August 14, 2018 | POSTED BY | Articles, Clinical Optometry, Clinical Pearls, News
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Happy children in a multi ethnic elementary classroomAs we begin August, parents and kids are gearing up to head back to school. That means that the optometric offices around the country will be preparing for one of the busiest months of the year – back to school eye exam time.

Parents want to see their children succeed and one of the main things to be checked off the list is an eye examination. It’s up to us as optometrists to make sure the students’ visual system is intact and ready to carry them through the school year. Here are 5 tips on educating parents how we can work together to keep their kids’ eyes happy and healthy!

  1. Near Devices and Dry Eye Most kids have some sort of tablet or phone. We know that when people look at something for an extended period of time, especially at near, they blink less. While we typically think of adults who work at a desk of being our typical dry eye and digital eye strain patients, children can also suffer from these conditions. Be ready to answer parents’ questions about their children’s eye symptoms and recommend treKids using digital tablet and laptop on benchatments to help them.
  2. Visual Hygiene Also important is educating parents on monitoring how their kids are using devices, doing homework, or any near work. Visual hygiene is the act of reducing stress on the visual system by doing things such as using proper positioning, lighting, and utilizing the 20/20/20 rule. Ensuring that a child is in the proper setting keeps the demand on the eyes equal and discourages an increase in nearsightedness and astigmatism. A suggested distance for kids to work is at least at their Harmon distance – the distance between the elbow and the first knuckle. This decreases accommodative demand for the child. To decrease fatigue, it is also recommended that everyone (kids and adults) work with ample, full lighting on their material, and have their work elevated at 20 degrees to place less stress on the eyes and neck. With any extended work, a good rule to follow is the 20/20/20 rule – every 20 minutes take a 20 second break and look at least 20 feet away, allowing the eyes to relax.
  3. Amblyopia Much more common than pediatric ocular cancers, and one of the most concerning and necessary eye conditions to watch for in kids is amblyopia. It is estimated that 2-4% of children have amblyopia. Amblyopia is a condition in which both eyes don’t work together, making one (or more rarely, both) eyes incapable of being corrected to 20/20 (without an obvious pathological or structural cause)³. The most common categories of amblyopia are anisometropic (or refractive), strabismic, and deprivational. It is imperative that we watch children closely, as vision in an amblyopic eye can continue to worsen without intervention. This starts with monitoring infants during InfantSEE exams and continuing with regular exams while kids progress through childhood.InfantSEE
  4. InfantSee We can start by educating new moms and dads on the InfantSEE program. Doctors around the country sign up to be providers that donate their time to give no-cost comprehensive eye exams to babies 6 to 12 months. The exam is meant to recognize any red flags to major issues such as eye movement disorders, amblyogenic factors, and ocular cancers, namely retinoblastoma (the most common intraocular pediatric malignancy). Catching retinoblastoma early is vital, as more than 9 out of 10 of children are cured, however long term survival of the child is highly dependent on whether or not it has spread outside of the eye¹.
  5. Sunglasses We often think about putting our sunglasses on when we are outside, but even more important is the need for kids to wear UV protection when outside. One study estimated that only 5% of parents diligently keep sunglasses on their kids (4). The lens within the eye is at its clearest when we are children, and therefore the sun is able to maximally reach the retina at this time. The best way to prevent sun damage to the adnexa, cornea and conjunctiva, and retina is to put sunglasses on those kiddos. What is the best way to do that? The Vision Council suggests parents let their kids pick out a pair they like!

A special thanks to Dr. Alissa Proctor, Associate Professor at the NSU Oklahoma College of Optometry, for suggestions to improve this article!

  1. https://www.cancer.org/cancer/retinoblastoma/treating.html
  2. https://www.aoa.org/patients-and-public/eye-and-vision-problems/glossary-of-eye-and-vision-conditions/amblyopia/amblyopia-faqs
  3. https://www.preventblindness.org/amblyopia-lazy-eye
  4. https://www.thevisioncouncil.org/content/uv-eye-protection/kids