By John Messmer
Penn State Family and Community Medicine
Penn State Milton S. Hershey Medical Center
Penn State College of Medicine
October is designated for special emphasis on children's health and, in particular, ocular health. Eye exams start on the day of birth when a newborn's physician first examines the child looking for a normal lens and no obstructions to normal vision. Prematurity can predispose a child to retinal damage. Congenital cataracts and rarely, tumors, can interfere with normal vision. During subsequent examinations in the child's first years, the eyes are checked for the ability to see and for proper alignment.
Crossed or improperly aligned eyes, known as strabismus, are fairly common and are probably the most common of the problems that can lead to amblyopia. In amblyopia or "lazy eye," vision is impaired because the eye has not been used, often because of strabismus, but it can occur if other problems interfere with using the affected eye. Occasionally, nearsightedness in one eye results in amblyopia as the child essentially stops using the less clear eye. As many as one in 20 children have vision impairment severe enough to lead to permanent loss of sight in one or both eyes.
Parents can observe signs of possible eye trouble if their child favors one eye or one eye drifts in and out of alignment, especially when tired or in bright light. Other signs include closing one eye, rubbing the eyes, excessive blinking, tilting the head or holding things too close to them. These signs should prompt an examination by an eye professional.
Often lazy eye can be treated with glasses to correct vision or help line up the eyes. Special eye drops or patching an eye can help strengthen the weaker eye. Sometimes surgery is performed to realign the eyes by adjusting the attachment of the eye muscles. The earlier the treatment is instituted, the greater the success rate.
After the early years, children are at risk for eye injury from any number of sources. Unsuitable toys, particularly small objects and those that shoot projectiles are dangerous. Other common items include pens and pencils, forks and other flatware, edges of furniture, cigars and cigarettes, household chemicals and cleaners and hair care products and devices. Sports injuries are more common in teenage children and include injuries from balls, BB guns, and collisions during sports. About 90 percent of eye injuries are preventable with eye protection gear or increased awareness.
Halloween festivities have been associated with eye injuries. Costumes that include cosmetic contact lenses are discouraged unless the lenses are fitted and prescribed by an eye-care professional and proper sanitation and storage are understood. Hypoallergenic makeup is preferred to masks that can block vision. In all the excitement of the night, props such as swords and spears can endanger children's eyes and should be avoided.
The sun's ultraviolet rays increase the risk of cataracts and macular degeneration later in life. Parents can reduce the risk by helping their children find UV-blocking sunglasses that fit and which their children will wear. Even some inexpensive sunglasses can work if they are labeled as blocking at least 99 percent of UVA and UVB rays. When buying ove-the-counter sunglasses, look through the lenses to be sure your child will be able to see clearly without distortion. Adding a wide brimmed hat cuts down even more on the UV rays reaching the eyes.
The eyes are living organs and need proper nutrition, just like the rest of the body. The popular myth that eating carrots can improve vision is a misconception. Vitamin A found in carrots is needed for proper vision, but eating more than the required amount will not increase visual capacity in a person who is not deficient. Rather, multiple daily servings of fruits and vegetables are very important to maintaining the best health for growing and adult eyes.
Our eyes cannot be replaced. It makes sense to take care of our eyes and those of our children starting at birth.