August is Eye Health and Safety Month
EYE HEALTH AND SAFETY
Healthy eyes and vision are a critical part of kids' development. Their eyes should be examined regularly, as many vision problems and eye diseases can be detected and treated early.
Be sure to make vision care and eye checks a part of your child's routine medical care.
Different kinds of doctors offer eye care, and the names can be confusing:
- · Ophthalmologists are medical doctors who provide comprehensive eye care with medicine and surgery.
- · Pediatric ophthalmologists are doctors who have additional special training to treat kids' eye problems.
- · Optometrists provide services that may be similar to ophthalmologists, but they don't perform surgery. Some optometrists specialize in kids' eye problems.
- · Opticians fit and adjust eyeglasses.
Routine medical exams for kids' vision include:
- · Newborns should be checked for general eye health by a pediatrician or family physician in the hospital nursery.
- · High-risk newborns (including premature infants), those with a family history of eye problems, and those with obvious eye irregularities should be examined by an eye doctor.
- · In the first year of life, all infants should be routinely screened for eye health during checkups with their pediatrician or family doctor.
- · Around age 3½, children should have eye health screenings and visual acuity tests (tests that measure sharpness of vision) with their pediatrician or family doctor.
- · Around age 5, children should have their vision and eye alignment checked by their pediatrician or family doctor. Those who fail either test should be examined by an eye doctor.
- · After age 5, routine screenings should be done, and if symptoms such as squinting or frequent headaches occur. (Many times, a teacher will notice that a child isn't seeing well in class.)
- · Children who wear prescription glasses or contacts should have annual checkups by an eye doctor to screen for vision changes.
Spotting Eye Problems
Signs that a child may have vision problems include:
- · constant eye rubbing
- · extreme light sensitivity
- · poor focusing
- · poor visual tracking (following an object)
- · abnormal alignment or movement of the eyes (after 6 months of age)
- · chronic redness of the eyes
- · chronic tearing of the eyes
- · a white pupil instead of black
In school-age children, other signs to watch for include:
- · being unable to see objects at a distance
- · having trouble reading the blackboard
- · squinting
- · difficulty reading
- · sitting too close to the TV
Watch your child for signs of poor vision or crossed eyes. If you notice any eye problems, have your child examined right away so that the problem doesn't become permanent. If caught early, eye conditions often can be corrected.
Common Eye Problems
Several eye conditions can affect kids. Most are detected by a vision screening using an acuity chart during the preschool years.
Amblyopia ("lazy eye") is poor vision in an eye that may appear to be normal. Two common causes are crossed eyes and a difference in the refractive error between the two eyes. If untreated, amblyopia can cause irreversible visual loss in the affected eye. (By then, the brain's "programming" will ignore signals from that eye.) Amblyopia is best treated as early as possible, ideally before a child is 8 years old.
Strabismus is a misalignment of the eyes; they may turn in, out, up, or down. If the same eye is chronically misaligned, amblyopia may also develop in that eye. With early detection, vision can be restored by patching the properly aligned eye, which forces the misaligned one to work. Surgery or specially designed glasses also may help the eyes to align.
Refractive errors mean that the shape of the eye doesn't refract (bend) light properly, so images appear blurred. Refractive errors also can cause amblyopia. Nearsightedness is the most common refractive error in school-age children; others include farsightedness and astigmatism:
- Nearsightedness is poor distance vision (also called myopia), which is usually treated with glasses or contacts.
- Farsightedness (also called hyperopia), which is usually treated with glasses or contacts.
- Astigmatism is imperfect curvature of the front surface of the eye, which is usually treated with glasses if it causes blurred vision or discomfort.
Other eye conditions need immediate attention, such as retinopathy of prematurity (a disease that affects the eyes of premature babies) and those associated with a family history, including:
- · Retinoblastoma is a malignant tumor that usually appears in the first 3 years of life. The affected eye or eyes may have visual loss and whiteness in the pupil.
- · Infantile cataracts can occur in newborns. A cataract is a clouding of the eye's lens.
- · Congenital glaucoma in infants is a rare condition that may be inherited. It is the result of high pressure in the eye from incorrect or incomplete development of the eye drainage canals before birth and can be treated with medication and surgery.
- · Genetic or metabolic diseases of the eye, such as inherited disorders that make a child more likely to develop retinoblastoma or cataracts, may require kids to have eye exams at an early age and regular screenings.
Be sure to talk to your doctor if your child is at risk for any of these conditions.
Old wives' tales abound about the eyes. From watching TV to eating carrots, here's the lowdown on some vision facts and fiction.
Myth: Sitting too close to the TV is bad for the eyes.
Fact: Although parents have been saying this ever since TVs first found their way into our homes, there's no evidence that plunking down right in front of the TV set damages someone's eyes. The American Academy of Ophthalmology (AAO) says that kids can actually focus up close without eyestrain better than adults, so they often develop the habit of sitting right in front of the television or holding reading material close to their eyes. However, sitting close to a TV may be a sign of nearsightedness.
Myth: If you cross your eyes, they'll stay that way.
Fact: Contrary to the old saying, eyes will not stay that way if you cross them. If your child is crossing one eye constantly, schedule an evaluation by an ophthalmologist.
