-
Why does a child need glasses?
-
When is the best time to have my child’s eyes checked? How frequent should an
eye exam be done?
-
How can a child be tested for glasses, especially in infancy or early
childhood?
-
Why is there a need to dilate my
child’s eyes to check for refractive errors? Won’t the cycloplegic drops have
harmful side effects?
-
My 2 year old child was diagnosed to have an error of refraction. When can he
start wearing glasses? How often should he change them?
-
My child underwent vision screening in school and we were advised to consult
an eye doctor for the correction of her condition. How is an error of
refraction corrected in children? Is there a laser procedure that can be done
on my child?
-
What are the different types of refractive errors that can affect children?
-
Will wearing glasses make my child’s eyes worse or more dependent on them?
-
How do I get more information?
Because a
child’s vision system is growing and developing, especially during the first 5-6
years of life, glasses may play an important role in insuring normal vision
development. The main reasons a child may need glasses are:
-
To provide
better vision, so that a child may function better in his/her environment
-
To help
straighten the eyes when they are misaligned (strabismus)
-
To help
strengthen the vision of a weak eye (amblyopia or “lazy eye”)
-
To provide
protection for one eye if the other eye has poor vision
When is the best time to have my child’s eyes checked? How frequent should an
eye exam be done?
Ocular examination and
vision screening should actually start AT BIRTH and continue as part of routine
check-ups. Your pediatrician should know the essential parts of pediatric
vision screening because early detection and treatment of eye disease in
children is important. There are four critical periods in the growth of a
child’s vision: (1) preterm, (2) perinatal or infantile period, (3) preschool
years, and (4) elementary.
Preterm infants are at risk
of developing retinopathy of prematurity (ROP) and pediatricians are aware of
the guidelines for referral to an ophthalmologist for ROP screening. Preterm
babies with ROP should be screened by an ophthalmologist at regular intervals
until retinal vascular maturity is complete. Laser treatment should be
instituted when indicated. It is not safe to assume that babies born full term
will not develop eye problems such as cataract, glaucoma, strabismus, and
anterior segment dysgenesis. These are the conditions that should be looked for
when screening healthy infants. Preschoolers are likewise not safe from
developing eye problems because it is during this stage that conditions such as
strabismus, high error of refractions, anisometropia, and amblyopia start to
manifest. Amblyopia treatment should be instituted right away. Lastly,
children in grade school or elementary should be screened for refractive errors
like hyperopia, myopia, astigmatism, or any combination of these. Children are
not small adults; they cannot verbalize what they feel (or see) most of the
time. Parents only notice the change in behavior or head posture when the child
is already symptomatic.
It is the presence of the
above critical periods that led to the practice of regular eye evaluation in
children. The following are suggested eye exam schedule for children:
Your pediatrician should be
aware of indications for referral to an ophthalmologist. The frequency of eye
evaluation for children with abnormal findings depends on the abnormality and
the severity of the problem.
By doing a
complete eye examination, an ophthalmologist can detect the need for glasses
even in very young children. Typically, the pupils are dilated in order to
relax the focusing muscles, so that an accurate measurement of the error of
refraction can be obtained. By using a special instrument, called a retinoscope,
your eye doctor can arrive at an accurate prescription. The ophthalmologist will
then advise parents whether the measured error of refraction is appropriate or
expected for his or her age and whether there is a need for glasses, or whether
the condition can be monitored.
Why is there a need to dilate my
child’s eyes to check for refractive errors? Won’t the cycloplegic drops have
harmful side effects?
Children have great accommodative amplitudes and they can change the measurement
of refraction. In a child who has no error of refraction (emmetropic), a
significant myopia, and sometimes astigmatism, may be picked up if he or she
accommodates. The only way to get an accurate measurement of error of
refraction in children is to inhibit accommodation with the use of cycloplegic
agents.
There
are several agents commonly used in practice and these include tropicamide,
cyclopentolate, and atropine. The first two agents have rapid onset of
accommodation, short duration and few side effects. The last one has a longer
onset, requiring three days of drug application, and longer duration, but
provides the greatest amount of cycloplegia. Most children may be refracted
using the first two. However, children with dark irides like Asians are not as
responsive as Caucasian children to the cycloplegic action of the first two
agents. Atropine refraction is therefore recommended for this set of children.
