School is out! How to keep your child’s eyes healthy during summer

Photo courtesy of Andrew Eick on Flickr

Photo courtesy of Andrew Eick on Flickr

A few weeks ago we published a blog about how important it is for our children to spend time outdoors to prevent myopia. ‎

Being outdoors is great for helping to prevent nearsightedness and for exercising our eye focusing muscles, but you may wonder what else you need to do to make sure your child’s eyes stay healthy through the summer.

A few things come to mind.  It has become very common practice to never let our children leave the house with out sun protection: Sunblock, hats, UV blocking clothes and bathing suits. But, what is less common is remembering sunglasses for UV protection for the eyes.  Kids playing outdoors in the sun are exposing the lenses of their eyes and their retinas to harmful UV radiation.  Additionally, their lenses are so young that they do not block UV as well as adult lenses thus sending more UV to the retina.  UV damage to the lens and retina can by a cause of early cataracts and Macular Degeneration.  When buying sunglasses for kids, make sure that they are UV blocking and polarized if possible to reduce glare when around water. More information about children and sunglasses can also be found here.

Next, swim goggles are a good idea for the pool to help keep chlorine out of the eyes.  Chlorine can cause redness, burning, and blurry vision as well.  An added bonus would be swim goggles with a little tint or UV protection as well. If your child experiences these symptoms after playing in the pool, ask your eye doctor what eye drops are right to use to help.

Lastly, the use of sports goggles for eye protection during sports activities is also a must for eye injury prevention while playing soccer, baseball and any other outdoor sports.  For more information about preventing eye injury this summer, here is another great resource.

Enjoy your summer, enjoy the outdoors and the sunshine and stay eye healthy and safe!

~Lisa Weiss, OD, FAAO
California Optometric Association
http://eyehelp.org

http://www.coavision.org

 

 

 

 

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Traumatic Brain injury: A rising concern in youth sports

Photo courtesy of K8tilyn on Flickr

Photo courtesy of K8tilyn on Flickr

Spring is almost here, and soon spring sports such as soccer, baseball and softball are going to be in full swing for our kids.

And while we encourage participation in outdoor activities and sports, it is good to be aware of the possible injuries and what to look out for.  According to the Centers for Disease Control and Prevention, emergency department visits for sports related traumatic brain injury (TBI) and concussions have increased by 60% for children and teens in the last ten years. The most common activities that can cause injury are bicycling, football, playground, basketball and soccer.  With this increase, there is also an increased awareness of safety in sports and signs and symptoms related to a TBI that can occur during play. This allows for steps to be taken to improve safety and reduce risk for our kids.

A TBI can occur if a person receives a blow to the head or a jolt to the body the causes quick head movement.  Some signs and symptoms of TBI include:

  • confusion
  • dizziness
  • memory and concentration loss
  • clumsy movement
  • change in mood, behavior, or personality
  • double or blurry vision
  • light and noise sensitivity

Once and injury like this has occurred, symptoms can last up to months and it is important to not go back to sports too quickly as the brain needs time to heal.

Optometrist’s role in treatment

Photo Courtesy of Fitness Hospital on Flickr

Photo Courtesy of Fitness Hospital on Flickr

Optometrists can play a large roll in the healing process from a TBI.

Because the brain nerves related to vision go everywhere in the brain, almost all TBI patients have some effect to their vision system and visual function in some way.  Issues such as memory and concentration loss, dizziness, double and blurry vision and light sensitivity can affect more than just sports performance. These problems can also affect academic performance even in a child who was succeeding academically prior to the injury.  Neurorehabilitative Optometry can address these problems and help improve brain and visual function though the use of specialized vision therapy techniques, specialized glasses and prisms.

If you suspect that a lingering brain injury is affecting your child’s academic performance, an evaluation by a California Optometric Association optometrist can help determine what can be done to help and refer you the appropriate optometrist specialist that can assess and treat the visual problems associated with the head injury.

Play Hard and Be Safe!

~Lisa M. Weiss, OD, FCOVD
California Optometric Association
http://www.eyehelp.org
http://www.coavision.org

CDC resources for parents and coaches on TBI and concussions can be found here.

What if my child’s eyes are crossed? Strabismus 411.

HELP! It looks like my child’s eye is turning in, or out or I’m not sure. What do I do? What is strabismus anyway?

