Little children are too young to tell us when they suffer bad eyesight. That's why it's important to seek professional help.
Eye testing for young children
Eye screening in children begin when they are born (done by the paediatrician), and if any problems are detected, this should be further investigated by an eye specialist.
It is important to have your preschooler examined by an ophthalmologist at a fairly young age to determine whether all the ocular (sight) milestones are met. Screening for the most common eye conditions can begin as early as 3 to 4 years of age but most children should undergo at least one screening eye examination before going to school for the first time.
During the school years, it is a good idea to pay regular visits to the optometrist to ensure ocular development takes place normally and no spectacles are required.
Children with a family history of eye-related problems should undergo examination by an eye specialist as soon as any abnormality is suspected.
Just as one would prepare your child for a doctor's visit, it's advisable to prepare them ahead of an eye examination. Schedule the appointment at a time when your child is happiest – in the morning or after nap time in the afternoon.
It is also preferable to take things like toys or colouring books to keep them busy while waiting. Be sure to bring a list of concerns to ensure that all questions are answered during the examination.
Several tests will be done to ensure that the necessary milestones are met for your child’s age. It is important to stay calm during the examination and keep the event playful and upbeat. The eye specialist will make use of special equipment that is designed specifically for use with smaller children.
Common eye problems in young children
In young children the most common eye conditions causing poor vision or blindness are amblyopia, refractive errors, eye infections and the most serious condition, retinoblastoma.
The vision in one eye is poor due to the abnormal development of the normal visual pathways to the brain. Causes can include cataracts, strabismus (skew deviation of the eye) and unrecognised refractive errors in one or both eyes.
2. Refractive errors
This can be divided into hyperopia (far-sightedness), myopia (near-sightedness) and astigmatism (distorted image that forms mostly due to an abnormally shaped cornea /lens).
3. Eye infections
An eye infection in children is not always easy to recognise unless it's very severe and presents with a red eye with a purulent discharge.
A constant eye rubbing can sometimes be a clue, if the infection is not severe. Constant eye rubbing is almost never normal and should always be investigated by a qualified eye specialist.
This is the most common eye cancer in children younger than 15 years of age. This very complex disease has a very high mortality rate and is usually diagnosed in very young children.
The most common presentation is when a child presents with a white discoloration in the pupil area (centre part of the coloured part of the eye). This can easily be seen on photographs if one eye has a red reflex and the other eye does not. This is not the only reason for not having a red reflex in one eye, but can give a clue to look for help.
Most healthy and fit young adults do not require regular eye examinations unless there is a positive family history, or poor vision and even eyestrain that affect their daily activities or school work.
In the technologically advanced area we live in today, there is a very real and sometimes overlooked eye condition, called computer vision syndrome (CVS). This happens when prolonged exposure to the computer screen causes a reduced rate of blinking.
This will lead to eye strain, dry eyes and even blurry vision. Ways to prevent this and improve the symptoms of eyestrain include the following:
• Taking breaks from the computer screen,
• Sitting at the optimal distance of at least 60cm from the screen, and
• Using an anti-reflective computer screen or special anti-reflective spectacles.
Dr Marcel Niemandt is an ophthalmologist at Intercare.