Children’s Eye Health

August, designated as children’s eye health and safety month, is here! While there remain many pandemic-related unknowns for the 2021-2022 academic year, there are several aspects of children’s eye health on which parents and caregivers can focus to promote healthy vision. From birth to toddlerhood, children’s eyes change rapidly. Central vision and the core connections between what the eye sees and the brain processes develop early in life, with babies being able to fixate on and follow objects by three months of age. By the end of this period, they develop consistent, synchronous movements. At five to six months of age, as babies gain depth perception, they show increased interest in reaching for objects. During this early development, if a caregiver notices jerky, repetitive eye movements, extreme light sensitivity or no sensitivity to bright lights, excessive tearing, no interest in objects dangling directly in front of the baby, or no red reflex and instead a white, opaque eye when photos are taken, talk to the child’s pediatrician, who can perform an initial eye exam and provide best next steps.

A misalignment of the eye muscles, also known as strabismus, often manifests during the toddler years. If a child constantly tilts their head, squints, has poor hand-eye coordination or one or both eyes periodically turn in, out, up or down, be sure to have the child evaluated early; this will allow for timely intervention, if required, preventing long-term vision problems. Despite children’s ability to accomodate and focus on objects at varying distances, some school-aged kids may require glasses for visual improvement, thus optimizing their learning environment. Even though patching and glasses may feel like a “scarlet letter,” it is vital to adhere to recommendations given by the eye care provider in order to prevent permanent vision loss.

While developmental issues are concerning and many are picked up during routine pediatric office visits and preschool screenings, eye injuries are the leading cause of vision loss in children, especially older ones. Fireworks, BB guns, paintballs or any other object that can lead to blunt or penetrating trauma should be avoided altogether or only be used with proper eye protection. As was the case for Javonte McNair, who the author operated on after a severe fireworks injury, the consequences can be devastating. Additionally, most sports related injuries can be prevented by wearing safety goggles, as non-polycarbonate lenses and regular sunglasses can shatter and cause extra harm.

Additionally, the consequences of excessive screen time, which have been exacerbated by virtual schooling and limited outdoor play, are becoming increasingly problematic for children. Too much near work and eye strain can lead to increased myopia, dry eyes and computer vision syndrome. This syndrome, also known as digital eye strain, is associated with headaches, blurry vision, eye pain, and red eyes. In kids who also wear contact lenses, have allergies, or have underlying immune-mediated disease, the ocular surface and tear film can be further compromised, leading to long term eye problems. Adhering to the 20-20-20 rule, with a screen break every twenty minutes to look twenty feet in the distance for twenty seconds, can minimize eye strain. Keeping work at arm’s length and spending forty-five minutes to an hour outdoors daily can further alleviate issues. Finally, many basic recommendations, like eating green, leafy vegetables and carrots, increasing omega-3 in one’s diet by eating tuna, salmon or flax seeds, outdoor play, and maximizing restorative sleep are additional habits parents and caregivers can help their children develop. Together, screening for eye-related abnormalities, preventing eye injuries, minimizing digital eye strain and instilling healthy habits are sure to promote life-long healthy vision.

About the Author:
Tayyeba K. Ali, MD, a physician writer and ophthalmologist, is double-fellowship trained in cornea and uveitis from Bascom Palmer Eye Institute, ranked #1 eye hospital in the United States by U.S. News & World Report. Dr. Ali sees patients at Palo Alto Medical Foundation (PAMF) in Sunnyvale, CA, holds an adjunct faculty position at California Pacific Medical Center (CPMC) Department of Ophthalmology and is a medical specialist on contract for Google Health. She is keenly interested in international medicine, resident education, and taking a closer look at the moral crossroads we face in healthcare. For more information, follow Dr. Ali on Instagram.