Prioritise your child's eyes

World Sight Day this year highlights the importance of children’s eye health. Dr Frank Proudlock from the University of Leicester speaks with Sight Research UK about how we can prioritise eye health from infancy to adulthood and teach children to appreciate their vision. 

In the landscape of eye conditions affecting children, we are seeing cases of myopia (near-sightedness) dramatically rise across the urban world. Eye conditions never experienced in past generations, such as digital eye strain, are also emerging. Amblyopia – or lazy eye - can lead to permanent vision loss if untreated. It affects 3% of children but diagnoses are increasing due to widespread screening initiatives. Neonatal advancements now mean more premature babies survive - but there can be sight issues as a result. Retinopathy of prematurity (ROP) is a common condition that affects the eyes of premature babies, causing abnormal blood vessel growth. Laser treatment may be required in severe cases. Many of these childhood eye conditions are treatable if detected early. 

Spot the signs early

By simply taking children for regular eye tests, parents and guardians alike can ensure any warning signs are dealt with quickly. Over 90% of eye conditions can be prevented due to early detection, as they can be managed or treated effectively. When sight loss in children is not addressed, it can result in heightened risk of secondary health issues. Not only is the child’s vision likely to worsen, but they are also more likely to be diagnosed with diabetes, hypertension, and even heart attacks in later life. 

Thanks to studies from researchers at the University of Leicester, we can now accurately diagnose eye conditions in babies just weeks after birth. Optical Coherence Tomography (OCT) is a non-invasive imaging technique that takes detailed pictures of the eye using light waves. 

Initial versions of OCT were not optimised for use on children. Previously, babies would have to be lifted to the scanner and have their chin placed on a rest, which was difficult to do. “We have been using hand-held OCT to take measurements from children, and a little probe is put up to the child's eyes to take the scan,” Frank Proudlock explains. It takes about two seconds.

The imaging captured by this non-invasive tool then helps clinicians to diagnose a range of eye conditions in infants. Mere seconds to alleviate parents' concerns about their child’s vision, or to determine where they can get the right support so their child can thrive. Some conditions may even disappear without requiring any medical intervention, and others may need only minor corrective adjustments- like wearing glasses or an eye patch. But one thing is clear - the earlier the diagnosis, the less invasive the treatment.  

“If a disease is detected and treated in childhood, it can positively affect the whole of your life. So, early detection does make a difference,” says Frank. Just one small action has lifelong benefits for children’s vision. So be sure to get their eyes tested routinely!

That's child's play

But what about when your child is no longer a newborn? Warning signs may be more prevalent now that your child is older, showing symptoms such as eye rubbing, sensitivity to light, fluttering eyes or clumsiness, among others. They may even complain of headaches and eye pain.  

Lazy eye (amblyopia) affects around one in 30 people in the UK and is a major condition to watch out for in pre-school children. In paediatric eye clinics, it’s this condition that accounts for most visits and resulting costs. “It’s a big problem all around the world,” says Frank. For lazy eye, there are two main forms of treatment – wearing glasses or eye patching. Counterintuitively, the eye patch goes over the good eye to force the lazy eye into gear. 

Prompt diagnosis of lazy eye is crucial due to two reasons. First, “after about 7-8 years of age, it’s often too late to treat amblyopia. It’s very difficult to make the change, so you must get there when they’re young,” explains Frank. And second, a child may feel embarrassed to wear a patch once they’re in school. This social stigma of eye patches is a huge barrier to effective treatment. According to Frank, “they’re uncomfortable… they sometimes get bullied at school.” 

Sadly, there is still a taboo attached to patches, but with awareness raised amongst parents, guardians, and children, we can make strides to demystify the treatment.

Technology, friend or foe?

There is a common misconception that technology is the sole reason behind increasing levels of myopia, but this relationship has multiple factors, including genetics and environment. Myopia, or near-sightedness, is when the point of the eye’s focus is at the front of the retina, making faraway objects appear blurry. And consequently, children may have difficulty focusing on schoolwork from straining their eyes through extended screen use, known as Digital Eye Strain. 

It’s true that today’s youngsters are growing up with unprecedented access to digital devices, and a full understanding of this impact is yet to be grasped. However, we can know that rates of myopia and Digital Eye Strain are predicted to skyrocket over the coming decades. But technology is not the sole perpetrator of this issue.

Frank and his colleagues believe that exposure to daylight is another consideration that preserves us from getting myopia. “So, the two [technology and daylight] are related to each other. If you’re inside looking at a screen, you’re not outside playing and getting all this light.” 

Given the downsides, parents and guardians may feel tempted to keep their children from accessing the pandora’s box of the digital world altogether- locking up and throwing away the key. But for the most part this just isn’t feasible. 

School-age children are likely to feel the pressures of spending more and more time connecting or playing with friends online, even facing social alienation if they don’t. And in the UK, 64% of schools regularly incorporate technology into their teaching and learning practices. In short, measures to shield children from digitisation can result in social discrimination and may even cause them to fall behind at school. 

Technology may also bring surprising advantages to young people with vision impairments. “You can access large print stuff at school through electronic means. So instead of having a big magnifier, you can do it in a much less conspicuous way,” says Frank, explaining that children are often nervous to draw attention to themselves. Devices such as large phones and iPads are very important to those living with moderate visual impairment, such as nystagmus (wobbly eyes). 

They can get text messages and enlarge them; they can have websites read content aloud or adjust fonts. They can take pictures of things far away - like train times on large screens or restaurant menus on walls and read them up close on their device without needing to ask for help.   

So rather than fighting against technology, parents and guardians should work with it to find a happy balance for their child between screen time and outdoor time, between homework and play. All to ensure their child retains healthy vision in a complex world of social pressures, school and screens.

The big picture 

As guardians of the next generation, we hold the key to safeguarding our children's vision. By prioritising regular eye tests and fostering open conversations about eye health, we can empower children to recognise and address their own visual needs. In an age where screens dominate their lives, let’s not forget the simple joys of outdoor play and exploration—elements vital for preserving their eyesight. This World Sight Day let’s all commit to ensuring our children not only see the world clearly, but thrive in it. Every small step taken today can light up their path tomorrow.