ONE of my biggest concerns given the prolonged school closure is how much screen time my daughter is having and the impact on her eyesight.
She was diagnosed with myopia last year and is wearing spectacles and I anticipate that her eyesight is going to get worse with extended screen time.
Online classes mean most children are glued to their computers or tablets on a daily basis and given that most children spend a significant amount of time indoors because of the pandemic, their leisure activities are also on screen.
OasisEye consultant ophthalmologist Dr Manoharan Shunmugam says overwhelming evidence has shown that sustained, intense near-work is significantly linked to the onset of myopia in children and possibly progression of myopia, particularly in young adult-onset myopia.
"Especially with the Movement Control Order and extended periods of indoor activity and gadget use, children are prone to developing refractive errors."
Numerous studies have consistently shown that children who spend more time outdoors are less likely to become myopic.
Dr Manoharan says with gadgets being increasingly used for education and in classrooms, avoiding them may be impossible. Instead, limiting their use for entertainment, encouraging outdoor activities and ensuring good eye habits such as taking regular breaks, would be more practical.
UNDERSTANDING MYOPIA
Myopia is a multifactorial condition. Numerous studies have shown that it's not just related to genetics even though there have been numerous genes found to predispose one to it. Environmental factors have an important effect as well.
Children are most susceptible until the age of 12 but myopia can still rise until adulthood.
Dr Manoharan says uncorrected refractive errors are critical to address as they frequently affect children, who do not usually complain of visual symptoms, especially if it only affects one eye.
If left uncorrected in the first decade of life, it is likely that these children will be left with life-long visual impairment of varying severity in one or both eyes in the form of amblyopia (lazy eyes).
"It is therefore, imperative that children are screened at regular intervals and that this initiative is adopted nationally and executed by all eye care providers."
Childhood eye screening is important as the treatment is usually simple and the benefits, invaluable.
Dr Manoharan says children are completely and wholly reliant on their parents or carers to look out for them and ensure their well-being and development.
Unfortunately, having no prior experience or reference, it makes it impossible for a child to tell you that there is something wrong with their senses.
"Think about it. If a child's vision has always been blurry, that's what they think the world is — a blur. They will never know to ask for spectacles. If they've always had difficulty seeing colours like in some retinal conditions, they will never have seen the full spectrum of colours that most of the population see, and so will sometimes get colours mixed up."
UNCHECKED PROBLEM
Some children have such poor vision that they are unable to keep up in the classroom as they can't see well enough to read books or the blackboard. This makes them crave stimulation from other senses and so, they become fidgety and physically active.
Dr Manoharan says they are then mislabelled as attention-deficit or just plain naughty, and punished at school and at home when all they ever needed were glasses.
Some children have a problem in only one eye, but because the vision in the other eye is good, they unconsciously compensate and carry on, unaware of their issue.
Once a child has been screened and is found to have normal vision, one just needs to ensure that this is maintained.
Any child having difficulty with vision such as when reading, or at school, should be examined by an optometrist or ophthalmologist.
A child who requires spectacles should be reviewed at least once or twice a year to ensure that their prescription is stable.
Myopia usually progresses with age and children with confirmed myopia should be monitored every six months.
Infants and Vision
THE vision of newborns is very blurry and their appreciation of colours is primitive. They can only perceive faces from as close as 8 to 10 inches away.
It is helpful to provide them with a rich, visually-stimulating environment by ensuring the presence of high-contrast, colourful 3-dimensional objects.
Helpful tips to stimulate visual development in infants include:
* Changing cot positions in the room at intervals to provide a different "view".
* Keep large colourful toys within reach.
* Talk to the child while moving around the room so they learn to track you.
* Let the child creep and crawl on the floor with toys of different shapes and sizes to explore.
* Roll a ball around the room so they learn to track it.
* Play peek-a-boo.