Screen Time Pros and Cons

Whether it is homework, email, gaming, chatting with friends, searching the web or watching Youtube, kids these days seem to have an endless number of reasons to be glued to a screen. Many parents out there are wondering how bad this can be for their kids and whether they should be limiting screen time.

There are certainly benefits to allowing your kids to use digital devices, whether it is educational, social or providing a needed break. However, studies show that excessive screen time can have behavioral consequences such as irritability, moodiness, inability to concentrate, poor behavior, and other issues as well. Too much screen time is also linked to dry eyes and meibomian gland disorders (likely due to a decreased blink rate when using devices), as well as eye strain and irritation, headaches, back or neck and shoulder pain, and sleep disturbances. Some of these computer vision syndrome symptoms are attributed to blue light that is emitted from the screens of digital devices.

Blue light is a short wavelength, high-energy visible light that is emitted by digital screens, LED lights and the sun. Studies suggest that exposure to some waves of blue light over extended periods of time may be harmful to the light-sensitive cells of the retina at the back of the eye. When these cells are damaged, vision loss can occur. Research indicates that extreme blue light exposure could lead to macular degeneration or other serious eye diseases that can cause vision loss and blindness. Studies show that blue light also interferes with the regulation of the the body’s circadian rhythm which can have a disruptive impact on the body’s sleep cycle. Lack of quality sleep can lead to serious health consequences as well.

Beyond these studies, the long term effects of blue light exposure from digital devices are not yet known since this is really the first generation in which people are using digital devices to such an extent. While it may take years to fully understand the impact of excessive screen time on our eyes and overall health, it is probably worth limiting it due to these preliminary findings and the risks it may pose. This is especially true for young children and the elderly, who are particularly susceptible to blue light exposure.

How to Protect the Eyes From Blue Light

The first step in proper eye protection is abstaining from excessive exposure by limiting the amount of time spent using a computer, smart phone or tablet – especially at night, to avoid interfering with sleep. Many pediatricians even recommend zero screen time for children under two.

The next step would be to reduce the amount of blue light entering the eyes by using blue light blocking glasses or coatings that deflect the light away from the eyes. There are also apps and screen filters that you can add to your devices to reduce the amount of blue light being projected from the screen. Speak to your eye doctor about steps you can take to reduce blue light exposure from digital devices.

As a side note, the sun is an even greater source of blue light so it is essential to protect your child’s eyes with UV and blue light blocking sunglasses any time your child goes outside – even on overcast days.

The eyes of children under 18 are particularly susceptible to damage from environmental exposure as they have transparent crystalline lenses that are more susceptible to both UV and blue light rays. While the effects (such as increased risk of age-related macular degeneration) may not be seen for decades later, it’s worth it to do what you can now to prevent future damage and risk for vision loss.

What Is Progressive Myopia?

Nearsightedness or myopia is one of the most prevalent eye disorders worldwide and its incidence is increasing. In fact by 2050, myopia is projected to affect half of the world’s population!

Many children diagnosed with nearsightedness (myopia) experience a consistent worsening of their vision as they grow into adolescence. This condition can be so aggressive that for some, each time they take their child to the eye doctor for a vision checkup, their prescription gets higher.

This is called progressive myopia and can be a serious condition for many children now and in the future. Not only is there a financial burden and inconvenience associated with having to replace eyeglasses on a regular basis, but high myopia is a risk factor for many eye diseases later in life such as retinal detachment, early onset cataracts, glaucoma and macular degeneration.

What Causes Progressive Myopia?

Myopia is a refractive error that happens when the eye focuses incoming light in front of the retina, rather than directly on it, resulting in blurred distance vision. While an exact cause of progressive myopia is not known, most research indicates that a combination of environmental and genetic factors trigger the condition.

First of all, there is evidence that a family history of nearsightedness is a contributing factor. Additionally, spending a lot of time indoors may play a role in myopia development, as studies show that children who spend more time outside have less incidence of myopia. Lastly, near point stress, which can be caused from looking at a near object for an extended period of time, can prompt the eye to grow longer and result in myopia. Several eye doctors recommend following the 20-20-20 rule when using digital devices (stopping every 20 minutes to look 20 feet away for 20 seconds) to reduce near point stress caused by computer use.

What Can Be Done To Prevent or Treat Myopia?

