.
Optometrists who specialize in pediatric vision and vision development hold the designation of “Fellow of the College of Optometrists in Vision Development” or “FCOVD”, and /or a post graduate residency in pediatric optometry. Ophthalmologists who have completed a residency in pediatric ophthalmology will also specialize in children’s vision.
The most important advice any eye doctor will give is to have a child evaluated early if a problem is suspected. Otherwise it’s best to have your child examined by an eye care professional at six months of age. Through infantSEE, a no cost public health program for babies between six and twelve months of age, any potential eye problems can be identified, while sight threatening conditions and even the look of “coke-bottle” glasses later on in life may also be prevented.
In summary, parents may prevent myopia (nearsightedness) in their children by providing consistent outdoor activity, practicing good vision habits, eating right and visiting a pediatric developmental optometrist or pediatric ophthalmologist. Success, however, hinges upon compliance with the doctor’s recommendation.
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