Vision is arguably the most important of the five senses; it plays a crucial role throughout childhood and beyond. Yet many parents don’t understand how vision helps their children develop appropriately. The articles below can help.
An individualized program of eye exercises and other methods can treat non-refractive vision problems such as focusing problems, eye alignment and lazy eye.
Many children have vision problems other than simple refractive errors such as nearsightedness, farsightedness and astigmatism. These “other” vision problems include amblyopia (“lazy eye”), eye alignment or eye teaming problems, focusing problems, and visual perceptual disorders. Left untreated, these non-refractive vision problems can cause eyestrain, fatigue, headaches, and learning problems.
What Is Vision Therapy?
Vision therapy is a doctor-supervised, non-surgical and customized program of visual activities designed to correct certain vision problems and/or improve visual skills.
Unlike eyeglasses and contact lenses, which simply compensate for vision problems, or eye surgery that alters the anatomy of the eye or surrounding muscles, vision therapy aims to “teach” the visual system to correct itself.
Vision therapy is like physical therapy for the visual system, including the eyes and the parts of the brain that control vision.
Vision therapy can include the use of lenses, prisms, filters, computerized visual activities and non-computerized viewing instruments. Non-medical “tools,” such as balance boards, metronomes and other devices can also play an important role in a customized vision therapy program.
It is important to note that vision therapy is not defined by a simple list of tools and techniques. Successful vision therapy outcomes are achieved through a therapeutic process that depends on the active engagement of the prescribing doctor, the vision therapist, the patient and (in the case of children) their parents.
Overall, the goal of vision therapy is to treat vision problems that cannot be treated successfully with eyeglasses, contact lenses and/or surgery alone, and help people achieve clear, comfortable binocular vision.
Many studies have shown that vision therapy can correct vision problems that interfere with efficient reading among schoolchildren. It also can help reduce eye strain and other symptoms of computer vision syndrome experienced by many children and adults. See below for more on conditions treated with vision therapy.
Problems Vision Therapy Can Correct
Vision problems being treated with vision therapy include:
- Amblyopia. Also called “lazy eye,” amblyopia is a vision development problem where an eye fails to attain normal visual acuity, usually due to strabismus or other problems of eye teaming.
- Strabismus. The success of vision therapy for strabismus depends on the direction, magnitude and frequency of the eye turn. VT has been proven effective for treating an intermittent form of strabismus called convergence insufficiency, which is an inability to keep the eyes properly aligned when reading despite good eye alignment when looking at distant objects.
- Other binocular vision problems. Subtle eye alignment problems called phorias that may not produce a visible eye turn but still can cause eye strain and eye fatigue when reading also can be minimized or corrected with vision therapy.
- Eye movement disorders. Studies have shown vision therapy can improve the accuracy of eye movements used during reading and other close-up work.
- Accommodative (focusing) disorders. Other research shows near-far focusing skills can be improved with vision training.
- Other problems. Other vision problems for which vision therapy may be effective include visual-perceptual disorders, vision problems associated with developmental disabilities and vision problems associated with acquired brain injury (such as from a stroke).
Vision Therapy and Learning Disabilities
The relationship between vision problems and learning disabilities has been well-established.
Many optometrists support the use of vision therapy as part of a multidisciplinary approach to the treatment of certain types of learning disabilities. They contend that, in many cases, children with learning disabilities also have underlying vision problems that may be contributing in some degree to their learning problems. It’s possible, they say, that these learning-related vision problems may be successfully treated with optometric vision therapy, which may improve the child’s overall capacity for learning.
The First Steps
If you think your child has a vision problem that may be affecting his or her performance in school or sports, the first step is to schedule a routine eye exam to rule out nearsightedness, farsightedness and/or astigmatism.
If the basic eye exam suggests that no glasses are needed (or there is no change in your child’s current eyeglasses prescription) and each eye has 20/20 visual acuity, be aware that a vision problem still may exist. The eye chart used in routine eye exams tests only a person’s distance vision and does not test all critical aspects of visual performance.
For a thorough analysis of your child’s vision, including tests that evaluate vision skills needed for efficient reading, consider scheduling a comprehensive eye exam with an optometrist who specializes in binocular vision, vision therapy and/or vision development.
Examinations used to diagnose non-refractive vision problems differ from routine eye exams provided by most optometrists and ophthalmologists. Usually they are longer and include a number of tests of eye teaming, depth perception, focusing, eye movements and visual-motor and/or visual-perceptual skills.
At the end of the exam, the doctor should give you a detailed assessment of your child’s vision and visual skills. If vision problems are identified and a program of vision therapy is recommended, be sure to get information about the likely duration of the therapy and success rates for the specific type of vision therapy being recommended. Also, ask what criteria are used to define “successful” treatment.
Finally, request details about the expected cost of the therapy program, and whether any of the costs will be covered by your health insurance or vision insurance policy. In many cases, vision therapy is not a covered benefit in insurance programs.
