CHILDREN AND COMPUER USE - points to remember

Millions of children work on the computer on a daily basis. While this may be a necessity in some cases as they may have school assignments, some may be just playing computer games for hours on end. It is important to be aware of the harmful effects of computer use in children.

Dry eyes
Adults do complain of symptoms of dry eyes like redness, pain , irritation of the eyes  after prolonged computer use. Children also have the same symptoms but they have some unique aspects which makes them more susceptible to the eye problems

Use of adult computer
Children may not adjust to the table height or the ergonomics may be wrong. Hence they may end up having eye strain or back and neck pain

Increased tolerance
Children are too engrossed in their own world and may ignore the warning signs like eye strain . If they have an underlying refractive error or eye problem they may ignore the poor vision as something that everyone may have. Children many a times have a hypermetropia or plus number which they can overcome with their eye power, but this may become an issue when they use the computer for long hours.

Reduced blinking
Children are not bothered about other things when they are hooked on to computer games and reduced blinking will lead them to forcefully blink their eyes or to severe eye strain.

Accommodation problems
Focussing can be at strain and the internal eye muscles may fatigue because of the excess eye strain .
This can lead to difficult focusing for distance - accommodative spasm.

Room lighting
The room light should not be too bright nor too dark. Comfort while viewing is a must.

POINTS TO REMEMBER
1, PREVENT CONTINOUS USE
2, GET THEIR EYE EXAMINED IN CASE OF ANY ISSUES
3, CHECK THE ERGONOMICS
4, USE OPTIMAL LIGHTING
5, ENCOURAGE THEM TO PLAY OUTDOORS

ALL ABOUT MYOPIA

v  Myopia, also called nearsightedness or shortsightedness, is the eye condition where objects nearby or a short distance away are clear but objects that are far away are blurred. It is caused by the eye being slightly too long.

v  One can stop the eyes from becoming myopic or progression of myopia.

v  Myopia is getting worse around the world, even to the point of being called an epidemic by some. In some parts of Asia, 80% of the girls in high school are myopic. In the United States, myopia has increased 66% in thirty years so that now 42% of people aged 12-54 are myopic.

v  Myopic parents have more myopic children than non-myopic parents.

v  People in urban environments have more myopia than rural or primitive societies.

v  The amount of reading or near work a person does is not predictive of whether they will become myopic.

v  People who spend more time outdoors, even if they have myopic parents and even if they read a lot, are less likely to become myopic. We don't know why exactly - it may be the sun, it may be focusing on distant objects or some other factor.

v  Spending too much time on the tablets and mobile games can accelerate the progression

v  ­­­­Your child needs an eye exam every year starting at age five. (Check-ups before then.) The goal is to actively start treatment within a few months of myopia starting. In general, you can slow or stop it, you can't make it better. 

Treatment options……

v  Atropine: reviews - the ATOM study. - 77% myopic progression reduction

v  Pirenzepine: approximately 50% reduction; not available easily.

v  Bifocals: No slowing of myopia

v  Progressive Addition Lenses(COMET study): PALs are "not clinically meaningful"

v  Contact lenses (RGP): "not effective for myopia control"

v  Orthokeratology: "...no evidence for long-term efficacy of orthokeratology in reducing myopia progression...A gold standard randomized controlled trial is needed .."

v  Undercorrection: makes things worse. "This means that myopes may have an abnormal mechanism for detecting the direction of optical defocus of the retinal image."

v  Part time lens wear: No effect seen. Larger study called for.

v  NeuroVision: A commercial internet based system of training. Preliminary results compared to age matched normals of another study showed slowing of myopia.

v  EyeRelax: "a microscope-like device". No evidence it can retard myopia.

v  Pinhole Glasses: No evidence it can retard myopia.

v  Bates Method: "Bates' anecdotal reports of improved vision have not been evaluated in trials.

Children and their eyes

Getting good results in ambyopia is difficult. BUT...

Let me share the story of this young boy who presented to me with ambyopia in one eye .. amblyopia is lazy eye where one eye is weaker than the other. 

A young boy improved from 6/ 60 to 6/6 just by patching and perseverance. He was the most motivated of the lot and he really did well. He used to patch about 12 hors per day and from Feb 2013 to June 2013 his progress was remarkable and steady. 

When he did not want to wear the patch he used frosted glasses which were fitted on curved frames so that he would not peek from the sides. 

Astounding success, anything is possible when there is motivation and keen desire. .

 

CHILDREN AND THEIR EYES

DID YOU KNOW ?

Amblyopia or lazy eye can be treated even upto 17 years of age. This is what the latest research has to tell us. This comes from the PEDIG ( pediatric eye disease investigator group)..

I thought I should give it a try. Previously the thought was that vision could not be improved in cases of amblyopia beyond 7-8 years of age.

I wish to share 2 cases with you. One was a 11 year old boy, very intelligent and well behaved. His parents were shocked when it was discovered that he had a vision of 6/60 in one eye. They came to me and the refraction was +2.00. He was prescribed glasses and patching. He improved to 6/12 and could read a few letters on the 6/9 line as well. In other words he was out of the definition of amblyopia. Of course the credit goes to the young lad as he was sincere in the patching and serious about improvement in vision.

My second interesting patient was a 23 year old girl with squint ( convergent ). She had a vision of 6/36 in the left eye which was the squinting eye. She was again advised intense patching and within 2 weeks her vision had improved to 6/12. For her and her family it was very reassuring. She had been indoors for two weeks and taken a break from her work to ensure that her eyesight improves.

I used to counsel them well, with positive reinforcement of the benefits of patching and use of near exercises. 

My message is
1. try patching even in the older age group.
2. intense counselling
3. positive reinforcement of benefits
4. show them the response in a week's time, which will spur them to perform better...

This will be our contribution towards the elimination of preventable visual impairment.

Amblyopia or Lazy eye - AXIS EYE CARE

Amblyopia or lazy eye is a common yet largely unrecognised eye problem in children. The importance can be gauged by the fact that this may affect 3 out of every 100 children. It can lead to irreversible diminution of vision if not identified and treated early. What is important is to screen children. Practically it may be difficult, it is a good idea to have at least one check up of the child by the third birthday. The causes of this condition include uncorrected refractive error, difference between the refractive powers in each eye, strabismus and media opacities like cataract or corneal problems. Largely preventable, early detection is the key solution to this problem. Treatment needs to be started at an early age for best results. Beyond the age of 8 or 10 years, the chance of reversing the vision loss is less. Patching therapy, use of blurring drops and now even computerised exercises are successful modes of management.