Children’s Vision And Learning
pEDIATRIC oPTOMETRY in Mississauga
Since 80% of what a child learns is through their vision, children with vision difficulty will likely suffer academically or have to work extra hard to overcome their visual discomfort or deficit. 1 out of every 3 children has a vision problem, yet children lack the experience before the age of 9 or 10 to know what normal vision is. Most parents are often surprised to find out their child needs visual assistance through either glasses, contact lenses, or visual training exercises.
Many children are misdiagnosed as learning disabled, when in fact, they have a correctable vision disorder. It is therefore recommended children have a thorough eye examination by an optometrist on a yearly basis from the age of 3 and infants should have their first eye exam at age 6 months.
School vision screenings should never take the place of a complete eye health and vision exam by a trained optometrist or ophthalmologist. A lack of early, routine eye exams can unfortunately result in an otherwise avoidable permanent visual deficit, known as lazy eye or amblyopia.
What you should know after your child’s exam:
- Are my child’s eyes healthy?
- Can my child see well at all distances and without eyestrain?
- Does my child see colors normally (boys especially)?
- Does my child have comfortable, coordinated binocular vision and depth perception?
Here are some symptoms that may indicate a child is having vision problems:
- sits close to the television
- has trouble reading or avoids reading tasks
- has trouble recognizing faces
- often squints
- tilts their head frequently to one side or angle
- is clumsy or bumps into objects frequently
- demonstrates anti-social/shy behavior
- experiences frequent headaches
- is having difficulty at school despite good effort
Myopia Control Therapy
New service now available! Myopia Control Therapy aims to slow or halt the progression of myopia/nearsightedness in children. With increased screen time at the expense of outdoor activities, myopia is growing at epidemic proportions. Nearsighted individuals see better near than far. Myopia is often the result of a growing eye, that inaccurately focuses light in front of, rather than on the retina – the photographic film at the back of the eye. Higher amounts of nearsightedness (greater than -6.00D) is correlated with an increased risk of the following: cataracts (5 x greater), macular degeneration (40 x greater), glaucoma (2.5 x greater) and retinal detachment (21 x greater). A number of treatment options exist that have been found to diminish the eye’s axial length growth and the corresponding myopia progression. Arrange a consult to determine which modality of myopia control is best suited for your child. To learn more about this subject, click here, or continue reading below.
To calculate your child’s future myopia based on their specific risk factors, visit www.MyKidsVision.org
When should we start Myopia Control Therapy?
The sooner the better! Studies show the earlier a child becomes myopic, the faster their distance vision and glasses prescription will worsen. If we are going to have the biggest impact on slowing myopia progression, we should act quickly. Half of myopic children stabilize by age 16, 75% will stabilize by age 18, while 90% will stabilize by age 21. Higher levels of myopia is associated with higher risks of eye disease and vision impairment in adulthood.
Sign up for the Myopia App – this ingenious digital device app measures how closely the device is being held and darkens the screen if it is too close, revealing the screen again when it’s held at or further than the ideal distance. Developed by a team of scientists and optometrists, early research on this app has shown it effectively modifies screen time behavior, making a significant reduction in visual strain.
Atropine Drop Therapy For The Control Of Myopia Progression
Low dose atropine eye drops can slow eye growth and myopia progression. They are taken once daily before bed, are generally well tolerated. Side effects include sensitivity to light due to enlarged (dilated) pupils and problems with reading vision due to reducing the eye’s inherent focusing mechanism. These side effects can be managed with spectacle lenses which darken when outside (called Transitions or photochromics) and that also incorporate a stronger power in the lens to support reading (a bifocal or progressive addition spectacle lens). Dr. Sciberras will advise on the treatment options and monitor their effects over time.
The most effective spectacle lens design for myopia control, according to recent research, is the Defocus Incorporated Multi-segment Spectacle (D.I.M.S.) lens, or Miyosmart, which has shown a 62% myopia control effect in a six-year study.
Miyosmart by Hoya
Miyosmart spectacle lenses are made up of a central clear optical zone for correcting myopia, with an outer band of defocus that acts to control myopia progression (D.I.M.S. lens design). The lens makes use of the natural eye adjustment known as “emmetropization”, where the eyeball reshapes to receive focused images. The Miyosmart lens was found to:
– slow myopia progression on average by 59%
– reduce the eye’s axial length growth by an average of 60%
– have completely halted myopia progression in over 20% of participants
Here is an image of the D.I.M.S. lens design. Each of the small segments seen in the periphery of the lens adds +3.50D of power to create a myopic defocus, image lands in front of the peripheral retina, to help slow elongation of the eye. These lenses have equal adaptation and acceptance to standard single vision lenses, with the benefit of slowing myopia progression in children.
Ortho K as it is better known, has been around for decades and involves the precise fitting of a rigid contact lens to reshape the surface of the eye (the cornea) to correct vision during sleep. The lens is removed on waking. Orthokeratology restores clear vision in the day for glasses-free vision. It also slows or halts the progression of myopia and vision deterioration over time.
MiSight: The First Daily Disposable Lens Proven To Slow Myopia
These FDA approved lenses offer a new tool to fight the progression of myopia in children. Studies have found MiSight contact lenses effective in reducing the progression of myopia (nearsightedness) in children by 59%. The daily disposable format means no cleaning or storage required, improving both eye health and comfort. Learn more here: “A Parents’ Guide to Contact Lenses.”
Recommended Screen Time
- 0-2 years of age should have no screen time. Watching a screen at a young age can limit time for active play and learning, reduce opportunities for language development and inhibit their attention skills.
- Children aged 2-5 years should have a maximum of 1 hour per day. Infants, toddlers and pre-schoolers should not be inactive or sedentary for more than one hour at a time, except for sleeping. In this age group, excessive screen time is associated with less outdoor, creative and active play time; poorer language skill development; poor social skills and an increased risk of obesity.
- Children of school age (5-17 years) should be limited to 2 hours of recreational screen time per day. When using screen-based electronics, positive social interaction and experiences are encouraged. Sleep is also so important in this age group. Children aged 5-13 years should have an uninterrupted 9 to 11 hours of sleep per night and 8 to 10 hours per night for those aged 14–17 years. Consistent bed and wake-up times are very helpful, as are restricting screen time 2 hours before bed and removing screens from the bedroom where possible.
- Apply the 20-20 Rule: take a break from reading or screen time every 20 minutes for 20 seconds. He or she should look across the room to relax the focusing muscles in the eyes before commencing near viewing. This can be managed as a break between book chapters, between Netflix episodes for tweens and teens, or timers set for younger children.