How often should your child’s eyes be examined? What’s the difference between a school vision screening and a comprehensive eye exam? and more. CLICK HERE TO FIND OUT MORE INFORMATION
Your Infant’s Visual Development
Knowing the expected milestones of your baby’s vision development during their first year of life can ensure your child is seeing properly and enjoying their world to the fullest.
Your baby’s visual system is not fully developed at birth and continues to develop gradually over the first days and months of life. In fact, from your baby’s perspective at birth, the world is black and white, blurry and rather flat. As the days and months go on, they begin to focus, move their eyes and start to see the world around them. While each child will grow and develop on his or her own schedule, knowing an infant’s vision milestones will help you ensure that your infant is on track to achieving good vision and eye health and start treatment early if there is a problem.Birth – 3 months
Because newborn babies’ eyes and visual system are underdeveloped, they can not focus their eyes on close objects or perceive depth or color. Babies need to learn to move, focus and coordinate eye movements to team the eyes (have them move together as a team). The brain also needs to learn how to process the visual information from the eyes to understand and interact with the world. In fact, until about 3 months, the optimal distance a baby can focus on is about 8 – 10 inches from their face, about the distance their parents face will be during feeding.Your baby will start to be able to perceive color within the first 2-3 weeks, however it will take a few months to learn how to focus and use the eyes, to track objects, differentiate between two objects and shift from one object to the other. During this time you may notice that the eyes appear crossed and do not work together or team. This is quite common at the early stages of development, however if one eye appears to be constantly turned in or out, seek a doctor’s evaluation.At around three months, as hand-eye coordination begins to develop, a baby should be able to follow a moving target with their eyes and reach for objects.4-6 Months
By 6 months, your baby will begin to move his eyes with more speed and accuracy, seeing at farther distances and focusing well. Color vision should be fully developed and the eyes should be able to work as a team and follow moving objects with relative ease. Hand-eye coordination and depth perception should be greatly improved as your baby will begin to understand the 3-dimensional world around them.At six months, you should take your baby for his or her first comprehensive eye exam to ensure that the eyes are developing on track and there are no signs of congenital or infant eye disease.7-12 Months
At this stage of development babies will be coordinating vision and body movements by crawling, grasping, standing and exploring the surrounding world. They should be able judge distances accurately, throw a ball toward a target and pick up a small object with their fingers. Delays in motor development can sometimes indicate a vision problem.The First Eye Exam
While at 6 months, your baby will not be able to read an eye chart, eye doctors can perform an infant eye exam through non-verbal testing to assess visual acuity (for nearsightedness, farsightedness or astigmatism), eye teaming abilities and eye alignment. The eye doctor will also be able to see inside the eye for any signs of disease or problems that could affect eye or vision health.
InfantSEE® is a public health program in which participating optometrists provide a free comprehensive infant eye exam to babies between 6 and 12 months of age. The program was initiated to provide accessible eye and vision care for infants to ensure they have the best chances for normal development and quality of life.If your child has any unusual symptoms such as excessive tearing, constant eye misalignment, red or crusty eyes or extreme light sensitivity consult an eye doctor as soon as possible.
Are Contact Lenses a Good Choice for Kids?
Contact lenses offer advantages in the areas of sports and self-esteem. But when is your child old enough for contacts?
Does your child want to wear contact lenses instead of eyeglasses? You are probably wondering if it’s a good idea or not. Actually, contact lenses offer specific benefits over other vision correction eyewear for children.
More than age, maturity is the main consideration that goes into deciding whether contact lenses are appropriate for your child. Physically, children’s eyes can tolerate lenses from a very young age. Even babies with certain eye conditions present at birth are treated with contact lenses. In addition, a recent study conducted on nearsighted children between the ages of 8 to 11, demonstrated that 90% of the kids had no difficulty inserting or removing one-day disposable lenses – with no help from an adult.
Signs of Maturity in Your Child
How do you know if your child is mature enough for contact lenses? You’ll need to assess whether they are able to insert, remove and take care of the lenses independently. One indication of the maturity necessary for these actions is your child’s general level of responsibility.
Does this child take on and successfully manage responsibilities at home? If so, that’s a good sign. Or does your child need constant reminders to do daily chores? Do they have poor grooming habits? If so, that’s an indication that wearing contact lenses may be premature.
Regardless of age, a conscientious child is the best candidate for lenses.
Advantages of Contact Lenses for Children
There are a number of reasons why contacts may be better suited than eyeglasses for your child’s visual condition and lifestyle. Some of these benefits include:
- Contact Lenses for Sports
When playing hard, running or engaging in physical contact sports, eyeglasses tend to slip off due to perspiration, get knocked off or fog up. Eyeglasses also limit your child’s peripheral vision, which is key for top sports performance. Contact lenses may resolve all of these issues. Specially tinted contacts may even help your child see the ball easier!
Soft contact lenses are generally the ideal choice for sports. Larger and with a more secure fit on the eye than rigid gas permeable (GP) lenses, soft lenses don’t carry the same risk of getting dislodged or knocked out during a game.