There are several treatments that have been shown to slow the progression of myopia.

Orthokeratology (ortho-k):

Also known as corneal reshaping, this treatment uses rigid gas permeable contact lenses that are worn while the patient sleeps to reshape the cornea, which is the clear, front part of the eye. During the day, the patient is usually able to see clearly, glasses-free. In addition to allowing glasses-free vision during the day, this treatment has been shown to reduce the progression of myopia in many children.

Distance Center Multifocal Contact Lenses:

This treatment uses distance center (which means the area for seeing at a distance is in the center of the lens) multifocal soft contact lenses to provide clear vision and slow the progression of myopia. The lenses are worn as normal contact lenses during the day.

Atropine Drops:

Atropine drops are a daily-use prescription eye drop that has been shown to reduce myopia progression. It can be used alone or in combination with ortho-k or multifocal contact lenses.

Additional Myopia Treatments:

While these treatments are available in all of North America, some countries offer additional options that are approved for myopia control. For example, in Canada, Zeiss^TM MyoVision glasses that have an innovative lens curvature design are available to help reduce the rate of myopia progression. Additionally some doctors in Canada offer Coopervision MiSight^® lenses, which are 1-day contact lenses that are worn during the daytime. These contacts have a multifocal lens design with distance centre and near surround that is specifically designed for children.

Myopia & Your Child

If your child’s vision keeps getting worse, it’s more than an annoyance – it can be a serious risk factor for their eye health and vision in the future. The best strategy for myopia control depends on the child and the severity of the case, and requires consultation with an experienced eye doctor in order to determine the best solution. If your child wears glasses, make his or her vision a priority; schedule an eye exam to ensure stable vision and healthy eyes.

Healthy eyes and good vision are essential for your child’s growth and development. In fact, learning is 80% visual, which means a child’s success in school, athletics and many other aspects of life can be impacted by poor vision. Good vision goes beyond how far you can see, and also includes a number of other skills such as visual processing and eye movement abilities.

Often times vision deficiencies are at the root of learning problems and behavioral issues and may unfortunately go unchecked and misdiagnosed. Remember, if your child is having trouble in school, an eye exam and a pair of prescription glasses is a much easier solution than treating a learning disorder or ADHD; yet many people fail to check that first.

It is common for children to think that their vision deficiency is normal and therefore they often won’t report it to parents or teachers. That is why it is even more important to know what to look for. Here are some signs that your child may have a vision problem:

Vision Signs

• Squinting or blinking often
• Eye rubbing
• Tilting the head to the side
• Covering one eye
• One eye that turns out or in
• Reporting double vision
• Holding books or reading materials very close to the face

Behavioral Signs

• Complaining of headaches or eye fatigue
• Short attention span
• Difficulty reading
• Losing their place frequently when reading
• Avoiding reading or any activity that requires close work
• Problems with reading comprehension or recall
• Behavioral issues that stem from frustration and/or boredom
• Poor performance and achievement in school or athletics
• Working twice as hard to achieve minimal performance in school

Another issue is that many parents and teachers think that a school vision screening is sufficient to assess a child’s vision, so if that test comes back okay, they believe there is no vision problem. This however, is far from the case. A school vision test usually only assesses visual acuity for distance vision or how far a child can see. Even a child with 20/20 vision can have significant vision problems that prevent them from seeing, reading and processing visual information.

Every child of school age should have comprehensive eye and vision exams on a regular, yearly basis to assess their eye and vision health, and ensure that any issues are addressed as soon as possible. It’s also important to have an exam prior to entering kindergarten, as undetected lazy eye may be more complicated to treat past seven years of age.

Some of the issues the eye doctor may look for, in addition to good visual acuity, are the ability to focus, eye teaming and tracking, visual perception, hand-eye coordination, depth perception and peripheral vision. They will also assess the health of the eye and look for any underlying conditions that may be impairing vision. Depending on the problem the eye doctor may prescribe eyeglasses, contact lenses or vision therapy to correct the issue.

During the school years a child’s eyes and vision continue to develop and change so it is important to continually check in on your child’s vision. If you have a family history of vision problems, follow-ups are even more important. Progressive conditions like progressive myopia, strabismus (crossed eyes), amblyopia (lazy eye) or astigmatism can be treated and monitored for changes with early treatment so it’s important to seek a doctor’s diagnosis as soon as signs or symptoms are present.