Minor
side effects of cycloplegic agents include transient stinging, blurring of
vision, and photophobia. The stinging sensation is diminished by the
application of a drop of anesthetic prior to the application of the cycloplegic
agent. Photophobia may be addressed by wearing wrap-around sunglasses or hats.
The duration of photophobia and blurring of vision is related to the duration of
the drug’s mydriatic effect. The shorter-acting agents provide faster recovery
of accommodation and of resolution of symptoms. Atropine is associated with
relatively more adverse effects such as dry mouth, flushing of the face, fever,
allergic reaction, irritability, tachycardia, and hallucinations. Therefore,
the child’s weight and age are important considerations in the choice of
atropine concentration or dose for cycloplegic refraction. Punctal occlusion
during drug administration of atropine helps in decreasing the systemic
absorption of atropine and greatly diminishes the occurrence of severe adverse
drug reactions. Any child with severe adverse drug reaction should be brought
to the hospital for immediate treatment.
My 2 year old child was diagnosed to have an error of refraction. When can he
start wearing glasses? How often should he change them?
Any child with an error of
refraction that is unexpectedly high for his age should wear corrective glasses.
Even 2 month- old babies with very high hyperopia may be given glasses to
prevent strabismus and amblyopia. The amount of correction will depend on the
degree of the error of refraction and the alignment of your child’s
eyes. Regular cycloplegic refraction, usually every 6 months, will indicate
whether the error is getting better or worse. This will also help your eye
doctor determine how much correction to add or subtract from your child’s
previous correction.
My child underwent vision screening in school and we were advised to consult an
eye doctor for the correction of her condition. How is an error of refraction
corrected in children? Is there a laser procedure that can be done on my child?
There
are two ways to do this: (1) the use of spectacles, and (2) the use of contact
lenses. Spectacles or eyeglasses have the advantage of being easy to use. They
provide protection for the eyes without inciting any corneal problems. Contact
lenses, on the other hand, are cosmetically desirable, and they do not magnify
nor minify the image that the child sees, as glasses can. However, there is a
risk of corneal infection, especially with soft contact lenses. Contact lenses
are very important in the treatment of aphakia (patients without the natural
lens), as they provide a constant, clear image without significant distortion or
magnification. Infants waiting for the proper timing of intraocular lens
implantation can be fit with contact lenses, if necessary.
Laser
surgery in children is still experimental. Recently, there has been a
considerable interest in the surgical correction of hyperopia (farsightedness)
using laser. So far, laser surgery is not advisable in children because of the
lack of long-term results on these procedures. Hopefully, researchers would
better understand the growth of the eye and the factors that result in
refractive errors, and learn to manipulate these to create eyes with normal
vision.
There are 4
basic types of refractive errors:
-
Myopia
(near-sighted) – This is a condition where the distance vision is blurred, but
a child can usually see well for reading or other near tasks. This occurs
most often in school-age children, although occasionally younger children can
be affected. The prescription for glasses will indicate a minus sign before
the prescription (for example, -2.00).
-
Hyperopia
(far-sighted) – Most children are far-sighted early in life (this is normal!)
and need no treatment for this because they can use their own focusing muscles
to provide clear vision for both distance and near vision. Glasses are rarely
needed if the far-sightedness is less than +1.00 or even +2.00. When an
excessive amount of far-sightedness is present, the focusing muscles may not
be able to keep the vision clear. As a result of this, problems such as
crossing of the eyes, blurred vision, or discomfort may develop. A
prescription for hyperopia will be preceded by a plus sign (+3.00).
-
Astigmatism – Astigmatism is caused by a difference in the surface curve of
the eye. Instead of being shaped like a perfect sphere (like a basketball),
the eye is shaped with a greater curve in one axis (like a football). If your
child has a significant astigmatism, fine details may look blurred or
distorted. Glasses that are prescribed for astigmatism have greater strength
in one direction of the lens than in the opposite direction.
