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August 20, 2020

E-Learning on the agenda? How to protect your child’s eyes

By Anu Varma Panchal

During any normal year, parents’ schedules fill with appointments to the healthcare professionals who take care of our children: dentists, pediatricians and orthodontists. Those of us whose kiddos wear glasses or contacts also visit our eye doctors often.

But this is no normal year. And parents are hesitating to visit doctors because they fear the COVID-19 virus, even while they worry about issues with their children’s health. When it comes to eye health, if a child has been referred to an eye doctor by their pediatrician for any vision problems, it’s best to schedule that visit, with the understanding that medical practices have implemented all CDC protocols, including mask-wearing, sanitizing and social distancing. 

“If you fail a vision screen early, you want to get that addressed, the earlier the better,” says Dr. Samantha Roland, a pediatric ophthalmologist in the Johns Hopkins All Children’s Hospital Department of Surgery. “The younger a child is, the more important it is.”

While Dr. Roland saw a dip in patient numbers during April and May, more patients have started coming back in now. One issue she has seen more of lately is children being brought in for excessive blinking. Dr Roland explains that when children focus intently on things close by, whether it’s a Zoom call or a book, their blink rate reduces drastically. While the blinking norm is an average of 8-21 times per minute, children who are super-focused on something close by can reduce this to as little as once a minute. This can cause their eyes dry out, so when they get off the device or book, they blink excessively to compensate. While this blinking could just be a benign tic that the child could outgrow, it could also indicate problems, such as Dry Eye Syndrome or a need for glasses.

After a certain age, adults find is difficult to focus for extended periods of time on something close up, but children “accommodate,” or are able to do so for long stretches without seeming to strain. However, this accommodation can contribute to myopia, or near-sightedness. According to the International Myopia Institute, recent estimates show that 30 percent of the world is myopic, or near-sighted, a number that is expected to climb to 50 percent by 2050. In the United States, the prevalence of myopia is up to 42 percent, having almost doubled in three decades. Dr. Roland says myopia is also being detected at earlier ages. “It’s not necessarily COVID-related, but we’ll probably see a little bit of a faster rate because of it.”

The best way to catch and prevent eye problems is by seeing a doctor. Pediatricians spot many issues by using vision screeners to detect problems in infants as early as 18 months. Babies are born with poor vision, but rapid development occurs within the first year, and a child’s vision is completely developed by the time they are 9. If a pediatrician points out a vision problem with your child, it is important to see an eye specialist as quickly as possible to correct the problem.

“If you’re screened at 18 or even 24 months, that’s early enough to correct vision and develop good vision,” says Dr. Roland.

Tips for Eye Health:

  • Decrease or minimize screen time to the extent possible. Encourage your child to participate in a mix of activities, including plenty of time spent outdoors. If they do want to watch or play something, use a television, which has a larger screen that is further away.
  • Make sure your child practices “near activity hygiene.” When reading a book, for example, this involves keeping a book 14-16 inches away from the face and making sure there is adequate lighting. Sitting at a desk and reading with good posture is better than reading in bed with the book pulled up close to the child’s face.
  • Teach children (and yourself!) the 20/ 20/20 rule: Every 20 minutes, look up from your screen or book and look at something 20 feet away for 20 seconds. 
  • Make sure children have a healthy diet rich in fruits and vegetables. “What’s good for your body is going to be good for the eyes,” Dr. Roland says.
  • Buy your little one sunglasses to protect them from harmful UV rays when they are outside. As for those popular blue filter glasses you may have seen people wearing lately to protect themselves from screens? Dr. Roland says there is no clear health benefit from wearing these as research does not show that blue light causes damage. Blue light is activating, however, which is why children should not use screens right before bedtime as it will prevent them from falling asleep right away.
  • Because there is potential for coronavirus infection through the eyes, the American Academy of Ophthalmology reminds children and adults to avoid rubbing their eyes. If you do feel like you need to rub your eyes or adjust your glasses, the Academy suggests using tissue rather than your fingers. Wash your hands frequently, especially before you touch your or your child’s eyes to administer drops or wipe them. 
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