The vision problem affecting 1 in 5 school children

Chronic underfunding, overcrowded classrooms, run down schools, and shortage of textbooks and resources are some of the school issues that grab the headlines.

Yet, there’s a problem in our schools that affects an estimated 15-20% of our children and receives virtually no publicity. It’s a problem that is as acute in affluent communities as in the inner city.

The problem is our children’s vision. I’m saddened to report that there are millions of school-aged children in the U.S. who have vision problems that are interfering with their ability to learn. Unfortunately, the vast majority of them, their parents, and their teachers are unaware of the problem.

In too many cases, I have seen these undiagnosed vision problems create a cycle of despair. A child is labeled as a “slow learner,” receives special attention, yet shows little progress if the underlying vision problems are not treated.

Courtesy of MDGovpics on Flickr

In other less severe cases, I have seen problems linger as life-long “nuisances”- hindering the productivity and job satisfaction of successful executives, attorneys, actors, and other professionals.

How is it that so many of these problems can go undetected? There are three main reasons:

1. Inadequate vision testing – The typical vision test given at schools (usually administered by the school nurse), and general eye doctors’ offices (that do not specialize in developmental vision) primarily only evaluate distance vision and eye health. Near vision tests, which determine if a child can read a book up-close, are often overlooked. More complex vision skills that are necessary to read effectively, such as eye tracking and teaming, are very rarely tested.
2. Poor vision skills are “silent” ailments – A child cannot tell if he is seeing clearly because he cannot objectively compare his vision skills with others. By the same token, a parent or teacher cannot assess how a child is seeing because they cannot see through the child’s eyes.

No matter how poor a student’s vision skills, it is all that he or she has known. I have seen extreme cases where a child with double vision has never reported this to her parents because she thought everyone saw like this. Consequently, it is especially important that parents and teachers are aware of the behavioral signs that indicate a possible vision problem.

Signs of vision problems include:

• School or sports performance below potential
• Resistance to school work and homework
• Slow reader or test taker
• Clumsy catching a ball
• Words go in and out of focus
• Rubs eyes while reading
• Covers an eye while reading
• Uses finger to keep place reading after the 2^nd grade
• Moves reading material closer or further away to see it better
• Short attention span on visual activities
• Poor penmanship, doesn’t stay on the line

3. Lack of public awareness-
   • The fact that proper vision is the learned mastery of variety of skills is not widely understood. Most people assume that visual skills naturally develop, when in fact, for approximately 20% of people these skills do not develop fully by themselves.
   • Fortunately, most people with these vision problems can be helped through a program of Vision training. A Vision training (VT) program builds and enhances deficient visual motor and perceptual skills step by step.

I am hoping that we will reach a time when poor vision skills are eliminated as a reason why many of our children are not performing to their potential in school and sports. This begins with one child at a time, and one developmental vision exam  at a time.

~Elise Brisco, OD

California Optometric Association

http://www.coavision.org

Night blindness 101

The term night blindness sounds alarming, as though some people are actually blind at night.  There is a small percentage of the population that does in fact experience true night blindness, but it is rare and often the result of late stage eye disease.  In optometry, it is not common to use the term night blindness although we do encounter a significant number of patients who complain of poor night vision.  The symptoms are usually blur and dimming of vision at night, glare and haloes around lights and poor adaptation from light to dark environments.  How do you know if what you are experiencing is normal or a result of something more serious?

There are a handful of eye conditions that can create symptoms of poor night vision.

Photo Courtesy of kenleewrites on Flickr

1.  Patients who have had surgery to the corneas such as LASIK or corneal transplants may notice glare and haloes around light.  They may also experience diminished contrast sensitivity which can cause images in the evening to appear more dim.  Unfortunately, surgical results usually cannot be reversed.
2. Cataracts are the number one cause of decreased night vision.  Patients over the age of 40 will begin developing mild cataracts.  This is when the natural lens inside the eye becomes more yellow and opaque as a result of age and ultraviolet exposure.  Cataracts can cause haloes and dimming of vision in the dark and decreased contrast sensitivity.  Fortunately, cataracts are easily removed thereby restoring problems with night vision.
3. Corneal diseases such as keratoconus and severe dry eyes may also affect one’s vision in the evenings causing double vision or haloes.  For some of these patients, specialty contact lenses or eyedrops will alleviate these symptoms.
4. Newer technology has also allowed optometrists to detect higher order aberrations in some patients.  For these patients, standard spectacle lenses may not improve night vision problems.  An instrument to detect higher order aberrations will determine whether a patient requires a specialty custom-made spectacle lens to improve night vision.

Some patients do in fact have true night blindness caused by an eye disease in its late stage.  Usually, symptoms begin slowly over time and progress to an inability to see in the dark.  These patients usually suffer from one of two eye conditions.

