Too much screen time and other dangers to the normal development of a child's eyesight have been identified by Dr Phil Dang, clinical optometrist with Australia's largest network of eye care clinics. Dr Phil suggests that parents monitor the daily activities of their kids to ensure they develop good habits to optimise their sight.
While working with children at PersonalEYES, which specialises in optometry, ophthalmology and corrective eye surgery, Dr Phil has highlighted the over-use of screens, too much close work, and a lack of time playing outdoors as the key threats to a child's sight.
Dr Phil reveals the top six childhood habits that parents are best to monitor, to help prevent vision problems later in life.
Too much screen time
Dr Phil says that eye experts believe there is a strong association between myopia – short-sightedness - and excessive -near work' activities, including using screens, tablets and phones and reading. 'Short-sightedness is thought to be caused by genetic and environmental factors. Unfortunately, you can't choose your parents, but minimising environmental risk factors may prevent myopia progressing."
What to do
While the jury is still out on the specific length of time it takes for -near work' to cause vision problems, most experts' recommend that kids avoid excessive screen use and they encouraged regular rest breaks. 'This means get them focussing on a distant object, leaves on trees or a picture on the wall, at least every 20 to 30 minutes," Dr Phil says. 'This makes the eye move in a different way, with a range of focus leading to healthy development."
Staying indoors too long
Allowing kids to stay inside over long periods can effect the way their eyes grow. Dr Phil says, 'Time outdoors has been shown to have protective qualities against myopic progression. The mechanism that makes time outdoors protective involves the light-stimulated release of dopamine from the retina, which inhibits axial elongation of the eye, the main structural cause of myopia."
What to do
Start with indoor games that children like, then take the same games outside. Studies recommend play time of at least half an hour a day with balls, bats and aiming games such as bowls.
Not checking your child's prescription regularly
Like the rest of their body, a child's eyes change and grow over time. This means glasses can quickly become redundant. 'Children who wear incorrect prescription glasses may be at risk of amblyopia often referred to as lazy eye. This is where the connection between the eyes and brain fails to develop as a result of deprived visual signal," Dr Phil says. 'If a child has the wrong prescription for too long it can be difficult to improve their vision in the long run and there is not a lot you can do."
Other consequences of an incorrect prescription are blurred vision, headaches and eyestrain – all of which can disrupt a child's learning experience.
What to do
Prescriptions should be checked every year or more regularly if you suspect your child is struggling. A test will reveal if a child has developed a lazy eye allowing for early treatment. 'Lazy eye can require up to a year's treatment of eye patching – and is only successful if caught early."
Wearing sunglasses all the time is safer than going without
Dr Phil says that while playing outside for at least half an hour a day is important, it's a good idea for children to wear sunglasses. 'Eyes need light exposure for development, but this refers to a different wavelength of visible light. Exposure to too much UV light, however, can have serious consequences; pterygiums, cataracts and photokeratitis," Dr Phil says.
What to do
Buy sunglasses from a reputable retail outlet or your optometrist. Novelty or toy sunglasses should be avoided – ensure glasses meet the Australian Standard AS/NZS 1067:2003 and have an eye protection factor (EPF) of 10. Broad-brimmed, legionnaire or bucket-style hats will also shade a child's eyes, reducing the amount of UV radiation reaching them.
Missing the right food for good eye development
The latest research reveals the right nutrition can prevent long-term eye issues and common conditions such as dry eye, which Dr Phil diagnoses in many children. 'Encouraging good eating habits early will go a long way to preserve their eye health," he says.
What to do
'Make sure children eat green leafy vegetables such as spinach, kale which are rich in lutein and zeaxanthin. Both sustain eye development and keep dry eye at bay. -Hide' green vegies in tomato-based pasta sauces, home-made burgers, stews and soups. Most children will eat fruit. Go for vitamin C-rich fruit like strawberries and kiwis. With cereals, include nuts where allergies are not an issue, and serve up fish as both have plenty of Vitamin E and omega-3 fatty acids," Dr Phil advises.
Excessive eye rubbing can cause long term damage
There is a strong association with eye rubbing and keratoconus - a thinning of the front of the eye resulting in visual impairment. Several cases have reported the onset of keratoconus in young children after vigorous rubbing in that eye. 'Whether it makes an existing disease worse, or causes it in otherwise healthy patients is uncertain. However, eye rubbing is best avoided," Dr Phil says.
What to do. When you tell a child (or an adult) to stop rubbing their eye, they'll end up doing it more frequently – Excessive eye rubbing should warrant examination to rule out possible causes. 'Eye rubbing can be a sign of other vision problems. Young children aren't always able to verbally describe their symptoms and may resort to rubbing in response to anything from an allergy to uncorrected refractive error," says Dr Phil.
Question: What would you say is the biggest threat to children's eye site?
Dr Phil Dang: Difficult question – many conditions we see are treatable, the worst outcomes usually come from patients who either present long after they first notice symptoms, or present for their very first eye exam at 18 years of age (or older). Early detection and management of any eye condition will always ensure the best outcome.
Question: How do screen affect a child's normal eye development?
Dr Phil Dang: Excessive screen based tasks can cause a range of problems like accommodative spasm, dry eye, eye-strain. Often when concentrating on screens we forget to blink which can also cause problems.
Question: How much screen time is too much?
Dr Phil Dang: There is no magic number to suggest > than x time is good and < then x time is bad however a general recommendation would be to take regular rest breaks, ideally every 30 mins.
Question: How often should a child's eyes be tested?
Dr Phil Dang: Annually or as recommended by your optometrist/ophthalmologist.
Question: How can eye rubbing cause long term damage?
Dr Phil Dang: Excessive eye rubbing is thought to induce/worsen a condition called Keratoconus. This results in structural changes to the cornea which can caused blurred/distorted vision.
Question: What are the best foods for eye health?
Dr Phil Dang: Green leafy vegetables such as spinach, kale which are rich in lutein and zeaxanthin. Vitamin C-rich fruit like strawberries and kiwis. Nuts and fish both have plenty of Vitamin E and omega-3 fatty acids. Obviously, be mindful of any food allergies.
Question: What should we look for when purchasing sunglasses?
Dr Phil Dang: Purchase from a reputable outlet to ensure they meet Australian Standard AS/NZS 1067:2003 Good coverage and glasses that wrap around the face and eyes are also important. By law all sunglasses sold in Australia must meet this standard however novelty and toy sunglasses do not.
Question: Can long-term contact wear cause damage to the eyes?
Dr Phil Dang: If worn appropriately, contact lenses can be a very safe method of vision correction. However many bad habits/shortcuts people take as a result of cost or convenience can have very damaging consequences. Eg overwearing lenses past their disposal schedule, using the incorrect storage/cleaning solutions. This may result in infections which can sometimes cause permanent vison loss.
Interview by Brooke Hunter