Photo courtesy of mjtmail (tiggy) on Flickr

Photo courtesy of mjtmail (tiggy) on Flickr

Strabismus, or crossed eyes, is a condition in which both eyes do not look at the same place at the same time. It occurs when an eye turns in, out, up or down. Strabismus is classified by the direction the eye turns:
• Esotropia = Inward turn
• Exotropia = Outward turn
• Hypertropia = Upward turn
• Hypotropia = Downward turn

There are six muscles attached to each eye that control eye movement. Normally, the eyes work together so both eyes look at the same place at the same time. An eye turn may be visible when there are problems with eye movement control.
The eye turn may be present constantly or only at certain times such as when the person is tired, ill, or has done a lot of reading or close work. One eye or both eyes may alternate turning.

Proper eye alignment is important to avoid seeing double, for good depth perception, and to prevent the development of poor vision in the turned eye.

What causes strabismus?

There are many causes, including:

  • Eye muscle problems.
  • Problems with the nerves that transmit information to the muscles.
  • Trouble with the control center in the brain that directs eye movements.
  • General health conditions or eye injuries.

What are risk factors for developing strabismus?

  • Family history – Those with parents or siblings who have strabismus are more likely to develop it.
  • Refractive error – Especially a large amount of uncorrected farsightedness (hyperopia).
  • Medical conditions – Including Down syndrome, cerebral palsy, stroke or head injury.

How is strabismus diagnosed?
Strabismus is diagnosed through a comprehensive eye exam. Testing may include:

  • Visual acuity, or vision – “Normal” distance visual acuity is 20/20.
  • Refraction – Determine the appropriate lens power needed to compensate for any refractive error (nearsightedness, farsightedness, or astigmatism).
  • Alignment and focusing testing – How well the eyes focus, track, move and work together.
  • Examination of eye health – This includes the front and back of the eyes. Eye pressure is also evaluated.

Because vision may change frequently during the school years, regular eye and vision care is important.

How is strabismus treated?
There are several treatment options to treat strabismus, including:

  • Eyeglasses or contact lenses – For some conditions, glasses alone will align the eyes.
  • Prism lenses – Prisms align the images seen by both eyes, so the eyes can fuse or see the same image, restoring visual clarity and depth perception.
  • Vision therapy – Vision therapy trains the eyes and brain to work together more effectively.
  • Eye muscle surgery – Surgery may be able to physically align the eyes so they appear straight. A vision therapy program may also be needed after surgery.

What can happen if the eye turn is not treated?

Photo courtesy of jmoneyyyyyyy on Flickr

Photo courtesy of jmoneyyyyyyy on Flickr

Potentially an untreated eye turn can lead to amblyopia, otherwise known as lazy eye. Amblyopia is permanently reduced vision in one eye.

When does a child develop strabismus?
Typically strabismus develops in infants and young children by age 3. It may be present in older children and adults. Children do not “outgrow” strabismus.

Most importantly…
If detected and treated early, strabismus can often be corrected with excellent results. Eye examinations are important for all children and adults, starting at 6 months of age. If any eye turn is in question, schedule a comprehensive eye examination immediately.

~Melissa Barnett, OD, FAAO
California Optometric Association
http://www.eyehelp.org
http://www.coavision.org

Health care reform & vision coverage for your children

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Children’s vision now covered by most plans
If your child is covered by an individual or group health insurance plan in California, their annual eye exam and eye glasses are covered with no out-of-pocket cost until the child reaches age 19. This is required for health plans purchased through or outside Covered California.

Legal residents of California will be able to get health coverage through a new marketplace established by Covered California. Starting in 2014, there will be several new and expanded government programs, including Medi-Cal, that offer financial assistance to reduce the cost of health insurance.

covered california2

  1. Premium assistance — Federal help will be available to reduce the cost of an individual’s or family’s monthly health insurance payments.
  2. Cost-sharing assistance — Cost-sharing subsidies reduce the amount of health care expenses an individual or family has to pay at the time of medical care.
  3. Medi-Cal assistance — Starting in 2014, Medi-Cal will cover more people under age 65, including people with disabilities and those with incomes $15,856 or less a year for a single individual and $32,499 or less for a family of four. Medi-Cal is free for those who meet the requirements and is part of the changes included in the Patient Protection and Affordable Care Act (Affordable Care Act).

An online calculator at the Covered California website helps estimate how much it will cost to purchase health insurance in 2014 and the amount of financial assistance available to qualified individuals. In addition, by completing a Covered California application, an individual will learn whether he or she qualifies for financial assistance.

~Kristine Shultz, Government and External Affairs Director
California Optometric Association

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

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 2nd 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
  1. 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

Are computers bad for my child’s eyes?