Myth: If parents have poor eyesight, their kids will inherit that trait.
Fact: Unfortunately, this one is sometimes true. If you need glasses for good vision or have developed an eye condition (such as cataracts), your kids might inherit that same trait. Discuss your family's visual history with your doctor.
Myth: Eating carrots can improve vision.
Fact: Although it's true that carrots are rich in vitamin A, which is essential for sight, so are many other foods (asparagus, apricots, nectarines, and milk, for example). A well-balanced diet can provide the vitamin A needed for good vision, says the AAO.
Myth: Computer use can damage the eyes.
Fact: According to the AAO, computer use won't harm the eyes. However, when using a computer for long periods of time, the eyes blink less than normal (like they do when reading or performing other close work). This makes the eyes dry, which may lead to a feeling of eyestrain or fatigue. So encourage your kids to take frequent breaks from Internet surfing or video games.
Myth: Two blue-eyed parents can't produce a child with brown eyes.
Fact: Two blue-eyed parents can have a child with brown eyes, although it's very rare. Likewise, two brown-eyed parents can have a child with blue eyes, although this is also uncommon.
Myth: Only boys can be color-blind.
Fact: It's estimated that up to 8% of boys have some degree of color blindness, whereas less than 1% of girls do.
Myth: The eye is full size at birth.
Fact: The eye is NOT full size at birth but continues to grow with your child. This growth partially accounts for refractive (glasses) changes that occur during childhood.
Myth: Wearing glasses too much will make the eyes "dependent" on them.
Fact: Refractive errors (near-sightedness, far-sightedness, or astigmatism) change as kids get older. Many variables come into play, but most of this change is likely due to genetics and continues despite wearing glasses earlier or later or more or less. Wearing glasses does not make the eyes get worse.
Eye injuries are the most common preventable cause of blindness. While many minor eye irritations can be treated at home by flushing the eye with water, more serious injuries need medical attention. So when in doubt, err on the side of caution and call your doctor for help.
What to Do:
(sand, dirt, and other foreign bodies on the eye surface)
- · Wash your hands thoroughly before touching the eyelids to examine or flush the eye.
- · Do not touch, press, or rub the eye itself, and do whatever you can to keep your child from touching it (a baby can be swaddled to prevent this).
- · Do not try to remove any foreign body except by flushing. Other methods can scratch the surface of the eye, especially the cornea.
- · Tilt your child's head over a basin or sink with the affected eye down and gently pull down the lower lid. Encourage your child to open the eyes as wide as possible. For an infant or small child, it's helpful to have a second person hold the child's eyes open while you flush.
- · Gently pour a steady stream of lukewarm water (do not heat the water) from a pitcher or faucet over the eye.
- · Flush for up to 15 minutes, checking the eye every 5 minutes to see if the foreign body has been flushed out.
- · Because a particle can scratch the cornea and cause an infection, the eye should be examined by a doctor if irritation continues after flushing.
- · A foreign body that remains after flushing probably will require removal by a trained medical professional.
Embedded Foreign Body
(an object penetrates or enters the globe of the eye)
- If an object, such as a piece of glass or metal, is sticking out of the eye, take the following steps:
- · Call for emergency medical help or bring the child to the emergency room.
- · Cover the affected eye with a small cup taped in place. The point is to keep all pressure off the eye.
- · Keep your child (and yourself) as calm and comfortable as possible until help arrives.
- · Many chemicals, even those found around the house, can damage an eye. If your child gets a chemical in the eye and you know what it is, look on the product's container for an emergency number to call for instructions.
- · Flush the eye (see Routine Irritations) immediately with lukewarm water for 15 to 30 minutes. If both eyes are affected, flush them in the shower.
- · Call for emergency medical help.
Call your local poison control center for specific instructions. Be prepared to give the exact name of the chemical, if you have it. However, do not delay flushing the eye first.
Black Eyes and Blunt Injuries
A black eye is often a minor injury. But this bruising also can be the result of a significant eye injury or head trauma. A visit to the doctor or an eye specialist might be needed to rule out serious injury, particularly if you're not sure what caused the black eye.
For a black eye:
- · Apply cold compresses intermittently: 5 to 10 minutes on, 10 to 15 minutes off. If you use ice, make sure it's covered with a towel or sock to protect the delicate skin on the eyelid.
- · Use cold compresses for 24 to 48 hours, then switch to applying warm compresses intermittently. This will help the body reabsorb the leakage of blood and may help reduce discoloration.
- · If the child is in pain, give acetaminophen — not aspirin or ibuprofen, which can increase bleeding.
- · Prop the child's head with an extra pillow at night, and encourage him or her to sleep on the uninjured side of the face (pressure can increase swelling).
- · Call your doctor, who may recommend an in-depth evaluation to rule out damage to the eye.
Call immediately if you see any of these problems:
- · increased redness
- · drainage from the eye
- · lasting eye pain
- · any changes in vision
- · any visible abnormality of the eyeball
- · visible bleeding on the white part (sclera) of the eye, especially near the cornea
If the injury happened during one of your child's routine activities, such as a sport, follow up by investing in an ounce of prevention — protective goggles or unbreakable glasses are vitally important.