AskMeDoctor! Season 4 Episode 3: Does My Child Need Glasses?

Undetected vision problems can impact your child’s performance, both in and out of the classroom. Therefore, it’s important to understand eye health so you can recognise the signs that your child may have a vision problem and possibly need glasses. Today, we are very fortunate to have Dr Malisa Ami to help parents understand better about the topic. She is an ophthalmologist from Sunway Specialist Centre Damansara, specialising in Paediatric Ophthalmologist and most important, she is a mother of four. Q1: Why does my child need glasses? Dr Malisa: The most simple answer to why a child needs glasses is for them to see clearly. So, what are glasses for? Glasses are visual aids — glasses or spectacles that will refocus the light so that the child can see clearly and this occurs in children with problems of refractive errors. Types Of Refractive Errors The most common is myopia which is nearsightedness; when a child sees something near clearly but far vision is blurry. Another type of refractive error is hypermetropia which is the opposite of myopia where they can see clearly from far but near vision is blurry. Or astigmatism—whenever the focus of light doesn’t fall onto one point and then it causes blurry vision. Maybe I shall explain with this eye model. Refraction is a process of the eye focussing the light to the sharp point on the retina. So, the structures that focus the light are the cornea; the clear transparent window in the front of the eye and the lens. Myopia The refractive system or the focussing system is too powerful or the eyeball is too long. Therefore, the light is refracted and focussed at a point in front of the retina. So, it falls short. So, a lens is used to refocus the light and pushes the focus light back onto the retina. Therefore, the vision will be clear when that occurs. Hypermetropia Is the opposite, whereby the eyeball is either too short or the focussing system is too low making the focussing light fall behind the retina. So, again, glasses will correct that. Astigmatism Is when the surface of the eye is not regular. So, glasses with different steepness and curvature at different angles will correct that and help a child to see clearer. Q2: How to know that my child needs glasses? Dr Malisa: As I’ve mentioned before, the best way is to get your child tested for their vision. Either with an Optometrist or at the eye clinic, with an Ophthalmologist. But, there are certain signs that parents can look out for that may indicate that the child has vision problems. So, for refractive errors myopia, sometimes kids will squint their eyes together, bring the two eyelids close together when they want to look at something far. Because that sort of streamlines the ray of light, so that they can see a bit clearer. The kid might have a persistent head posture when they’re viewing an object, like watching television, they might turn their face to one side or have a bit of head tilted and it’s always at the same side or the same position. And if it’s very persistent, parents should bring their child for a vision check. Older children may complain and say that they can’t see clearly or even teachers at school, in their classes would notice this and inform the parents. Other things for younger children, sometimes they can have eye blinking or eye rubbing and they can become sort of tired after looking at something for a long period of time which indicates that maybe they have a bit of eye strain. Normal visual behaviour also includes that the child is able to coordinate very well. Their motor coordination is good. There’s no problem in running, in catching a ball, in pouring water into a glass. So, if there’s any problem in those situations, then parents might think that: “Oh, is it because the child is not seeing well?” Sometimes kids can also have squint, which is the eyes are not straight, one eye can either be turned in or turned outwards. If that occurs, of course, then you should get the child’s eyes checked. Q3: Does too much screen time also could be the cause of needing glasses? Dr Malisa: I did mention earlier about what can prevent myopia. So, one of them is reducing near work activities. Studies have shown that prolonged and intense near work activities can bring the development of nearsightedness which is myopia. So, near work activities are looking near for example: reading looking at digital screens Which include handphones iPads laptops computers Image Credit: Motherhood Story So, those are near work activities. There’s a recent study in Hong Kong, China, looking at children before and during the pandemic, they found that can use this as a teaser opening because of the lockdowns during the pandemic, that the occurrence of myopia has nearly doubled in children due to the prolonged lockdowns, staying indoors. Another problem with prolonged digital screen time is that kids can get eye strain. This is because whenever we look at something nearby, we have to focus. So, the focussing muscles of the eye become really tired. So, they can get; fatigue eyes headaches dry eyes Image Credit: Motherhood Story So, the way to alleviate this is to take frequent breaks to relax the eyes. So, we called it the