1.  Retinitis pigmentosa is an inherited eye disease of the retina, the tissue that lines the back wall of the eye and captures visual images.  Retinitis pigmentosa affects the rods of the retina and causes slow deterioration of these structures.  The rods (unlike the cones) are responsible for night vision and for peripheral vision.  As the disease progresses, patients will notice a decrease in their ability to see in the dark and in the periphery.  Unfortunately, there is no current cure for retinitis pigmentosa.
2. Glaucoma is an eye disease where the optic nerve slowly degenerates.  Patients with glaucoma usually have no symptoms in the early stages of the disease.  As the disease progresses, nerve fibers in the retina begin to deteriorate resulting in a decrease in peripheral vision as well as night vision.  Usually, patients do not experience symptoms of poor night vision and poor peripheral vision until the late stages of the disease.

Now that you know the causes, what are some ways to alleviate or improve poor night vision?  The simplest solution is to wear an updated pair of prescription glasses (if you have a prescription) with higher index lenses and an anti-glare coat.  Your optometrist can also inform you if you require customized lenses to correct for higher-order aberrations.  If your night vision problems are not a result of surgery or any eye diseases that you are aware of, then it is important that you visit your optometrist for a comprehensive eye examination.

– Cindy P. Wang, O.D., F.A.A.O.
California Optometric Association
www.coavision.org

Are contact lenses dangerous?

Courtesy of wader on Flickr

The Benefits

Contact lenses are medical devices that millions of people wear safely every single day. Many people enjoy the freedom from glasses that contact lenses allow.

Contact lenses are also great options for:

• Sports
• Changing eye color
• People who have irregularities to the front of the eye, cornea, or are not able to see with glasses.

Contact lenses make it possible to see and function in everyday life.

The Dangers

Contact lenses can be dangerous if they are abused.

Contact lenses are medical devices and can only be prescribed and dispensed by a licensed eye doctor. If they are sold without being evaluated on the eye by a doctor it can lead to:

• Eye infections
• Eye inflammation
• Eye injuries

Proper care is key

Proper contact lens care and handling are important components of the contact lens fitting process. Contact lens solution used incorrectly or “topping off contact lens solution” (adding more without disposing of the current solution) can lead to multiple complications. It is important to use sterile contact lens solution and not tap water due to bacteria in water. Never, ever put contact lenses in your mouth or spit on them to try to clean them.

Courtesy of listentothemountains on Flickr

It is also important to replace contact lenses at the recommended frequency. For example, daily disposable contact lenses should be replaced each day. Contact lenses that are overused and abused can lead to serious problems.

Certain contact lenses are approved for sleeping or extended wear. However, if your contact lenses are not approved for extended wear, this can lead to complications on the cornea, or front of the eye.

If you are interested in contact lenses, schedule an appointment with a doctor of optometry today.

~Melissa Barnett, OD, FAAO

Should I get contact lenses? Quick guide to help you decide!

Prescription contact lenses can provide the freedom and comfort to perform a number of activities that cannot be achieved in glasses.

• The most common example is sports. For those instances where you know you will be running or jumping for extended amount of time and hopefully breaking a sweat at the same time, contact lenses are an ideal choice for vision correction. No need to worry about your frames slipping off your nose or blocking your peripheral vision. Contacts can provide you with crisp and clear vision throughout your entire visual field so you can focus on being your best.

Courtesy of nikozz on Flickr

• Another great example is for social events or gatherings where you know there will be cameras everywhere. This can range from brides-to-be prepping for their big day to just spending a night out with friends. When you know you want to look your best in the photos commemorating important times in the lives of your family and friends, contact lenses are the best accessory you could ask for!

• Similarly, prescription color contact lenses can give you that extra pizzazz when you want to be a little different. Whether you are just adding a little blue or green to match your outfit or a purple or gray tint to draw some extra attention to your face, prescription color contacts can be a great choice to help you stand out in a crowd.

• I personally choose to wear my prescription contact lenses on days when it is raining or cold. That way I can avoid having rain drops on my glasses or having my lenses fog up for 30 seconds or more when I go indoors in the winter time.

Courtesy of maikel_nai on Flickr

• The best thing about contact lenses is the new technology used in the current manufacturing processes of prescription contact lenses. This allows your optometrist the ability to fit nearly any prescription you can imagine in materials that are approximately 10 times better than what we used only a few years ago! Today’s prescription contact lenses are available in aspheric designs to help you see more clearly and with UV blocking filters to help protect your eyes throughout the day.

If you think contact lenses may work for you, call your optometrist today to schedule a contact lenses fitting.

~Ranjeet S. Bajwa, OD