CHILDREN'S VISION

 
 
 
 
 
 
What Is Myopia (nearsightedness)?
 
Parents — especially those who are nearsighted and had to wear glasses throughout childhood — are often concerned about the causes of myopia and whether their children are doomed to being nearsighted, too.
If this sounds like you, try not to worry too much.
Myopia is a common refractive error, it's easily treatable with contact lenses as well as eyeglasses, and it's not strictly hereditary.
Also, nearsightedness typically does not affect a child's academic performance or hold them back in any way. In fact, there's evidence that nearsighted children tend to perform better in school than their counterparts with normal eyesight, farsightedness or astigmatism.
 
 
How To Reduce Your Child's Risk of Myopia
 
This might sound glib, but perhaps one of the best things to tell your child to reduce his or her risk of myopia is, "Go outside and play!"
A number of recent studies have found that spending more time outdoors may help prevent or reduce the progression of nearsightedness in children. Among them:
  • In the Sydney Myopia Study, researchers in Australia evaluated the effect of time spent outdoors on the development and progression of myopia among 6-year-olds and 12-year-olds randomly selected from 51 Sydney schools.

    The 12-year-old children who spent more time outdoors had less myopia at the end of the two-year study period than others in the study — even after adjusting for the amount of reading performed, parental myopia and ethnicity.

    Children who performed the most amount of near work and spent the least amount of time outdoors had the highest mean amount of nearsightedness.
  • In Taiwan, researchers evaluated the effect of outdoor activity during class recess on myopia risk and progression among elementary school students.

    Children participating in the one-year study ranged from 7 to 11 years of age and were recruited from two nearby schools located in a suburban area of southern Taiwan.

    A total of 333 children from one school were encouraged to go outside for outdoor activities during recess, whereas 238 children from the other school did not participate in a special "recess outside the classroom" (ROC) program.

    At the beginning of the study, there were no significant differences between the two groups of children with regard to age, gender, and myopia prevalence (48 percent vs. 49 percent). But after one year, the children from the school that spent time outside during recess had a significantly lower onset of new myopia than the children from the school that did not encourage outside activity during recess (8.4 percent vs. 17.6 percent).

    There also was significantly lower average progression of myopia among already nearsighted children in the ROC group compared with the group that spent more recess time indoors (-0.25 diopter [D] per year vs. -0.38 D per year).

    The study authors concluded that outdoor activities during recess in elementary school have a significant protective effect on myopia risk among children that are not yet nearsighted and reduce the progression of myopia among nearsighted schoolchildren.
 
 
What Causes Amblyopia?
 
There are three types of amblyopia, based on the underlying cause:
  • Strabismic amblyopia. Strabismus is the most common cause of amblyopia. To avoid double visioncaused by poorly aligned eyes, the brain ignores the visual input from the misaligned eye, leading to amblyopia in that eye (the "lazy eye"). This type of amblyopia is called strabismic amblyopia.
  • Refractive amplyopia. Sometimes, amblyopia is caused by unequal refractive errors in the two eyes, despite perfect eye alignment. For example, one eye may have significant uncorrected nearsightednessor farsightedness, while the other eye does not. Or one eye may have significant astigmatism and the other eye does not.

    In such cases, the brain relies on the eye that has less uncorrected refractive error and "tunes out" the blurred vision from the other eye, causing amblyopia in that eye from disuse. This type of amblyopia is called refractive amblyopia (or anisometropic amblyopia).
  • Deprivation amblyopia. This is lazy eye caused by something that obstructs light from entering and being focused in a baby's eye, such as a congenital cataract. Prompt treatment of congenital cataracts is necessary to allow normal visual development to occur.
 
An eye care professional can diagnose refractive errors during a comprehensive dilated eye examination. People with a refractive error often visit their eye care professional with complaints of visual discomfort or blurred vision. However, some people don’t know they aren’t seeing as clearly as they could.
 
 
 
 
 
What Causes Myopia In Children?
 
