KEEP AN EYE ON YOUR CHILD’S VISION

Weak eyesight has nothing to do with age anymore. An increasing number of children are complaining of it     Have you noticed a substantial rise in the number of children wearing glasses? Well, there's a reason for it. Experts say kids these days have more eye-related problems since the load placed on the eye has significantly increased.  Not only has the quantum of school work increased, new technology has also led to massive eye strain. Says Ophthalmic surgeon Dr Keiki Mehta, "Ideally, for a growing child, nearpoint application, which includes reading on computers and tablets, should be restricted to two to four hours per day. However, the increasing emphasis on competition, at an even earlier age, has led to excess pressure on their developing system."      Consultant cataract and refractive surgeon Dr Nikhil Nasta says many problems leading to visual loss are related to lifestyle. "Vision depends on a clear lens and rich microcirculation to the retina and the visual nerve cells of the retina called rods and cones. These are adversely affected when exposed to toxins and oxygen-free radicals. Poor dietary habits can also be harmful," he says.  COMMON EYE PROBLEMS IN CHILDREN Near and far sightedness:  Dr Nasta says refractive errors (spectacle number) account for 80% of visual impairment in kids. "This includes Myopia or nearsightedness, where distance vision is blurred, but a child can usually see well enough to read or do other such tasks. This occurs most often in school-going children. The prescription for glasses will indicate a minus sign before the power (for example, -2.00). Another problem is Hyperopia (far-sightedness), because of which crossing of the eyes, blurred vision or discomfort may develop. Most children are far-sighted early in life and it becomes a concern only in extreme cases where the focusing muscles are not able to keep the vision clear. A prescription for hyperopia will be preceded by a plus sign (+3.00)," he says.  Astigmatism:  This is commonly caused by a difference in the surface curve of the eye. Instead of being shaped like a perfect sphere (like a basketball), the eye is shaped with a greater curve in one axis (like a rugby ball). This causes fine details to look blurred or distorted. Prescribed glasses have greater strength in one direction of the lens than in the opposite      direction.      Anisometropia:  This problem causes children to have a different prescription in each eye. This can create a condition called lazy eye, where the vision in one eye does not develop normally. Glasses (and sometimes patching) are needed to ensure that both eyes can see clearly. Lazy eye or Amblyopia:      Seen only in one per cent children, it is a failure of the eye to connect to the brain due to lack of use of one eye during infancy and childhood. Therefore, the vision in the amblyopic eye remains poorer than in the normal one.      To solve this, the weaker eye is forced to be used by patching the other one. Treatment also includes using glasses if necessary. Amblyopia must be corrected by nine years of age, by when it becomes permanent. To detect and treat amblyopia, it is necessary to examine preschool age children.  Squint or Strabismus  "Also called crossed-eyes, this means that the eyes are not aligned but are pointing in different directions. They may either point inwards towards the nose (esotropia), outwards to the ear (exotropia) or up or down (vertical strabismus). The problem can be constant or intermittent. However, intermittent strabismus occur in the first few months of infancy, especially when the baby is tired, since they are still learning to focus their eyes and to move them in a coordinated fashion. Most babies outgrow this by the age of three months. For others, various treatment options are available, including exercises for the eyes called orthoptics. Other common eye problems in kids include cataract, glaucoma and retinal problems," adds Dr Nasta.  SIMPLE THINGS MAKE A DIFFERENCE  • All children need the same nutrients, no matter what their age. A healthy diet with an emphasis on fresh vegetables, fruits, whole grains, beans, seeds and nuts is a must. For non-vegetarians, add eggs and a small amount of fish. Avoid addictive sweets as well as junk food. Natural, unprocessed foods help preserve circulation to the retina, rods, cones and lens.  • Regular exercise helps maintain low blood pressure and preserves blood vessels, which the retina is rich in. It also helps support the health of endothelium, the cells that line the arteries. These cells relax blood vessel muscles and maintain blood flow.  • Lens and retina are damaged when exposed to ultraviolet light. However, moderate sun exposure is healthy. Widebrimmed hats and UV filtering sunglasses (in older children) protect the eyes.  • In India, over 25% of childhood blindness is due to Vitamin A deficiency. Many dietary supplements improve vision and protect the macula (the area of the retina with the sharpest vision) and the lens. These are vitamins E and C, and the trace minerals Selenium and Zinc. Others are amino acid Taurine, carotenoids such as betacarotene, lycopene (found in tomatoes), lutein (from spinach) and anthocyanosides (found in grapes).      — Dr Keiki Mehta  WHAT TO DO  • Increase rest periods and emphasise on ocular hygiene. Reading in good light and keeping the book at a minimum distance of 12 to 14 inches are basic requirements. • Playing sports is one of the best ways to increase blood circulation to the eye and end point mobility.  • A child should study in an area where he/she does not face the wall. It is preferable if they sit near an open window or in one corner of a big room — this way, when they look up, they can look into the distance and relax.  • While taking breaks in between studies, the eyes need to be relaxed. Reading a comic book or playing on a computer or cell phone defeats this purpose.  • Yearly eye check-ups are recommended for children.  Eye examination in children  A pediatrician should examine a newborn's eyes. An ophthalmologist should examine all premature infants. Vision screening should be done between three and threeand-a-half years of age. Detailed eye examination is a must if there aresymptoms of visual impairment.