- A Way to Control Nearsightedness
Hard, rigid gas permeable (GP) contact lenses may be a superior option for children with myopia (nearsightedness). Durable GP lenses typically offer crisper vision than soft lenses.
Orthokeratology, referred to as ortho-k, is a modified technique for fitting GP lenses in order to temporarily reverse myopia. The ortho-k contacts are worn nightly while sleeping and removed in the morning. Nearsighted children should then be able to see clearly with no lenses needed throughout the day.
Multifocal soft lenses, which have various lens powers within different zones of the contact, have also been found to help control myopia.
- Boost Self-Esteem with Contact Lenses
Is your child embarrassed to wear eyeglasses? Many children are so uncomfortable with their appearance in glasses that they become very self-conscious about how they look. In this case, contact lenses are an excellent way to enhance your child’s self-esteem. Participation in school and social activities often improves when children make the switch from eyeglasses to contact lenses.
Hold On to those Eyeglasses!
An up-to-date pair of eyeglasses is still necessary to keep around even if your child begins to wear contact lenses. Eyes need to breath, and contacts that are worn daily must be removed at least an hour before bedtime. There may also come a time when your child prefers eyeglasses over lenses. In the event of any eye redness or discomfort, contact lenses must be removed immediately.
Motivation is the Main Criterion
Who wants the contact lenses, you or your child? This is the most important factor in determining success with lenses. Just because you may wear contacts and simply love them doesn’t mean they’re right for your child. Some kids favor eyeglasses and the cool, fashionable look they can create!
Timing is also significant. Your child may decide against contact lenses right now, but become interested in wearing them a few years later. For success, good vision and healthy eyes with contact lenses, it’s important to never push children into wearing them.
Controlling Nearsightedness in Children
Certain types of contact lenses and eyeglasses may play a role in slowing the progression of myopia, or nearsightedness.
Myopia (nearsightedness) is a common vision problem affecting children who can see well up close, while distant objects are blurred. Nearsighted children tend to squint to see distant objects such as the board at school. They also tend to sit closer to the television to see it more clearly.
Sometimes, childhood myopia can worsen year after year. This change can be disconcerting to both children and their parents, prompting the question: “Will it ever stop? Or, someday will this get so bad that glasses won’t help?”
Myopia that develops in childhood nearly always stabilizes by age 20. But by then, some kids have become very nearsighted. Here are three possible ways to slow down the progression of myopia in children:
Gas permeable contact lenses
Wearing rigid gas permeable contact lenses (also referred to as “RGP” or “GP” lenses) may slow the progression of nearsightedness in children. It’s been proposed that the massaging action of the rigid GP lens on the eye during blinking may keep the eye from lengthening, thereby reducing the tendency for advancing nearsightedness.
In 2001 to 2004, the National Eye Institute (NEI) conducted a controlled study to determine whether wearing GP lenses is effective in slowing the progression of myopia in children. The 116 participants in the study were 8 to 11 years old when the research began.
At the end of the three-year study period, the children who wore GP lenses had only 0.63 diopter (D) less nearsightedness than the kids in the control group who wore soft contact lenses.
The study also found that wearing GP lenses does not slow the growth of the eye, which causes most of the myopia in children. The reduced progression of myopia among those children wearing GP lenses was due only to the effect the lenses had on the front surface of the eye (the cornea). Children who wore the GP lenses had less increase in corneal curvature than those who wore soft contact lenses. The NEI researchers believe these GP lens-induced changes in corneal curvature are not likely to be permanent, and therefore the effect of GP lenses on controlling myopia progression may not be permanent.
Orthokeratology, or “ortho-k,” is the use of specially-designed gas permeable contact lenses to flatten the shape of the cornea and thereby reduce or correct mild to moderate amounts of nearsightedness. The lenses are worn during sleep and removed in the morning. Though temporary eyeglasses may be required during the early stages of ortho-k, many people with low to moderate amounts of myopia can see well without glasses or contact lenses during the day after wearing the corneal reshaping lenses at night.
Recent research suggests ortho-k may also reduce the lengthening of the eye itself, indicating that wearing ortho-k lenses during childhood may actually cause a permanent reduction in myopia, even if the lenses are discontinued in adulthood.
Some evidence suggests wearing eyeglasses with bifocal or progressive multifocal lenses may slow the progression of nearsightedness in some children. The mechanism here appears to be that the added magnifying power in these lenses reduces focusing fatigue during reading and other close work, a problem that may contribute to increasing myopia.
A five-year study published in the February 2007 issue of Investigative Ophthalmology & Visual Science produced an interesting result involving nearsighted children whose mother and father were also nearsighted. These children, who wore eyeglasses with progressive multifocal lenses during the course of the study, had less progression of their myopia than similar children who wore eyeglasses with regular, single vision lenses.
See us for a consultation
If you are concerned about your child becoming more nearsighted year-to-year, call us to schedule a comprehensive eye exam and consultation. We can evaluate the progression of their myopia and discuss the best treatment options with you.