Although the exact reason why some children become nearsighted and others do not is not fully understood, it appears heredity is a factor, but not the only one.
In other words, if both parents are nearsighted, there is a greater risk their children will be nearsighted, too. But you can't predict who will become nearsighted by simply looking at their family tree.
In my case, my parents and both my older brothers had perfect vision. I'm the only one in the family who is nearsighted. Go figure.
I loved to read when I was a kid (still do); my brothers, not so much. Some researchers think focusing fatigue from excessive reading or holding a book too close to your eyes for extended periods can increase the risk for myopia in children. But nobody knows for sure.
The cause (or causes) of myopia may remain a mystery, but researchers recently have discovered something about the progression of nearsightedness that is very interesting: conventional glasses and contact lenses that have been prescribed for years to correct myopia may actually increase the risk of myopia worsening throughout childhood!
Many of these same researchers are investigating new lens designs to see if they can develop contact lenses or eyeglasses that can control myopia and halt or slow the progression of nearsightedness in children.
 

What Is Amblopia (lazy eye)?

 
Amblyopia, also known as lazy eye, is a vision development disorder in which an eye fails to achieve normal visual acuity, even with prescription eyeglasses or contact lenses.
Amblyopia begins during infancy and early childhood. In most cases, only one eye is affected. But in some cases, reduced visual acuity can occur in both eyes.
Particularly if lazy eye is detected early in life and promptly treated, reduced vision can be avoided. But if left untreated, lazy eye can cause severe visual disability in the affected eye, including legal blindness.
It's estimated that about 2 to 3 percent of the U.S. population has some degree of amblyopia.
 
 
Amblyopia Signs and Symptoms
 
Because amblyopia typically is a problem of infant vision development, symptoms of the condition can be difficult to discern. However, a common cause of amblyopia is strabismus. So if you notice your baby or young child has crossed eyes or some other apparent eye misalignment, schedule an appointment for a children's eye exam immediately — preferably with an optometrist or ophthalmologist who specializes in children's vision.
Another clue that your child may have amblyopia is if he or she cries or fusses when you cover one eye.
You can try this simple screening test at home by simply covering and uncovering your child's eyes (one eye at a time) when he or she is performing a visual task, such as watching television.
if your child is not bothered when one eye is covered, but objects when the other eye is, this may suggest that the eye you have covered is the "good" eye, and that the uncovered eye is amblyopic, causing blurred vision.
But a simple screening test is no substitute for a comprehensive eye exam.
Have your child's eyes examined as recommended to make sure he or she has normal vision in both eyes and that the eyes function together properly as a team.
 
Amblyopia Treatment
 
In some cases of refractive amblyopia, normal vision can be achieved simply by fully correcting the refractive errors in both eyes with glasses or contact lenses. Usually, however, at least some patching of the "good" eye is needed to force the brain to pay attention to the visual input from the amblyopic eye and enable normal vision development to occur in that eye.
Treatment of strabismic amblyopia often involves strabismus surgery to straighten the eyes, followed by eye patching and often some form of vision therapy (also called orthoptics) to help both eyes work together equally as a team.
Patching may be required for several hours each day or even all day long and may continue for weeks or months.
If you have a lot of trouble with your child taking the patch off, you might consider a specially designed prosthetic contact lens that prevents light from entering the good eye but does not affect your child's appearance.
Though prosthetic contact lenses are more costly than a simple eye patch and require a contact lens exam and fitting, they can work wonders in difficult cases of amblyopia treatment when compliance with eye patching is poor.
In some children, atropine eye drops have been used to treat amblyopia instead of an eye patch. One drop is placed in your child's good eye each day (your eye doctor will instruct you). Atropine blurs vision in the good eye, which forces your child to use the eye with amblyopia more, to strengthen it. One advantage of using atropine eye drops is that it doesn't require your constant vigilance to make sure your child wears the patch.
In one large study of 419 children younger than 7 years of age with amblyopia ranging from 20/40 to 20/100 prior to treatment, atropine therapy produced comparable results to eye patching (though improvement in visual acuity in the amblyopic eye was slightly greater in the patching group). As a result, some previously skeptical eye care practitioners are using atropine as their first choice for amblyopia treatment over patching.
However, atropine does have side effects that should be considered: light sensitivity (because the eye is constantly dilated), flushing and possible paralysis of the ciliary muscle after long-term atropine use, which could affect the eye's accommodation, or ability to change focus.
N.B Children With Amblyopia Read More Slowly Than Kids With Normal Vision, Study Finds
Children with amblyopia make more corrective eye movements while reading and read slower than normally sighted children, according to a study.
 
 
 
 
 
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