-
Anisometropia – Some children may have a different prescription in each eye.
This can create a condition called amblyopia, where the vision in one eye does
not develop normally. Glasses (and sometimes patching) are needed to insure
that each eye can see clearly.
No. In
fact, the opposite may be true. If a child does not wear the glasses
prescribed, normal vision development can be adversely affected.
There are several ways of reaching the ophthalmologists of EYE REPUBLIC Ophthalmology Clinic:
Hover note: Please place your mouse cursor over the red box
to click on the web and email links. For websites, a new browser
window will open. For emails, your default email program will
open. You may cut and paste the URLs or email addresses if you
prefer not to open new windows.
ONLINE ACCESS
WEBSITES.
http://www.EyeRepublic.com.ph - EYE REPUBLIC
Ophthalmology Clinic
http://www.OCP.com.ph - Ophthalmic
Consultants Philippines Co. -
http://www.LASIK.com.ph - Refractive
Surgery Resource
http://www.Cataract.com.ph - Cataract Surgery Resource
http://www.Eye.com.ph - Eye
Information Online
http://www.EyeDoc4Kids.com.ph - Eye Information for Kids
http://www.Retina.com.ph - Retina
Surgery Resource
http://www.Glaucoma.com.ph - Glaucoma
Online
http://www.Uveitis.com.ph - Uveitis Online
EMAIL. After writing down your comments,
suggestions, problems and/or questions, kindly tell us how
to get in touch with you by providing your name, email,
home/office numbers, and mobile phone.
General inquiries - help@EyeRepublic.com.ph
Refractive Surgery Service - refractive.surgery@EyeRepublic.com.ph
Glaucoma Service - glaucoma@EyeRepublic.com.ph
Cataract Service - cataract@EyeRepublic.com.ph
Doctors - eyemd@EyeRepublic.com.ph
Administrative - president@EyeRepublic.com.ph
Website - webmaster@EyeRepublic.com.ph
Newsletter -
newsletter@EyeRepublic.com.ph (receive
news and updates, discounts and promotions)
BLOG. Send us your comments.
EYE REPUBLIC
Ophthalmology Atlas
CLINIC INFORMATION
Mobile E-Yellow Pages. Via
SMS, text LUK4 EYEREPUBLIC
(send to 2851 for Globe and Sun Cellular, and 2951 for Smart). |
EYE REPUBLIC Ophthalmology Clinic
Manila
3/F Don Santiago Building Units 309-310
1344 Taft Avenue, Ermita
Manila, 1000 Philippines
Direct and Fax: (632) 536-2398
Trunk Line: (632) 523-8271 to 79 local 30
Mobile: (63917) 899-2020
Map and directions
|
EYE REPUBLIC
Ophthalmology Clinic
Asian Hospital
and Medical Center
5/F Medical Office
Building (MOB) Suite 509
2205 Civic Drive,
Filinvest, Alabang
Muntinlupa City,
1781 Philippines
Direct:
(632) 771-9253
Direct and Fax:
(632) 771-9254
Mobile: (63917) 795-2020
Map and Directions
|
EYE REPUBLIC Ophthalmology Clinic
Medical City
6/F Medical Arts Tower Inc (MATI) Suite 602
MERALCO Compound, Ortigas Avenue
Pasig City, 1604, Philippines
Direct and Fax: (632) 632-7846
Mobile: (63917) 537-2020
Map and directions
|
EYE REPUBLIC
Ophthalmology Clinic
St. Luke's
Medical Center
6/F
Cathedral Heights Building Complex (CHBC)
North Tower Suite 614
279 E. Rodriguez
Sr. Boulevard
Quezon City, 1102
Philippines
Direct and Fax:
(632) 407-3883
Mobile: (63917) 855-2020
Map and directions
|
CLINIC HOURS
First-Come, First-Served
Monday to Saturday 9:00 AM to 6:00 PM
All clinics are closed on Sundays and Holidays
|
|
Back to Top
REFRACTIVE ERRORS IN CHILDREN information
compiled by Dr.
Barbara L. Roque and initially uploaded on May 1, 2005.
Last updated on
September 14, 2007. |