This is a question that patients often ask me. Sometimes parents hint that they want me to tell their kids to stay off the computer/tablet/smartphone and others just really want to know how much is too much.  The fact of the matter is this: technology is not going to go away. It is everywhere. We do want our kids to be tech savvy and take advantage of all of the great learning experiences that technology offers, don’t we? We just need to be smart about it.

Courtesy of Paul Mayne on Flickr

Courtesy of Paul Mayne on Flickr

Using too much technology at a near point can have several negative effects on the body and on the visual system.  Kids who spend a lot of time in front of their devices, are less active physically and can have difficulty with posture.  We know that childhood obesity and diabetes is on the rise. One way to combat these diseases is to keep our children active, which means less time in front of the computer.

Computer vision syndrome is not a term that only applies to adults.  Symptoms such as eye fatigue, blurry vision, red eyes, headache and difficulty shifting focus to objects at a distance after computer use can also affect kids.  When focusing is fixed at a certain object in space for a long time, a child’s developing visual system does not get the benefit of practicing how to focus at different distances. This can cause persistent  problems with clarity of vision and possibly reading problems.

So how much is too much? A rule of thumb I usually give my patients is if school-aged children use the computer for schoolwork or for recreation, they should be on it for no more than 40 minutes without a break. By break, I mean at least 5 minutes away from the desk – getting up, looking outside, getting a drink of water and moving around.  For younger kids, try no more than 20 minutes per day. In fact, keep younger kids off electronic devices as much as possible. Encourage more free play, book reading and imagination. Try to use the technology only as needed or as a reward, not as a given or expected everyday activity.

There will be plenty of time to use technology as they get older. As I said, it is not going to go away!

Courtesy of sean dreilinger on Flickr

Courtesy of sean dreilinger on Flickr

In the meantime, do what you can to make computer use safe. Make sure children have annual comprehensive eye examinations to make sure their eyes are not being adversely affected by computer use.  Make sure the computer station is set up ergonomically for your child. The monitor should be slightly below eye level and a foot stool should be used to prevent dangling feet. Minimize glare on the computer by using glare filters and by positioning the computer away from windows as much as possible. These suggestions will help with healthy computer use for our children.

~Lisa Weiss, OD

It’s just the FACTS: Vision & Learning Go Hand in Hand

August has been recognized as the Vision & Learning month.  It would seem appropriate since many children return to school in August or shortly thereafter.  In addition to getting new clothes and supplies for our kids, this yearly routine should spur us to take our children in for a comprehensive eye and vision examination.

Vision is a highly complex and intricate process.  So, it is not surprising that reading and learning is dependent on not only having excellent 20/20 vision, but also accurate eye movement, eye focusing, eye teaming, and visual motor skills.

It’s just the plain ole fact that there is a direct correlation between vision and learning.

Courtesy of woodleywonderworks on Flickr

Courtesy of woodleywonderworks on Flickr

Did you know that…

  • “25% of students in grades K-6 have visual problems that are serious enough to impede learning.” – American Public Health Association
  • Approximately “80% of children with a learning disability have an  undiagnosed vision problem.”– Vision Council of America
  • “1 in 4 children has an undiagnosed vision problem which can interfere with learning and lead to academic and/or behavioral problems.”  – College of Optometrists in Vision Development
  • Studies show that “children who had visual perceptual and eye movement difficulties did poorly on standardized tests.” – Dr. Lynn Hellerstein, FAAO, FCOVD, Past President of COVD
  • “When vision problems go undetected, children almost invariably have  trouble reading and doing their schoolwork.  They often a display fatigue, fidgeting and frustrations in the classroom – traits that can lead to a misdiagnosis of dyslexia or other learning disabilities.” – American Optometric Association
  • A “child with a vision based learning problem has excellent verbal skills, causing parent and educators to think the child must be lazy, have ADD/ADHD, or is learning disabled.”
    – College of Optometrists in Vision Development

A cursory vision screening is just not enough to detect vision-related learning difficulties.  Early prevention of a child’s vision problem is so important for school readiness, learning and academic success.  So make it an integral part of your child’s back-to-school preparations.  Buy school supplies, outfit your child with new clothes, and most important, take your child to see a doctor of optometry for a thorough eye and vision examination.

~Judy Tong, OD, FAAO

(Special thanks to my colleagues Drs. Carmen Barnhardt, Eric Borsting, Ray Chu, and Rebekah Louie.)