The basic tenets of eye care in children are not very different from that of adults. To makes sure that their eyes remain healthy, we should ensure a proper balanced diet and nutrition; prevention of eye injury, infections and allergy; limitation of screen time and schedule regular eye examinations in order to screen for eye diseases and vision problems.
Common eye diseases in children include refractive error, amblyopia, squint, ptosis and blocked tear ducts.
Why do children’s eyes need special care?
- Often, kids cannot express their discomfort and/or inability to see clearly, or do not do so in order to avoid wearing glasses, or using eye drops.
- Kids spend a lot of time outdoors, and so are more prone to allergies, infections and also trauma.
- Several childhood eye diseases may irreversible loss of vision. Even refractive errors, if not treated in time can cause permanent irreversible vision loss called amblyopia or lazy eye.
What are the basic tenets of eye care in children?
Ensure a healthy, well-balanced diet
A well balanced diet is essential for overall development, as well as vision and eye health and therefore is a cornerstone of proper eye care in children. This is equally true for adults, but assumes greater importance in children, since they are often fussy eaters. Also, junk food is extremely popular in this age group, which only provides empty calories, and can cause several nutritional deficiencies.
These factors can result in several nutritional deficiencies, for example, vitamin A deficiency in children which can potentially cause loss of vision. Symptoms of Vitamin A deficiency include keratomalacia, night blindness, dry eyes and blurred or clouded vision.
The best sources of vitamin A include:
- Sweet potatoes, squash
- Dark leafy green vegetables including spinach and collard greens
- Carrots
- Dried fruit (especially apricots)
- Fish (tuna, mackerel)
- Yellow fruits like mango and papaya
Similarly, zinc is a micronutrient that is essential for the eyes and its deficiency can cause problems, such as poor night vision and cloudy cataracts. Zinc is found in wheat germ, liver and pumpkin seeds.
We must ensure that each child has the recommended daily allowance of all essential micronutrients, and vitamins.
Limit screen time
Excessive screen time results in eye strain and Computer Vision Syndrome, and so must be regulated. While we do not know if excessive screen use can result in damage to vision, it’s better to err on the side of caution. There is enough evidence from clinical trials to say that playing outside reduces the incidence of myopia in children, and the besides aiding overall development and health. So we must encourage children to play outdoors rather than on smartphones and X-boxes alone.
Use age appropriate toys, and ensure supervision for small children
Injuries during playing with toys and during sports are an important cause for childhood blindness and ER visits. Prevention of trauma to the eye is imperative for ensuring proper eye care in children. Therefore, it is essential to ensure that the toys children play with are appropriate for age, and do not have sharp, broken and jagged edges. We must also provide the kids with proper safety equipment like helmets and protective goggles during high risk sports. We should avoid giving toys like bow and arrow, and guns which shoot projectiles to children. Avoid firecrackers, or at least ensure adult supervision, as they carry a high risk of eye injury.
Help prevent eye infections
We must remember to encourage hand hygiene and discourage eye rubbing in order to prevent eye infections due to spread of germs from grubby hands. We must teach children to avoid touching their eyes, and if absolutely necessary, they must do so only after washing their hands with soap and water. In certain cultures, kohl is applied inside the eyes of children, and can often cause eye injuries and infections.
Schedule regular eye examinations
Remember, children often cannot tell you that their vision is not perfect. They will also refrain from telling you about vague discomforts and strain because they are scared of eye drops and glasses. You must, therefore, take your child for regular eye examinations. This will ensure that any refractive errors and other eye diseases are detected and treated as early as possible.
More importantly there are several eye diseases do not have symptoms. These diseases can only be detected by a comprehensive eye examination. These disorders, if not detected in time, can often cause irreversible damage to the child’s vision.
A vision check in school, or a routine visit with your pediatrician is not sufficient, and ophthalmologists suggest a proper eye check-up strictly as per schedule.
The American Academy of Ophthalmology recommends the following (Read more at https://www.aao.org/clinical-statement/frequency-of-ocular-examinations) directives, in order to ensure adequate eye care in children:
High risk infants and children
Infants at high risk must be identified. These include children at risk for retinopathy of prematurity and those with a family history of retinoblastoma, childhood cataracts, childhood glaucoma, or metabolic and genetic disease. These children must have a comprehensive examination by an ophthalmologist as soon as possible.
All infants and children
All children must have a screening evaluation for eye health in the newborn period and at all subsequent visits. Any suspicion requires an expert opinion regarding eye health.
School age children
All school-age children should be evaluated regularly, at least once a year. Mandatory tests include tests for visual acuity, refractive errors, amblyopia and squint.
What are the common eye problems affecting children?
The common eye diseases that affect children include:
- Refractive errors (myopia, hyperopia, astigmatism)
- Strabismus or squint.
- Amblyopia(Lazy Eye)
- Conjunctivitis(Pink Eye): which may be allergic or infective
- Eye injuries
- Eye infections: stye, chalazion, keratitis
- Ptosis or drooping of eyelids
- Abnormalities of tear drainage like nasolacrimal or tear duct block
- Vitamin A deficiency
- Childhood cataract
- Childhood glaucoma
- Tumors like retinoblastoma, lymphomas and leukemias
- Genetic disorders like retinitis pigmentosa, heredomacular degenerations etcetera