Make sure that your child has the best possible chances for success in school and add a comprehensive eye exam to your back to school to-do list.

Many teens who wear glasses are eager to try out contact lenses for convenience, fashion or to just provide another option for vision correction. For teens who feel self-conscious in their glasses, contact lenses can be a way to improve self-esteem. Young athletes find that contacts are an excellent option for sports, especially as younger kids are becoming involved in travel sports and club teams outside of school.

While contacts might appear to be the perfect solution for teens that need corrective eyewear, they are a convenience that comes with a lot of responsibility so it’s not a decision to take lightly. Improper use of contact lenses can cause severe discomfort, infections, irritation and, in the worst cases, eye damage or even permanent vision loss.

“With Privilege Comes Responsibility”

Contact lenses are a medical device and should always be treated as such. They should never be obtained without a valid contact lens prescription from an eye doctor, and always purchased from an authorized seller. Among other issues, poor fitting contact lenses bought from illegitimate sources have been known to cause micro-abrasions to the eyes that can increase the risk of eye infection and corneal ulcers in worst case scenarios.

Particularly when it comes to kids and teens, it is best to purchase contact lenses from an eye doctor as they possess the expertise to properly fit contact lenses based on the shape of the eye, the prescription, the lifestyle of the child and other factors that may influence the comfort, health and convenience of contact lens use.

There is some debate over the recommended age for kids to start considering contact lenses. While some experts will say the ideal age is between 11 and 14, there are many responsible children as young as 8 or even younger who have begun to successfully use them. When children are motivated and responsible, and parents are able to ensure follow-up to the daily regimen, earlier contact lens use can be a success. A good measure of whether your child is responsible enough to use contacts is whether they are able to keep their room clean, or maintain basic hygiene like brushing teeth regularly and effectively.

When you think your child might be ready, you should schedule an appointment with your eye doctor for a contact lens exam and fitting. The process will take a few visits to perform the exam, complete a training session on how to insert, remove and care for lenses, then to try out the lenses at home and finally reassess the comfort and fit of the contacts. You may try out a few varieties before you find the best fit.

What Kind of Contact Lens Is Best for My Teen?

The good news is that contact lens use has become easier than ever, with safety, health and convenience being more accessible as technology improves. There are a number of options including the material used to make the lenses (soft or rigid gas permeable), the replacement schedule (if disposable, how often you replace the pair – daily, weekly, biweekly or monthly) and the wear schedule (daily or extended overnight wear).

Single use, daily disposable lenses have become very popular, particularly with younger users, because they are easy to use, requiring no cleaning or storing, and therefore they reduce the risk of infection and misuse. You simply throw out the lenses at night and open a new one in the morning. Your eye doctor will be able to help you and your teen determine the best option.

Tips for Contact Lens Wearers

Following are some basic contact lens safety tips. If your teen is responsible enough to follow these guidelines, he or she may be ready for contact lens use:

1. Always follow the wearing schedule prescribed by your doctor.
2. Always wash your hands with soap before applying or removing contact lenses.
3. Never use any substance other than contact lens rinse or solution to clean contacts (even tap water is a no-no).
4. Never reuse contact lens solution
5. Follow the eye doctor’s advice about swimming or showering in your lenses
6. Always remove your lenses if they are bothering you or causing irritation.
7. Never sleep in your lenses unless they are extended wear.
8. Never use any contact lenses that were not acquired with a prescription at an authorized source. Never purchase cosmetic lenses without a prescription!

Contact lens use is an ongoing process. As a child grows, the lens fit may change as well, so it is important to have annual contact lens assessments. Plus, new technology is always being developed to improve comfort and quality of contact lenses.

Contact lenses are a wonderful invention but they must be used with proper care. Before you let your teen take the plunge into contact lens use, make sure you review the dangers and safety guidelines.

Your toddler may show every sign of good eyesight including the ability to see objects in the distance, however that doesn’t necessarily mean that he or she doesn’t have a vision problem.

Amblyopia is one common eye condition that is often hidden behind the appearance of good eyesight.

Also known as “lazy eye” it usually occurs when the brain begins to ignore the signals sent by one eye, often because that eye is weaker and doesn’t focus properly. Sometimes it can occur in both eyes, in which case it’s called bilateral amblyopia. This eye condition is especially common in preemies, and tends to run in families as well, so it’s important to provide your eye doctor with a complete medical and family history.

