When it comes to children’s vision, it’s not as simple as deciding who does and doesn’t need glasses. As kids grow, their eyesight continues to develop, making it important for parents to keep an eye on them. Dr. Megan Geloneck, a pediatric ophthalmologist at McGovern Medical School at UTHealth affiliated with Children’s Memorial Hermann Hospital, talks about the best way to do exactly that.
A: It’s tough because kids like to be right up close to the TV, just in general, whether they need glasses or not. One thing parents can look out for is any crossing of the eyes, especially when they’re looking at things up close or if there’s the drifting of one eye. If a child routinely squints one eye in bright sunlight or has a tendency to hold their head in a particular way when they’re focusing, they should be evaluated soon
A: We tend to recommend that children get a dilated eye exam before they’re kindergarten age. The earlier we catch problems, the better the outcome and the easier it is to treat it.
A: There’s no specific age, but I rarely give glasses to kids less than one year. There needs to be a very significant reason, not just a little bit of nearsightedness or a little bit of astigmatism.
Did you know? Doctors recommend that children get a dilated eye exam before they’re kindergarten age.
A: Absolutely. Especially for young children, you have to get creative. I might try asking them about shapes or have them point to a letter on a page that they see on the vision chart. I can also decipher if they have a strong preference for one eye over another by using a special prism test. I can check if young children need glasses by using a special type of flashlight to look at the red reflex of the eye.
A: As a child grows, they’re developing visual connections between the brain and the eye. If they’re getting a good, clear image in one eye, they’re going to develop good visual pathways in the brain to recognize and have that perfect 20/20 sharp vision. If anything prevents that clear image from reaching the brain, a child can develop amblyopia, which means poor vision development. If caught early enough, we can treat it and recover good vision. If not caught until after 16 or 17 years old, and sometimes as early as 8, we really can’t get anything back.
A: We’re finding out more and more about how amblyopia, or poor vision development, affects kids’ ability to read. Even after the amblyopia has been treated, they still have a tendency to be slower readers and slower processers. And strabismus, which is eye misalignment, usually crossing or drifting—can also challenge children and they may not develop good depth perception.
A: Older kids tend to be very worried about their appearance, so it’s helpful if they have a friend or other sibling who wears glasses to encourage them. Some kids might need a strap that goes around the back of the head or a nicely-fitted earpiece, so that the child doesn’t easily tear them off. If your child has a tendency to hold their head in a particular way when they’re focusing, they should be evaluated soon.
A: The need for glasses is fairly common for children, whether it’s to fix astigmatism, farsightedness or nearsightedness.
Remember when your parents told you to eat all your carrots so you wouldn’t need glasses? Turns out Mom and Dad might have been listening to too many old wives’ tales. Below, Dr. Geloneck gives the truth behind the myths we grew up with:
FALSE: The worst thing that can happen if children sit too close to the TV or hold a book too close to their faces is a little bit of eye strain and a headache. It does not cause any permanent damage whatsoever.
NOT REALLY: Vitamin A, which is what we get from carrots, is needed to help with our vision and photoreceptor cells in our retina. A deficiency of Vitamin A is detrimental to the vision, but neither extra Vitamin A nor extra carrots makes for extra vision.
FALSE: We get this one a lot. No, they’re not going to get stuck. The worst case is, it causes children’s eyes to strain, and they can get a headache.
FALSE: Researchers are still investigating this, but so far, we do not think there is any permanent damage associated with phone/tablet/computer usage. After staring at a screen too long, however, children (and adults) may not blink very well. As a result, the eyes can dry out and become irritated, but no permanent damage takes place.
MAYBE: Children who read a lot, or spend the majority of their time indoors, do tend to have more of a need for glasses. But those who spend an equal amount of time reading indoors and playing outdoors frequently don’t require them. We don’t know what it is about being outside, but it does tend to help prevent them from needing thicker and thicker glasses every year.
To contact Children's Memorial Hermann Hospital, please fill out the form below.