rules of 20-20-20. For every 20 minutes that you use digital screens, take a break for 20 seconds by looking at far objects at 20 feet away. Q4: Do glasses with blue light filters help protect the kids’ eyes from blue light? Dr Malisa: I think there have been concerns about the harmful effects of blue lights coming from digital screens. And there is an increasing popularity of blue light blocking dark glasses. Blue lights are something that occurs naturally around us. The biggest source of blue light is the Sun, so we are exposed to blue lights naturally anyway. Theoretically, blue light with shorter wavelengths which has higher energy can be harmful to the retina. But, the blue light that is emitted from the digital screens; whether your handphones, computers or laptops, are off the lower energy level. So, it is not harmful. And there is no concrete scientific evidence saying that using your computers for a long period of time or handphones are harmful to the eyes. Like you said, nowadays, these devices have built-in blue light filters. And yes, I would use those sorts of filters to help with eye strain and to minimise the brightness, especially at night. But, wearing special eyewear sort of eyeglasses to block the blue light, I can’t strongly recommend it because I don’t have enough strong evidence showing that it actually prevents harm to the eyes. So, actually, what’s more important is limiting the screen time and taking frequent eye breaks. Because, another thing about giving blue light blocking glasses to children is I’m afraid that it can become a false sense of security for the parents; thinking that; “Oh, my child is protected with these glasses, so if they spend one or two hours on the screen, then it’s okay,” Like you might have a lower threshold of stopping them from being on the screen. But, in saying that exposure to blue light before sleep: Affects someone’s ability to sleep Disrupts the circadian rhythm Suppresses the melatonin hormone that is important to tell our body that it is night time, time to sleep. So, what I would advise is to tell your children and yourselves, to not use digital screens at least one or two hours before sleep. So, you will get a better quality of sleep. Q5: Can my child outgrow the need for glasses? Dr Malisa: Depending on the types of refractive error. For a child who has myopia, which is nearsightedness - like I said, because the light is focussing in front of the eye. So, as the child grows, the eyeballs will grow longer. So, the child will need high power to correct that. The power will increase. Unlikely, myopic children will outgrow their glasses. Conversely, a child that has hypermetropia, when the eyeball is too short, and as the eyeball grows longer, the power can be decreased and for some kids, they may outgrow their glasses once they reach their little teens. And for another refractive error, which is astigmatism, so for that, the power will also change as the eyeballs grow because the surface and curvature of the cornea will change with growth. But, regardless of the types of refractive errors, It is important for parents to realise that the glasses’ power will change as the child grows up. Therefore, the children who wear glasses should have their vision and power of their glasses checked periodically. Ideally every six to eight months. Because you want to make sure that correct power is given and good vision is maintained throughout. Advice From Dr Malisa Yes. I would like to summarise the important points of our chat today. #1 It is important for children to get their vision screening To detect the problems early because early detection can prevent permanent vision loss. So, getting vision screening at least at the age of three years old is important. #2 Another thing that we touched on is myopia So, early detection of myopia is important because we want to control it. And parents can do two measures, the two important factors that cause myopia are the lack of outdoor time; so increase the time spent on outdoor activities for at least a minimum of two hours a day. #3 And to reduce the near work activities The digital screen time, near work activities and balance it out with taking frequent eye breaks. #4 Remember the rule of 20-20-20 For every 20 minutes of being on screens or spending on digital screens, take an eye break by relaxing the eyes for 20 seconds by looking at something far 20 feet away. Wow! That is some valuable info about our eyes and how to take of them, Dr Malisa! Hopefully, Mummies and Daddies can fully use this information and try to be cautious of their children eye sights. Go to the nearest eye clinic today to get your children tested. You will never know until you get tested. https://www.youtube.com/watch?vQRMxZWFbIIA Tuned in next time with more videos and knowledge on children's health care. Disclaimer: The information provided in this article is for informational purposes only and should not be considered as medical advice from Motherhood. For any health-related concerns, it is advisable to consult with a qualified healthcare professional or medical practitioner. For more insightful stories and fun recipes, stay tuned to Motherhood Story!

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