There are several factors that can cause amblyopia to develop. These include:

• astigmatism,
• high nearsightedness or farsightedness,
• uneven eye development as an infant,
• congenital cataract (clouding of the lens of the eye),
• strabismus (where the eyes are misaligned or “cross-eyed”)

However in many cases of amblyopia there may be no obvious visible structural differences in the eye. In addition to the fact that the eyes may look normal, vision often appears fine as the brain is able to compensate for the weaker eye by favoring the stronger one. Because of this, many children live with their eye condition for years before it is diagnosed. Unfortunately, as a person ages, the brain loses some of its plasticity (how easy it is to train the brain to develop new skills), making it much harder – if not impossible – to treat amblyopia in older children and adults. That’s why it’s so important for infants and young children to have a thorough eye exam.

Are There Any Signs of Amblyopia?

If you notice your child appears cross-eyed, that would be an indication that it’s time for a comprehensive eye exam to screen for strabismus and amblyopia development.

Preschoolers with amblyopia sometimes show signs of unusual posture when playing, such as head tilting, clumsiness or viewing things abnormally close.

However, often there are no signs or symptoms. The child typically does not complain, as he or she does not know what normal vision should look like. Sometimes the condition is picked up once children begin reading if have difficulty focusing on the close text. The school nurse may suggest an eye exam to confirm or rule out amblyopia following a standard vision test on each eye, though it might be possible to pass a vision screening test and still have amblyopia. Only an eye doctor can make a definitive diagnosis of the eye condition.

So How Do You Know If or When To Book a Pediatric Eye Exam?

Comprehensive eye and vision exams should be performed on children at an early age. That way, hidden eye conditions would be diagnosed while they’re still more easily treatable. An eye exam is recommended at 6 months of age and then again at 3 years old and before entering first grade. The eye doctor may need to use eye drops to dilate the pupils to confirm a child’s true refractive error and diagnose an eye condition such as amblyopia.

Treatment for Amblyopia

Glasses alone will not completely correct vision with amblyopia in most cases, because the brain has learned to process images from the weak eye or eyes as blurred images, and ignore them. There are several non-surgical treatment options for amblyopia. While your child may never achieve 20/20 vision as an outcome of the treatment and may need some prescription glasses or contact lenses, there are options that can significantly improve visual acuity.

Patch or Drops

In order to improve vision, one needs to retrain the brain to receive a clear image from the weak eye or eyes. In the case of unilateral amblyopia (one eye is weaker than the other), this usually involves treating the normal eye with a patch or drops to force the brain to depend on the weak eye. This re-establishes the eye-brain connection with the weaker one and strengthens vision in that eye. If a child has bilateral amblyopia, treatment involves a regimen of constantly wearing glasses and/or contact lenses with continual observation over time.

Your eye doctor will prescribe the number of waking hours that patching is needed based on the visual acuity in your child’s weak eye; however, the periods of time that you chose to enforce wearing the patch may be flexible. During patching the child typically does a fun activity requiring hand eye coordination to stimulate visual development (such as a favorite video game, puzzle, maze etc) as passive activity is not as effective.

The earlier treatment starts, the better the chances are of stopping or reversing the negative patterns formed in the brain that harm vision. Amblyopia treatment with patches or drops may be minimally effective in improving vision as late as the early teen years (up to age 14) but better results are seen in younger patients.

Vision Therapy

Many optometrists recommend vision therapy to train the eyes using exercises that strengthen the eye-brain connection. While success rates tend to be better in children, optometrists have also seen improvements using this occupational therapy type program to treat amblyopia in adults.

The key to improvement through any non-surgical treatment for amblyopia is compliance. Vision therapy exercises must be practiced on a regular basis. Children that are using glasses or contact lenses for treatment, must wear them consistently. Your eye doctor will recommend the schedule of the patching, drops, or vision therapy eye exercise and the best course of treatment.

Amblyopia: Take-home Message

Even if your child is not showing any signs of vision problems, and especially if they are, it is important to have an eye examination with an eye doctor as soon as possible, and on a regular basis. While the eyes are still young and developing, diagnosis and treatment of eye conditions such as amblyopia are greatly improved.